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E-health and the digital patient: the digital revolution comes to healthcare

   

As part of April 2016’s Biovision, Lyonbiopole and Hospices Civils de Lyon organised a session on the highly topical theme of the digital patient. During the workshop and the plenary session that followed, SMEs, manufacturers, patients’ associations, practitioners and health economists examined the question from a variety of angles: legislation, data protection and smart objects. Read on to find out more.

 

THE DIGITAL SHAKE-UP IN BIOTECH AND MEDTECH

 

As digital technology spreads, it is bringing with it the third industrial revolution. It is redefining the way we interact and changing the biotech and medtech industries. Whether we are looking at the Internet of Things (IoT), the uberisation of services or 3D printing, future issues will depend on key values such as hyper-connectivity, instant responses and mobility. 

 

There is no doubt that Donald Jones, Chief Digital Officer at the Scripps Translational Science Institute in California has taken this on board. At Biovision, he summed up his idea of the future of health in a single phrase: “Check your health as your emails”.

 

 

To build up a complete overview of all these issues, we have collated opinions from Catherine Cerisey, co-founder of Patients & Web, Alain Ruffion, Clinical Lead at Hospices Civils de Lyon and Marc Frouin, COO of BioSerenity. These experts from different areas of healthcare offer us three very different but complementary visions of the digital patient.

 

THE DATA AGE

 

As new technologies such as smartphones have become essential tools for so many of us, the availability of data, including data from measuring systems, has increased exponentially.

Measurements have always been key to healthcare”, says Marc Frouin. We are collecting more and more simple and complex data, including blood pressure, temperature, electrocardiograms, encephalograms, impedance measurement and cardiac output. Once these data are collected, they can be transferred via the Internet and analysed.

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BioSerenity’s innovative Neuronaute  project is a perfect illustration, bringing together smart clothing, mobile applications and cloud-based data processing.

Data are far from limited to smart objects, however. At Hospices Civils de Lyon, for example, a pioneering IT system brings together all the data collected. The primary advantage, Alain Ruffion tells us, is “improved patient pathways”, but it also offers better access to information. “Twenty years ago, researchers worked through paper files, one at a time,” he adds.

Data use is strictly regulated and monitored by commissions. Sometimes, doctors and researchers have difficulty accessing the data they need to confirm their hypotheses. Large banks of data can be used to identify the results trends needed for medical research work. While it is clear that data are well protected, Catherine Cerisey raises some interesting questions. “What are health data? What makes them sensitive?” For example, our smartphones can track the number of steps we take in a day. If your physical condition is “normal”, that is not a sensitive piece of information.  However, if you are overweight or have heart problems, it is suddenly much more significant. It is important to define exactly what health data consist of, in order to refine and oversee their use.

 

 

PATIENT-CENTRED CARE 

 

Treatment is better, because we have a more complete and timely vision of the situation,” says Alain Ruffion. The situation is clear: in just a couple of clicks, clinicians can access a patient’s history and potential drug interactions, as well as contraindications for certain prescriptions. Nevertheless, if the patient has come from another healthcare facility, it may not be possible to access previous data. Hospitals will need to decide in the future whether they create a shared data system. This will raise ethical questions about the appropriate use of the data collected.

 

Smart objects appear to be one of the best solutions available for preventive medicine, in particular as regards chronic conditions such as diabetes, epilepsy and heart problems. But is there a trade-off? During Biovision, contributor Claude Le Pen1 highlighted the fact that “good information is rare and has a cost”. Should we be charging for these new solutions or should patient data come with a price tag? Catherine Cerisey believes healthcare should remain free and available to everyone. It is vital to stand up to GAFA2 and set limits on the collection of data, which often happens without our knowledge. “Who actually reads right through the Ts & Cs3 of an app?” asks the founder of Patients & Web. Industry debate must remain focused on the patient if the French authorities’ Healthcare Democracy strategy is to be fully upheld.

 

 

SAVING TIME

 

Information technology shrinks time and space, and nowhere is this truer than in telemedicine. Alain Ruffion testifies to a significant improvement in time management: nurses no longer have to enter data, letters can be dictated to secretaries more easily and information can be accessed and transferred on the spot.

 

However, healthcare professionals are finding themselves bombarded via digital communication channels, with constant text messages, emails and calls. This new workload is neither structured nor paid. Should we be looking at alternative ways to organise and pay for healthcare? Perhaps new technologies can offer a balance that will provide the answer. We can now monitor patients remotely and generate customised alerts, and thereby avoid overloading accident and emergency departments and GPs' surgeries. However, patients will undoubtedly be resistant to change. “Would you choose to be monitored remotely by a cardiologist from a leading specialist team, or would you feel safer seeing your own doctor once a month?” asks Marc Frouin. At the same time, smart objects will need to become more widespread if we are to overcome the financial issues. The lower the cost, the more our healthcare system will be able to draw on these complex and varied measurement instruments.

 

How can we make secure high-quality information both free and available to all? How can we process data to make it more than just the sum of its parts? How can we pool data to advance preventive medicine and research? Should doctors be prescribing applications like they prescribe drugs? Official bodies and businesses need to agree on new standards and procedures to unify and manage this new mass of data, without losing sight of its fundamental aim: to improve patient health.                                                                                                                     

 

Click here to watch videos of all the plenary sessions and presentations on the Digital Patient co-organised by Lyonbiopole!

 

1 Lecturer responsible for the Master’s degree in Health Economics at Paris-Dauphine University.

2 GAFA: an acronym referring to the major web companies, mainly Google, Apple, Facebook and Amazon.

3 Terms and Conditions of Use

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