Picard - Connected Healthcare for the Citizen

Robert Picard

Health Industrialization Set

coordinated by

Bruno Salgues

Edited by

First published 2018 in Great Britain and the United States by ISTE Press Ltd and Elsevier Ltd

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ISBN 978-1-78548-298-4

Printed and bound in the UK and US

Robert Picard

The digital world is becoming increasingly involved in the lives of the French. All of its uses are developing, both in the personal and professional worlds. According to the digital barometer, three quarters of the French population connect themselves to the Internet daily; one out of three workers bring their smartphone or tablet to work to use it for professional reasons. In the last few years, the smartphone has become indispensable and close to three quarters of the population own one.

The individual preoccupied by their health, the patient, the disabled person, just like medical and social workers, are concerned by this evolution. It justifies the use of the expression citizen connected healthcare. In this expression, the reference to citizenship reminds us that this healthcare concerns the socially involved. This is the point of view presented in this book. Here, health is defined by the importance attributed to it by global healthcare organizations, for example a state of complete physical, social and mental well-being, and not merely the absence of disease or infirmity . Finally, the notion of connection underlines the fact that the citizens healthcare refers to our new sociotechnical reality which transforms the relationship between individuals and their healthcare system.

The context which has led to the emergence of a citizen connected healthcare can be presented according to three different dynamics: that of healthcare linked to society, that of the economy of new technological solutions, and that of the rules and regulations of society, which created the conditions necessary for social and sanitary demands to meet technological opportunities and find satisfactory solutions to said demands. From now on, we will successively approach these topics.

Our society is increasingly involving its citizens, considering individual aspirations, allowing more autonomy and more solidarity. The digital world profoundly transforms social relationships and can allow new responses. The healthcare system is re-questioned due to the arrival of ever more efficient and targeted treatments, for economic and technological reasons, and considers research into a new approach for patients and their carers (the notion of a patients journey through treatment). This system initiates and is affected by profound transformations.

Here emerges a new vision of the healthcare systems role, called to support the autonomy of people and their ability to freely make life choices, despite their health vulnerabilities. Notions of empowerment (which refers to a patients ability to take control of their healthcare), and of literacy (meaning a form of knowledge about the said healthcare), illustrate this point and are now in common use.

The Cap Sant report by Christian Saout on supporting patients autonomy has developed this concept and its implications. This translates into a profound evolution of the relationship between society and the healthcare system. This report has been used as a basis for launching experimental work on the conditions and evaluations concerning patient support, aiming to develop in the patient, a broader control of their health.

The technological and digital environment is known as a transformational lever for a healthcare system undergoing a crisis, confronted with an aging population, a shortage of medical resources (or their inadequate distribution) and an increase in medical expenses.

Many international studies and reports offer statistics which underline the impressive diffusion of technologies connected to healthcare, of e-healthcare, health connected products and of connected healthcare. In 2016, 73 million healthcare devices were connected across the world. In 2020, there will be 161 million, according to a study by Grand View Research. This growth will mainly consist of three trends: the rise in the average age of the worldwide population, the prevalence of diseases requiring constant monitoring in certain countries (such as diabetes) and the growing demand for quantifiable solutions.

According to the Data Bridge Market Researchs 2017 market study, the Internets market for medical products rose to 157 billion in 2016 with a growth of + 30% per annum. Today, this market is dominated by wearables (bracelets, watches or all connected clothing), which represented 60% of the market for connected medical products in 2015.

Meanwhile, even though e-health projects are abundant, we have little information concerning future results (about observance, efficiency for the individual quality of life, permanent ownership, etc. or for healthcare systems coordination between medical professionals, organization of healthcare systems). In addition, the segmentation of the offer and chain of value are complex, unstable due to the lability of demand and the fact that technological evolutions are fast. Owing to this, evidence is difficult to establish.