Ninety-nine percent of young, French health care practitioners have a smartphone and 94% of them use a smartphone for professional purposes including internet medical research, professional social network, mApps, etc. Twenty-five percent of those physicians have already recommended an mApp or a connected medical device to their patients, and this proportion is expected to increase to 78% by 2020. These figures, taken from a study conducted by Lab e-santé in France in 2016, demonstrate that digital devices have a significant role to play in the future of healthcare.
Several areas of our health can already be monitored through digital devices such as connected bracelets, watches, and smart scales. How will the increase in our use of digital devices impact and transform the future of healthcare?
The proven benefits of consumer medical devices: the example of the pedometer
Connected devices are already having an impact on the health of millions of people worldwide. One of the most widely used digital healthcare tools is the pedometer that is integrated into smartphones and watches. Acting as a supportive coach, a pedometer challenges its user to attain a certain number of steps each day. According to an international study by Stanford University School of medicine based on 2767 participants, there is a significant increase in the physical activity among people who by use a pedometer: “ these little devices were shown to increase physical activity by just over 2,000 steps, or about 1 mile of walking per day [...] it might not sound that much, but it equates to a 27 percent increase in physical activity - which is really astounding”, stated the study's lead author, Dena Bravata, MD, MS, a senior research scientist in medicine. Indeed, even a slight overall increase in physical activity brings many positive effects including:
- Reduction of many health risks: CV disease, diabetes, obesity, cancers (breast, prostate, colon), high blood pressure, osteoporosis, back pain, depression, etc.
- Improvement of well-being conditions: sleep quality, physical condition, stress resilience, concentration and memory improvements, health food habits
It is important to note that there are also risk factors linked to medical devices including misuse and addiction.
The growing number of smart devices can also have detrimental effects on health, mainly due to the real-time connection to the consumer. As with all push notifications from smart devices, pedometers push alerts reminding the wearer of the number of steps they have completed and the calories they have expended among other metrics. There's a risk of consumers becoming obsessed or even addicted to receiving this volume of detailed information which can have dangerous consequences. For this reason, some argue that consumer medical devices should be more rigourously regulated. Furthermore, HCPs could benefit more than is currently the case from the data being collected by these devices. There are many advocates for putting this collected data to better use when building the future of healthcare.
From a physician’s perspective, what are the benefits of connected medical devices for the future of healthcare?
HCPs are increasingly likely to suggest medical devices to their patients. Many of the devices offer new patient management solutions to HCPs and have the potential to improve:
Prevention and diagnosis of disease
- The data delivered by connected devices will increase the physician’s knowledge of their patients and consequently improve clinical decision-making.
The daily management of patients
- For some patients, especially chronic disease patients, physicians can receive data in real-time and adapt the treatment scheme if needed. For example, patients suffering from hypertension can be monitored online with a smart blood-pressure device. The doctor is alerted in the case of there being a data anomaly, and the treatment can be immediately adjusted.
The quality of home visits
- Connected devices give the opportunity to HCPs to monitor home care patients at a distance. This reduces the number of visits and gives more time to physicians in consultation. Consequently, the diagnostic process will be improved. The reduction in patient overload will also reduce the physicians’ stress and lead to better medical decisions.
More globally, connected medical devices will also provide healthcare authorities with further benefits:
- Costs saved due to reduction of number of hospital visits and stays
- Improved and anticipated insights which could prevent seasonal diseases such as flu or allergies
- New data for primary healthcare research and development
The pharmaceutical industry will also benefit from this transformation. Demand for medical devices will rocket giving new business opportunities for big pharma. As manufacturers of these connected devices they will also have access to new data to improve existing treatments and to develop new ones with a targeted therapy approach.
Despite the numerous benefits, having access to such data could lead to bad business practices and ultimately security problems including:
Device security and safety
- The development of connected devices is so fast that the existing regulatory standards are out of date. I attended a conference on safety in E-health at GEM digital days in 2016 and learnt that 1300 cyber-attacks on French hospitals were listed in 2015 (source: ANSSI) and the number of attacks against hospitals in the US raised by over 600% in the past 10 months of the year 2014 (source: MIT Technology Review). In 2015, the US food and drug administration advised hospitals not to use a connected insulin pump due to a vulnerability of the device. The FDA stated "This (vulnerability) could allow an unauthorized user to control the device and change the dosage the pump delivers, which could lead to over- or under-infusion of critical patient therapies."
Data privacy management
- The connected medical devices increase the risk of illegal or abusive usage of confidential information. It is easier for hackers to steal confidential medical information from the cloud. Furthermore, this could be exploited by some manufacturers purely driven by financial interests.
There is no doubt that the development of digital medical devices is revolutionary for the future of healthcare due to the introduction of new devices and the vast amount of data it will be able to collect and store. From a medical point of view, this disruption should strongly benefit healthcare improvement. But these medical devices are not without risks which must be considered very seriously by all actors: healthcare authorities, manufacturers, hospitals, HCPs and, of course, patients.
AplusA conducted a study on this subject in 2018. The full presentation provides deep insights into the behaviors and attituess of GPs in France and the UK towards new technology, as well as three typical GP personas based on their daily use of technology.
If you are looking for more information on this topic, try these blog posts:
Which Digital Devices do Doctors use Professionally vs Personally in France and the UK?
What are the main effects of technology on GP's practice according to GPs?
Sources:
AplusA