How connected healthcare solutions can transform the lives of those who suffer from chronic pathologies.Posted on Sep 15,2017
Let’s imagine how technology could transform the life of Bea, a young woman suffering from high blood pressure and so, prone to the associated cardiovascular risks.
Every day, Bea records her blood pressure levels, weight, physical activity, and resting heart rate. She can, if necessary, record her heart activity with an electrocardiogram. All these data are then stored in a secure and confidential cloud – compliant with European Personal Data Regulations – where predictive analysis algorithms (machine learning) are regularly running. These analyses can be shared in real-time with her doctor and/or nurse, who will benefit from an aid to the diagnosis and evaluation of Bea’s condition and thus can verify the efficiency of the treatment. Data can also be shared with her pharmacist who will be able to analyse drug interactions and check Bea’s adherence to treatment.
Bea’s appointments with her doctor, her dialogues with her pharmacist or nurse, are made more precise, focusing on the evolution of her blood pressure and cardiovascular status. Doctors, pharmacists, nurses … have a better overall vision and can better determine the treatment and the hygiene-dietary rules that best apply to Bea’s condition. The risks associated with her blood pressure decrease and are then under control.
Furthermore, all these analyses are integrated and accessible in Bea’s personal medical record. Scheduling appointments with physicians is facilitated or even automatic, the renewal of her prescription can also be automated and her medicines are home delivered. Adherence is increased, while saving time and money.
The sharing of Bea’s data, once anonymized, also allows the conduct of medical research and epidemiological investigations on the pathology she’s suffering from and wishes to be defeated.
This scenario may seem to you like it belongs to a more or less distant future, but it is already possible today
Here are some examples:
- Since the first quarter of 2017, the monitoring of key parameters for the treatment of hypertension is possible: Blood pressure, weight, physical activity, and resting heart rate, can be shared in real time with the doctor, nurse or pharmacist chosen by the patient, via a GRDP compliant solution sitting in a secure cloud. It is called CARACAL.LIFE and which, moreover through rewards, encourages the patient to monitor themselves regularly and thus control their blood pressure.
- An electrocardiogram shared in real time with the cardiologist or his family doctor already exists! This is what I-CARDIO offers in Barcelona, with its connected device it allows the taking of an ECG in a simple and autonomous way, to be shared with specialized doctors who will make an initial analysis.
- Predictive algorithms, such as ‘artificial intelligence’ or machine learning are already under deployment! With the start-up of French origin called CARDIOLOGS, who has developed its ‘machine learning’ algorithms as a diagnostic aid for ambulatory ECG analysis.
All these services are developed or soon to be used, but their integration is yet to be achieved. A few start-ups are working on this topic, such as InnovSanté and its universal electronic health record project, which digitizes the health providers supply chain and provides patient data to caregivers in a secure way.
Thus, the main challenges are not technological, but related to usage and adoption by patients, but also and more especially by the caregivers. Indeed, these technologies change habits and require an adjustment of practices. Integrating these technologies into medical practice will be fundamental for the success of the medicine of the future.
Another key factor in the adoption of these technologies is their cost: it needs to be low cost and must avoid the ‘gadget’ affect, i.e. the too rapid obsolescence of connected objects. At CARACAL we advocate the rental of these objects, rather than their purchase. Renting proves to be more economically advantageous, but also brings technological advantages for the patient, the pharmacists and the doctors, in the update of the devices.
There remains one aspect to be addressed, not least of which is the security and the confidentiality of the data: – in fact our patient Bea does not wish her data to be used for commercial purposes at all. If today the CNIL in France and the next European regulation for personal data -RGDP- set the rules of confidentiality and impose the systematic collection of the agreement of the patients for the use of their data, then we need to recognize that many e-health services or “dodgy apps” exist that can be downloaded from the stores and which still have ‘data leakage’, and/or have data being monetized with brokers who sell their analyses to advertisers or other health industry stakeholders.
A promising track for ensuring absolute confidentiality is the ‘blockchain’ technology. Embedding ‘blockchain’ technology in health solutions will make the patient the sole owner of a key allowing the authentication and the decryption of data. The patient will then have full authority over the use of his or her own data. The blockchain should also make it possible to limit the security breaches and the tracing of the data, thus enabling the implementation of a single, distributed, interoperable and secure patient medical record.
Beyond the multiple benefits of connected Healthcare for the patient, sharing patient data in large epidemiological studies brings a lot of promise. “Big data”, or the science of data is in a period of exponential acceleration, thanks to the new techniques developed by silicon valley giants to take advantage of the huge volumes of data that are available today. These techniques – neural networks, deep learning – allow discovery of new tracks for treatments. Indeed, by analysing patient data – blood tests, blood pressure and ECG, genome, intestinal flora, parameters – and by finding previously undetectable correlations, it becomes possible to develop models of anticipation for the better control of risks and to improve the effectiveness of treatments.
While the future is full of promises, the present already offers real opportunities for advances, and public health actors have a fundamental role to play. Through their calls for projects and joint programs, they must encourage the emergence and adoption of new practices.
Lifestyle, population aging, environmental factors, etc are contributing to the growth of the hypertensive population – this population will be more than 15 million in the coming years in France. Controlling the cost of this pathology will quickly be a public health challenge, without mentioning the complications associated with it. Prevention and control of blood pressure will become “mandatory” objectives for the administration departments in charge of health population management: Connected Health is indisputably THE way to achieve it for the benefit of the patient, the doctor and the health economy.