Digital health, or digital healthcare, is a broad, multidisciplinary concept that includes concepts from an intersection between technology and healthcare. Digital health applies digital transformation to the healthcare sector, incorporating software, hardware and services. Under its umbrella, digital health includes mobile health (mHealth) apps, electronic health records (EHRs), electronic medical records (EMRs), wearable devices, telehealth and telemedicine, as well as personalized tailored health solutions.

Stakeholders in the digital health sector include patients, practitioners, researchers, application developers, and medical device manufacturers and distributors. Digital healthcare plays an increasingly important role in healthcare today.

According to Deloitte Insights, digital health employs more than just technologies and tools, it also views "radically interoperable data, artificial intelligence (AI), and open, secure platforms as central to the promise of more consumer-focused, prevention-oriented care."

Precedence Research projected that the global digital health market will see a compound annual growth rate (CAGR) of 27.9% from 2020 to 2027, when it will reach $833.44 billion.

Whether through the widespread use of telemedicine, or the more systematic collection of data and better use of it, technological innovations contribute to better patient care. In a health system under pressure, the democratization of such services appears to be a solution to many challenges.

Examples of digital health technology

-mHealth : eHealth+mobile

E-health brings together all devices (connected objects, smartphones, mobile applications, etc.), making it possible to follow the evolution of values ??on the state of health of an individual, offering him the possibility of being more autonomous. in the face of his state of health, or possibly his pathology.

Listening to the body, the devices used will capture all of an individual's activities, in order to report in detail on the user's smartphone, tablet or computer.

Permanently connected to the Internet, smartphones (mHealth) are the spearheads of this revolution. Thanks to a multitude of dedicated applications, connected objects or even services directly integrated into their programs, smartphones are the new hosts of our medical monitoring, offering many ways to sustainably improve the overall condition of their users. These are increasingly used as diagnostic tools and provide users with a wealth of medical information, usually accessible after a visit to the doctor or during a blood test.

–Consult station, telemedicine booth or health lounge

Consult station, telemedicine booth or health lounge are among the recent innovations that are gaining momentum. Consult stations are dedicated places equipped for teleconsultation. They are closed spaces, equipped with a seat and a screen so that the patient and the doctor can see and hear each other. Connected measuring instruments are present in the cabin: thermometer, balance, tensiometer, stethoscope... A printer is also installed for prescription printing.

Consultation stations facilitate access to healthcare by allowing patients to consult a doctor remotely. This innovation is a response to the problem of medical deserts.

While one would think them intended for rural areas, these cabins are also installed in urban areas where the problem of the shortage of doctors is also felt. For instance, in France, a large retailer has installed consult stations in two of its supermarkets, including one in Paris. Patients are connected with a general practitioner without an appointment and after a waiting period of seven minutes on average. The healthcare professional then guides the patient in the use of medical instruments that are directly available in the cabin. Registration for the service is done directly with the social security number and does not require advance fees.

In the same vein, the French company Bodyo markets AIPods and Health Lounge (photo), self-service standalone body measurement devices that provide 26 vital readings and a comprehensive health check-up in 6 minutes. The patient receives a report analyzed by artificial intelligence. Bodyo offers a comprehensive prevention-health solution based on AI that makes it possible to better anticipate risks and bring medicine closer to the patient, better control healthcare costs and simplify the patient's journey.

-Augmented reality (AR), Virtual reality (VR)

AR, which integrates digital information with the user's environment in real time, is applicable in patient and doctor education, surgical visualization and disease simulation.

In 2017, Pr Thomas Grégory, Head of Service, Department of Hand, Upper Limb and Sports Surgery, Assistance publique-Hôpitaux de Paris, was the first to have performed an operation enhanced with augmented reality, with 3D images and holograms. The surgeon was in communication with five of his international colleagues. He was assisted throughout this operation of fitting a shoulder prosthesis by an augmented reality headset. Thomas Grégory could, during the operation, have access to all the necessary information about the patient, which he could pin wherever he wanted in the room. In particular, he had access to 3D modeling of the photos.

But the use of AR and VR is not limited to assisting surgeons during operations. Beyond the surgical act itself, VR can also be used in the context of sedation. This is what the Belgian company Omcomfort offers for example. Omcomfort using virtual reality (VR) in combination with proven clinical techniques to deliver “Digital Sedation” in healthcare. “Digital Sedation” is a drug free therapy relieving patients’ pain and anxiety during medical procedures. This digital therapy combines clinical hypnotherapy and integrative therapeutic techniques through VR.

We can also cite the German company Living Brain which uses VR for rehabilitation of neurological diseases. Based on experiences of users, practitioners, clinics and patients, Living Brain develops virtual scenarios based on daily living. Instead of abstract and theoretical exercises, VR allows on the contrary to train patients with motivating, gamified and realistic exercises.

AI

Advances in AI, big data, robotics and machine learning continue to bring about major changes in digital healthcare. Also, alternations in the digital healthcare landscape continue developments in ingestible sensors, robotic caregivers, and devices and apps to monitor patients remotely.

According to Deloitte insights: "AI will enable major scientific breakthroughs, accelerating the creation of new therapies and vaccines to fight diseases. AI-enabled digital therapeutics and personalized recommendations will empower consumers to prevent health issues from developing. AI-generated insights will influence diagnosis and treatment choices, leading to safer and more effective treatments. Additionally, intelligent manufacturing and supply chain solutions will ensure the right treatments and interventions are delivered at the exact moment needed by the patient."

But the examples of digital health technology cited above are only a few among others, it is so very difficult to carry out a complete inventory of innovations made possible by new technologies in the medical field. We could also mention another significant application: blockchain-based EMRs, which aim to reduce the time needed to access patient information while improving data quality and interoperability. Blockchain's benefits – access security, data privacy and scalability – are attractive in digital healthcare.

Big Data and its issues

The digitization of health information led to the rise of healthcare big data. The use of this data has many advantages: identification of disease risk factors, help in diagnosis, choice and monitoring of the effectiveness of treatments, pharmacovigilance, epidemiology, etc. Companies, research organizations, profit or not, scientists, doctors, industrialists…. big data is of interest to a large number of players in the health world because it allows many medical advances. It nevertheless raises many technical and human challenges, and poses as many ethical questions.

The huge volumes of data now available pose technical challenges for their storage and operating capacities. Increasingly complex computer and statistical programs and algorithms are needed. Another problem is that big data is fragmented. The information collected is increasingly heterogeneous. To make it possible to process and use it, this complex information must be acquired in a structured way and coded before it can be integrated into databases. The need for standardization is real.

From an ethical point of view, it is the question of the protection of this data that arises in the first place. A lot of data is indeed collected without the knowledge of the contributors. This obviously poses ethical problems relating to the desire of citizens to share or not this data with third parties, as well as the preservation of anonymity. And many other questions arise: should we keep all the data? Should we pool them? Who should manage them and under what conditions should they be shared?

The doctor’s role in digital health

Technological advances in health are disrupting the traditional profession of the doctor as well as the relationship with the patient. The doctor is no longer faced with a disease but with an individual – and the sum of all the data concerning his organism. It is no longer a question of treating a specific condition as if it were isolated, but of working on patient’s well-being, in a more general approach and who takes into account both their medical history and their genetic predispositions as well as their way of life. The other big trend in e-health is prevention. The doctor, supported by the apps and all the data they collect, intervenes more and more upstream, before the disease or crisis occurs. Medicine becomes preventive.

At the technological level, doctors are not only users but they are also co-innovators and stakeholders in the changes underway. Like the Luxembourger Michael Witsch, pediatric doctor specializing in endocrinology and diabetology, CHL, Luxembourg, who has always been passionate about IT. Dr Witsch notably participated in the creation and development of a computerized pediatric record for a university in Germany. He is also involved in the NGO Sweet and in particular created the computer tool allowing a global benchmark aimed at comparing and improving the quality of care for children with diabetes. He is one of those doctors who believe that IT brings help to all health professionals and can be easily integrated into daily work.

Some doctors have a more radical vision, such as the pioneer Thomas Grégory, cited above. After the installation of a shoulder prosthesis assisted by augmented reality which was a world first, he told Le Parisien newspaper: "Before, everything was based on the skill of the surgeon. This is no longer the case today. hui. The future is digital. " And Thomas Grégory to spin the metaphor concerning the future of surgical operations: “We go from the time of Saint-Exupéry to the time of the airline pilot. The pilot is assisted by technology which helps him to standardize the flight and guarantee maximum safety. Until now, the success of a procedure has depended on the skill and experience of the surgeon. We have opened a new era, where the surgeon has his cockpit in front of his eyes."

[Digital Health will be one of the main topics discussed at the Digital Summit on September 15 in Luxembourg with many speakers from all over the world to present the latest developments in the sector. Digital Summit is part of the renowned tech summit ICT Spring Europe.

More information about Digital Summit HERE

More information about ICT Spring Europe HERE and registration HERE] 

Article by Nicolas Klein