| From its introduction into common law in July 2023 to the recent practical recommendations of the European Respiratory Society (ERS) {1}, the stars seem to be aligning for the remote monitoring of patients with respiratory failure. However, challenges remain in scaling up, particularly cultural and organizational barriers. That is why the Belvedair association, supported by private and hospital pulmonologists {2}, is working to simplify the implementation of remote monitoring by operating physicians, in coordination with providers and publishers of digital medical devices (DMNs). Explanations from Dr. Christophe Zanetti, President of Belvedair and private pulmonologist in Lens (62). |
| What needs did the creation of Belvedair in May 2023 address? |
 Dr. Christophe Zanetti: “We identified several obstacles to the deployment of remote respiratory monitoring. First, a lack of knowledge about DMNs among private pulmonologists. Second, remote monitoring could seem complex to set up and bill for. Then there was the issue of therapeutic support, which requires trained staff. This task is not always easy to carry out in private practices with small teams, hence the advantage of relying on a service provider. Belvedair was therefore created to demystify this practice, facilitate its implementation, and keep PSDMs in the loop, in line with the ETAPES program. Service providers, like doctors, also have the option of joining the association. |
| What specific actions are you taking? |
| Belvedair’s primary mission is to inform and train doctors and teams, based on the conviction that remote medical monitoring is essential for the future and that home installations will become more widespread. We then provide a one-stop shop to guide pulmonologists step by step in their remote monitoring projects. They can download all the necessary documents from our website, including a patient consent form that is valid for all platforms. Physicians can choose from a range of certified DMNs, including Vestalis. Our only request is to be able to retrieve telemonitoring data for the Renavo-tel registry currently being set up, in the shared interest of developing knowledge and indicators that are useful for our practices. For patient therapeutic support and pre-filtering of alerts, physicians can either choose to manage these tasks themselves or entrust them to a service provider—either the association’s partner (Zéphyr Paramed) or another provider of their choice. Regardless of the service provider chosen, the association acts as a facilitator for billing and other procedures. |
| In practice • The cost of joining Belvedair is €46 per year, which includes: access to the association’s website (documents, guide), a dedicated contact person, practical assistance with task delegation, and the opportunity to take part in clinical research projects conducted by Belvedair. • The doctor pays half of his operator fee (€28 per month per patient) to the association, which pays €12 to the service provider chosen by the doctor and keeps €2 for its operating costs. • More information at: https://assobelvedair.fr/ |
| Two and a half years after the association was founded, do you see a boom in NIV remote monitoring? |
| We are seeing a fairly sharp increase in referrals, especially since early 2025. A real turning point has yet to occur in community pulmonology. One of the association’s main messages is to reassure people about the volume of alerts generated by remote monitoring: studies show that there are not that many {3}, and pre-filtering by a service provider ensures that doctors only receive relevant alerts. We also remind operators that this is not an emergency system. Of course, response time is important, but the main objective is to improve long-term care. Finally, it is important to highlight the clinical benefits of remote monitoring—reduction in leaks and obstructive events, improved compliance—and the peace of mind it provides between appointments, thanks to the monitoring of the patient’s clinical condition. |
| See you soon, The Vestalis team References : 1. Duiverman ML, Ribeiro C, Tonia T, et al. European Respiratory Society Clinical Practice Guideline on Telemedicine in Home Mechanical Ventilation. Eur Respir J 2025; in press (https://doi.org/10.1183/13993003.00094-2025). 2. Fondateur de Belvedair, le Dr Yves Grillet, décédé début 2024, était Vice-président de la Fédération Français de Pneumologie. L’équipe de Belvedair comprend aujourd’hui, outre son Président Christophe Zanetti, les pneumologues François Bughin (CHU de Montpellier), François Jounieaux (Hôpital privé La Louvière à Lille), Bruno Stach (pneumologue libéral à Valenciennes et Président du SAR – Syndicat National de l’Appareil Respiratoire), Léo Grassion (CHU de Bordeaux), ainsi que Thomas Réginault, masseur-kinésithérapeute au CHU de Bordeaux, co-fondateur de Zéphyr Paramed, et Juliette Masson, chargée de mission qui gère le guichet unique. 3. Voir notamment Arnal JM., Arnaud PY., Courtières E., Roucou M., Balzeau P., Desteffani P.,Garnero A., 2024. Mise en place du forfait télésurveillance de la VNI : premières expériences. https://www.sciencedirect.com/science/article/abs/pii/S1877120324002453 |