E-health: what is the future of medicine?

Abstract: In the digital age, healthcare is no exception. A lucrative sector if ever there was one, and a field of science and technology in essence, health is the perfect playground for new technologies. Teleconsultation, connected objects and futuristic robots are therefore gradually invading health and multiplying medical possibilities.

2020: A Odyssey of Telemedicine

The big winner of the 2020 health crisis is undoubtedly telemedicine. It must be said that the coronavirus pandemic has disrupted health systems around the world, including developed countries. In France, teleconsultations made it possible to consult a doctor remotely throughout the confinement, relieving overloaded hospitals and practices.

Teleconsultations have been reimbursed by the Health Insurance since September 2018. Despite this, they have since accounted for only an extremely marginal share of consultations. Covid-19 has changed the situation: the Health Insurance has declared that more than one million teleconsultations were billed between 6 and 12 April, compared to 138,000 between September 2018 and December 2019.

Telemedicine could also provide a solution to medical deserts. The France has 3.1 doctors per 1000 inhabitants, a number that has remained stable since 2000 while it has increased in the rest of Europe. In Europe, the average number of doctors per 1000 inhabitants is 3.6.

A boom supported by circumstances but also by a new reimbursement: from March 18, the day after the beginning of the confinement, teleconsultations switched to a 100% refund. Any insured could therefore benefit from a consultation from the sofa in his living room with the certainty of paying nothing.

Telemedicine is only a small part of the huge iceberg of e-health, and the possibilities created by technology applied to health and medicine. Little by little, all the possibilities of the future of medicine are taking shape before our eyes.

Changing health behaviours

What the explosion of telemedicine shows is a gradual change in behaviour. Until the coronavirus, the adoption of e-consultation suffered, among other things:

1. A problem of looking, both on the side of doctors and patients;
2. Financial barriers (investment);
3. A fear of novelty.

It's simple: change takes time! Yet behaviors and uses are gradually changing and e-health has already entered our homes before the pandemic. Fitness apps that have become widespread in your watch or mobile phone? The health trackers that have settled on your mobile? It's already e-health!

E-health is defined as "all health-related means and services that use new information and communication technologies" (Futura Sciences).

And this part of e-health is doing well, thank you for it. Thus, in Q1 2020, more than 14 million smartwatches were delivered worldwide, a jump of 12% compared to 2019. According to GlobalData, connected objects in the medical market were worth nearly $27 billion in 2019, and the market is expected to reach $64 billion in 2024. Growth helped by:

• Costs of care;
• The aging of the population.

Even medical staff have started and connected health objects now represent a third of the IoT (Internet of Things) sector!

As for mobile health applications, there are more than 160,000 in France and more than 325,000 worldwide – a number that doubled between 2015 and 2017 alone. A juicy market that was estimated pre-Covid would amount to $ 236 billion in 2026.

Favored by the rise of the Internet and the smartphone, driven by the habit of having technology in our daily lives, these changes in behavior both of the medical profession and of patients and fitness addicts various have allowed connected health to become a flourishing market.

In connected health, everything is possible: patient monitoring, prevention (heart attack, etc.), support for chronic diseases... Some examples:

• Stars of connected objects, bracelets allow you to track your physical activity, track your sleep rhythm or watch over your exposure to the sun (yes, yes!);
• Smart scales are installed in homes to help with weight loss;
• Sensors can monitor the blood sugar of diabetics, a patch to geolocate Alzheimer's patients, implants to prevent heart attacks.

In the future, connected objects may play a role in the fight against cardiovascular disease and cancer. Already today, connected bras are being developed to detect breast cancer at an early stage.

When legislation interferes with innovation

But on the side of the law, then? Because the legislation had to follow. Collection of personal data, reimbursement by the Health Insurance or, in the United States, approval by the Food and Drug Administration (FDA), with which the Apple Watch HealthKit has not been validated: all essential steps for the development and generalization of e-health.

A European directive on medical devices regulates the conformity of these devices... and above all defines the very notion of medical device! This is Directive 93/42/EEC. It was succeeded by Regulation EU 2017/745.

All these regulations are intended to ensure that users:

• The reliability of medical equipment;
• Their safety;
• The medical effectiveness of this equipment;
• Respect for their privacy

Its very appearance, its evolution even more, both testify to the development of e-health. Faced with the rise of new health-related technologies, it has been necessary to regulate them to protect users and guarantee the rights and freedoms of everyone, medical professionals and patients alike.

Despite the rise of e-health and the growing place of technology in the medical sector, the French remain suspicious. In 2018, an IPSOS survey showed that only 29% of French people would accept a diagnosis made by an Artificial Intelligence (AI).

In essence, medicine is the playground of progress. In a century, it has helped to increase our life expectancy by more than 30 years. She created the vaccine, the pacemaker, the MRI, the transplant, the gene therapy.

Our battlefields have accelerated its advances; They have seen the birth or evolution of radiology, cosmetic surgery, blood transfusion, emergency medicine. Today, does the future of medicine lie in the machine and Artificial Intelligence?

So what will tomorrow's medicine look like?

Technological innovations make the possibilities of medicine almost endless. For chronic diseases, responsible for 70% of medical costs, e-health promises a cheaper future and a simpler daily life.

The economic aspect is a considerable challenge for e-health. For example, it could help lower Americans' large hospital bills. But, on the contrary, there is also concern about the expensive potential of medical technology.

An example: in France, nearly 650,000 diabetics have to monitor their blood sugar daily. Systems like Freestyle Libre allow them to measure their blood sugar without needling; an application like Diabéo to have remote monitoring and support.

For mental health too, technology can relieve suffering:

• Centre Axel's virtual reality can help relieve hallucinations of schizophrenics;
• Mobile apps help manage stress, insomnia, mood disorders;
• Connected objects and AI also offer solid prospects in the management of mood or anxiety disorders as well as addictions.

In England, the start-up Immersive Rehab offers rehabilitation associated with virtual reality. Reinventing physiotherapy is now!

As has been said, technology is also a solution to medical deserts. In France, there were more than 226,000 doctors in January 2019, 45% of whom were general practitioners. But not everyone has the same access to care. Teleconsultation makes it easier to access a doctor, but the prospects are also different.

                                                                                 Made with Visme Infographic Maker Made with Visme Infographic Maker

Imagine: sick and unable to move, you have your medication delivered by... a drone. Well, it's already a bit of a reality! In Ghana and Rwanda, the drones of the start-up Zipline make it possible to deliver medicines to rural populations.

In fact, the opportunities for innovation are limitless. They will sometimes require a certain degree of caution, in any case a certain evolution of legislation and extreme vigilance with regard to the protection of personal data, but we can dream of a world where technology will accelerate research and the fight against cancer; a world populated by 3D digital cores and virtual reality headsets; to a world where AI will rhyme with medicine.

Cancer is one of the great scarecrows of medicine. Worldwide, it is responsible for 1 in 6 deaths. On the program for the coming years: a probe pen to analyze cancer cells, nanoparticles or biological nano-drones.

One thing is certain: Health Tech is taking off. Investments in digital medicine are at an all-time high, with e-health further accelerated by the coronavirus pandemic. In 2018, more than 13,000 new patents were filed. In 2023, the e-health market is expected to grow 160% since 2019 and reach more than $230 billion.

Let general practitioners (or specialists!) not worry: their time is far from over. The future won't just be about robots and mobile apps. But the prospects for e-health will likely redefine the profession.

For their daily lives, technology could mean easier and faster follow-up, easier planning, anticipation of their patient's medical evolution. With perhaps, at the end of the road, the satisfaction of having saved a life that could not have been saved today.

Article written and updated by Ariane Dumont on the www.boutique-box-internet.fr website.

Ariane Dumont holds a Master 2 in Information-Communication and has been an editor since 2017. Ariane joined supplier-energy in 2018. Initially a web editor, she now manages the editorial team of Boutique-box-internet.fr.

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