How will the world of health be in 2030? – e-health innovation

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The information and the popularization concerning the evolution of the medicine reviewed and corrected by the New Techniques of the Information and the Communication has been our credo on absmarthealth.com, but the environment has evolved a lot since the creation of our blog almost three years ago.

We talked about domestic robots presented on the web with great marketing support. I have the impression today that the enthusiasm is rather at half-mast; many of these innovations seemed to be gadgets or at least they did not yet respond to real demand.

We also talked a lot about Big Data, "Artificial Intelligence" (AI) and the prowess of the Giants of the Web. Here too it was sometimes GAFA communication operations to talk about the companies themselves, rather than an allegedly scientific content (example of Google glass, connected ocular lens, and other follow-up outbreaks of influenza! … some examples of resounding flops with sometimes misinformation, or even according to some of a scientific dishonesty).

IBM seemed more mature on the subject and offered solutions to help health professionals with the Watson project, but again this is far from the enthusiasm today among e-health watchers.
Two years ago was born our organization of Continuing Professional Development (ODPC, validated by the National Agency for Continuing Professional Development (ANDPC) .We were obliged to teach the basics of connected health, ie to present to doctors the existence of the encrypted transmission of medical data (although Apicrypt existed for decades but was very unevenly used in the territory) .We kept the history of the "project" of the electronic medical record, the Internet of Objects (the IoT), and new ecosystems of App dedicated to health.These were still not in the concerns of doctors.
But a real sociological evolution, actually starting in the 70's, with progressively greater involvement of the public and the patients, (empowerment, quantified self) made possible the influence of the net (not the opposite!).

This implication of the patients and the impulse given by the health professionals who already underdeveloped that the "singular conference" no longer existed, in the era of the diffusion of medical information by the written press and television, precipitated the changes in Classes. The geek doctors knew that we had to reinvent, reorganize the new relationship between the patient and the doctor and the very exercise of medicine by using these new Information and Communication Technologies (NTIC), the truth does not exist. gushing more at the end of the one-on-one consultation. The information given by carers, relatives, associations, the media (including the web) had definitely blurred the old doctor / patient report.

In this new context, pioneering physicians have tamed new techniques by inventing systems that help the diagnosis, care, support and information of the patient. They even invented new forms of consultation (in the physical absence of the patient for example …), advocating reasoned self-medication … all under the frowning eyebrows of the majority of their colleagues, professional orders and governances.
For a long time, only these doctors assimilated the NICTs, and then they were helped by the professionals of these famous NICTs who were or were not in the world of health. They are now helped by digital marketing defectors who were not. These new interlocutors have teamed up with health professionals. They who had participated in the digitization of the company, including services (commerce, bank insurance …), who invented and implemented CRM (Customer Relationship Management) algorithms that often now frame a everywhere B to C reports, which invented and thrived the business around the web (targeted advertising to Internet users …). They wanted to clear new territories numerically almost virgin (ours)! The healthcare world is still overwhelmed by paperwork and totally "not data driven".

These digital marketers, with their past successes, started from scratch and invested in the world of health that was unknown or even strange to them (regarding the relationship between doctors and the public, so far away usual "B to C" relationships). They have created new start-ups and applied in our world of health techniques that have proven themselves elsewhere; they allied themselves with our geek doctors.
Specialists in new resources, (new computers, new mathematics …), they propose new tools to organize the medical professions as well in the fields of concierge services, making appointments, organizing data only in the organization of care and even by influencing basic and clinical research processes.
Regarding the organization of medical practices, nothing can be done without the development of law, decrees and therefore standards … it was necessary to pass under the caudine forks of governance.
Health professionals, who have for many years worked in the shadows or even in hiding, being often viewed with great distrust by governance and professional orders, see their first clinical experiences "deviant" assimilated. Little by little, the many virtual medicine and tele-consulting projects are on the right path leading to the development of medical platforms today, for example teleconsultation. Beta tests flourish here and there and prepare the integration of telemedicine in practices with a generalization that I predict very fast for most health professionals.

Finally, a general culture of connected health is gradually being established, often under the initiative of patient associations that work on customized digital solutions for their members.
Some smart health connected objects prescribed by doctors are used daily by patients. Applications improving the daily lives of many patients with chronic diseases are also used.
Doctors are now trading more and more through secure and encrypted systems. The CNAMTS takes over the destiny of the electronic file that may finally exist!
The unprecedented crisis of primary care medicine due to the lack of foresight of the tutelles influenced by the majority of the actors of the world of health (trade union, CPAMTS, services of the state …) will reach its paroxysm very soon, according to a report from the DREES 2009.
Kafkaesque situation or those who ask for reports do not read them or put their head in the sand.
But we finally see the beginning of a beginning of an improvement thanks to a new management allowing a better performance of our sector of activity, it is about:
– The digital organization of medical offices, health homes, and health facilities.
– A new distribution of roles in primary care with an increased role of the pharmacy that will equip itself with smart health connected objects, provide advice, care, vaccinations …

The paramedics who will also relieve the doctor of many tasks but it requires a more complex organization, a reorganization of the studies for example of future Nurses in Advanced Practice (IPA) … Here the beneficial effect on the recovery of medical time will be more distant ( 5 years of training!), And this is in the hands of governance ….
– a better way to care thanks to the multiple applications of the NTIC (improvement of the courses of care …)
– a much better organization of prevention where we are not good at all!
But university training (FU) and postgraduate training (FPU) must follow (in our case and for almost 3 years I would say that the FPU preceded the FU …).
A real impetus must be taken and validating scientific training must succeed to information and popularization!

This is the role of our ODPC, HAASTIN, initially dedicated to e-health, but unlike yesterday, today all health is included in this disruption e-health and e-prevention.
Continuing medical education is one of the best solutions for already installed health professionals to modernize their work tools and medical practices.
The academic community is struggling for the moment to establish adequate training for their students. The diplomas available to professionals already trained are of interest to only a few hundred doctors a year, where training should be generalized.

Our action already effective for two years is gaining momentum. We give the floor to the medical experts who have developed solutions that are scientifically proven and used routinely.
The use of these solutions is still often very localized, but the promoters work on projects of development and generalization on a larger scale, for example to generalize an application of follow-up of the patient carrying a precise cancer towards an application adaptable to the followed by most cancers.
One of the goals of our training is precisely to promote the spread of new medical practices.
Our training must prepare health professionals to use other digital patient monitoring systems that will accompany them in their medical care, acute or chronic care.
(Reasoned) hopes to significantly improve follow-up by reducing risks and morbidity and improving the health and quality of life of patients are legitimate. This real digital disruption will allow a better management of many public health problems with, for example, the relief to people outside the care sites (stroke, TIA, cardiac arrest …), better monitoring of chronic diseases (Diabetes, Obesity, hypertension, kidney failure …) and especially their prevention. Before 10 years we think that the prevention systems will be considerably developed at the initiative of the patients themselves (empowerment and quantified self). They will transform the French health system very effective on the care of acute and chronic pathologies by strengthening it on prevention (primary, secondary and tertiary).
The tools, NICT or technological products, already have a considerable impact on the medical world:
-Here a medical team is experimenting a robot surgeon who for the moment obeys the human surgeon, but it would be possible to educate him by integrating a large volume of data relating to a type of surgical intervention (the accumulated data of hundreds of interventions). The power of new mathematics allowing the robot to be perfectly in phase with the characteristics of the operated patient (his pathology, his anatomy the movements of these organs …). According to the authors, this results in the possibility of providing complete automation of the surgical procedure in 5 years for a given intervention.
There, the power of new computers can boost basic research in Pharmacology (study of new molecules) or in clinical research (diagnosis and treatment of cancers …), with hopes in research on neurodegenerative diseases and rare cancers. As of today program times resulting in the selection of new molecules that can be tested in the context of Alzheimer's disease are considerably reduced.
Finally, the Blockchain technique could accompany the reorganization of the health world by securing a freer flow of health data between all the actors (the patient in particular), with an infallible traceability useful for all and in particular for physicians (interest forensic). The blockchain also allows optimization of services (payments, record keeping …) and cost reduction. The Estonian example is eloquent: the digitization of all the administration and the health wanted already 30 years ago is effective for some years, it is source of considerable savings making it possible to finance other public services (free public transport …).

So helped by this schematic and optimistic overview of the birth of a new medical ecosystem that is looming: How do you see the world of health in 2030?
How do you think you will be treated and how will the daily life of the various actors be organized to prevent health problems?
These are the questions we will ask professionals who intervene or not in the world of health, business owners and startupers, scientists and politicians who want to lend themselves to this game of foresight.

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