Opening a teleconsultation practice: what nobody tells you before you start

The idea is appealing: a room, a nurse, connected devices, a remote physician — and you open a teleconsultation practice. Patients who were waiting months to see a doctor can be seen the same day. The reality is less simple than the idea, but it remains achievable if you ask the right questions from the start.

This guide is written for people considering opening a teleconsultation center — whether they are healthcare professionals, investors, local elected officials or entrepreneurs. It covers what the sales brochures don't tell you.

3 questions to ask before you open

1. Is there a documented local need?

A teleconsultation center works where patients cannot see a doctor within a reasonable time. Check the data: number of physicians per 10,000 residents, average wait for an appointment, rate of emergency department visits for non-urgent reasons. If the area is adequately served by physicians, the center will see few patients.

2. Which business model are you aiming for?

There are two models (detailed below). One requires upfront investment and business management skills. The other requires clinical skills and integration into the local healthcare network. Both work, but not for the same people.

3. What funding is available?

Sources of financing vary: equipment leasing, regional health agency (ARS) grants, local government support (DETR), and French national health insurance (Assurance Maladie) reimbursements. The financing plan should be worked out before ordering equipment.

What nobody tells you: medicine can't be improvised, but the operating model can be

You don't need to be a physician to open a teleconsultation practice. You need physicians to practice there — remotely. The difference is fundamental.

A teleconsultation practice is a facility where a registered nurse examines the patient with CE-marked connected devices. The physician makes the diagnosis remotely, through the platform, with real-time clinical data. The nurse does not diagnose, does not prescribe and does not practice medicine. She operates a technical setup under a physician's direction.

This model is legal, regulated and already operating. CubeSanté runs centers of this type in France (Bondy, Servon), at a cost of around €10 per consultation, compared with around €3,000 for the alternative public pathway when all resources are added up.

Regulations: what is allowed

In France, opening a teleconsultation practice does not require any specific prior authorization beyond the standard obligations for premises open to the public. However:

• Nurses working there must hold a French state nursing diploma and be registered with the Order of Nurses
• Physicians consulting remotely must be listed in the RPPS (the national health professional register)
• The software must be hosted by an HDS-certified provider (France's health data hosting certification)
• The confidentiality of health data must be ensured (GDPR)
• The premises must guarantee consultation privacy (soundproofing, an enclosed space)

The 2 business models

Model 1: Investor / entrepreneur

The investor provides the premises and the capital. They lease the MedConnect equipment (around €1,500 to €2,500/month over 24 months). They hire or contract nurses. Physicians are available through a telemedicine network.

Revenue: the teleconsultation is billed to Assurance Maladie at the standard rate (€25 for general practice). The TCA and TLL supplements are added on top. One station can handle up to 30 consultations per day.

Model 2: Clinical operator

A healthcare professional or medical facility opens a dedicated consultation point. The investment is lighter (the professional uses their own premises and medical network). The model fits into the existing practice.

Financing in detail

• Equipment leasing: 24 to 48 months, with monthly payments covering medical equipment, software and maintenance
• Assurance Maladie support: €350/year for video equipment and software + €175/year for connected devices (with certification)
• ARS grants: for projects approved within a CPTS (local primary care network) or in an underserved area
• Local government support: DETR, regional grants for access to care
• DPC training: €1,500 per nurse, eligible for DPC (continuing professional development) funding

The real time to open

From equipment order to first patient consultation: 2 to 4 weeks.

• Week 1: platform configuration, account creation, billing setup
• Week 2: equipment assembly and shipping (from the Promotal factory in Ernée, Mayenne, France)
• Week 3: on-site installation, nurse training (1 day)
• Week 4: supervised go-live

This timeline assumes the premises are already available and internet connectivity is in place. Fitting out the premises (furniture, acoustic insulation, signage) is the operator's responsibility.

Common first-center mistakes

• Underestimating local outreach: patients won't come if they don't know the center exists. Reach out to local pharmacies, town halls, CPTS and primary care physicians.
• Neglecting connectivity: an unstable internet connection makes synchronous teleconsultation impossible. Test real-world bandwidth before opening. Plan a backup connection (4G/5G).
• Opening without contracted physicians: make sure you have a network of physicians available during opening hours. The MedConnect platform lets you manage an on-call physician schedule.
• Ignoring the patient journey: from reception to discharge, every step must be smooth. Test the complete workflow with a test patient before the real opening.
• Not billing the right acts: TCA, TLL and TLD are supplements specific to assisted teleconsultation in France. Configure billing correctly in the platform.

FAQ

Do you need to be a healthcare professional to open a teleconsultation practice?

No. A non-medical investor or entrepreneur can open a center. The nurses who work there must be licensed, and the physicians consulting remotely must be listed in the RPPS. The model is that of a technical platform operator, not a medical practice.

How many consultations per day on average?

One station can handle up to 30 teleconsultations per day. In practice, a center that is ramping up performs 10 to 20 consultations per day in its first months, depending on local awareness and patient flow.

What is the minimum monthly cost to get started?

With leasing: around €1,500 to €2,500/month for equipment and software (24-month contract). The software subscription alone starts at €150/month excl. VAT. Add rent for the premises, overheads and the cost of the nurse.

Can the center open in the evening and on weekends?

Yes. The MedConnect platform runs 24/7. You just need nurses and physicians available during those hours. Night and weekend coverage is often the most requested service, because that is when access to care is hardest.

What happens if no physician is available?

The platform manages a physician availability schedule. If no physician is available, the consultation cannot take place — the patient is referred to the emergency department or to a later appointment. It is essential to size the medical network before opening.