IoT and health: from consumer well-being to better healthcare management?
There were 73 million connected objects in the world in 2016. More than half are wearables, or devices that control our physical activity or diet. How are they changing our relationship to health? What place do medical devices occupy in this space? And what confidence can we place in these new devices and services? Rémy Choquet, Innovation Director at Orange Healthcare, talks about the issues of connected health.
Nowadays the Internet of Things (IoT) is transforming all business sectors. What is happening specifically in the world of healthcare?
Rémy Choquet: Certain measurement tools (monitoring devices) have existed in hospitals for a long time. New personal measurement tools have started to appear more recently. These are usually for personal motivation (physical activity, weight), which can be used as a lever for reducing risk factors (cardiovascular, cancer). New monitoring devices that support telemedicine are currently being developed for diabetes, chronic heart failure, chronic renal failure and chronic respiratory failure monitoring.
R. C.: At Orange Healthcare, we built a very secure connectivity service a few years ago for patients who have a defibrillator or pacemaker fitted, which enables the healthcare professional to follow the patient and device remotely. We’re also taking part in a cancer trial where the patient is equipped with a device for monitoring physical and nutritional activity adapted to his condition, and which is validated by a doctor.
Will IoT-enabled telesurveillance or telemonitoring change the doctor-patient relationship or even disrupt healthcare?
R. C.: This is clearly an operational issue. By setting up a new device for remote pathology monitoring, we’re disrupting the usual protocols (scheduling medical appointments, visits in case of any problems…) and concrete questions are arising: does the patient have to wear this device at all times? Will it be autonomous enough to manage? Do I, as a doctor, need to change my care plan and space out 1, 2 or 3 month visits? Not to mention that the doctor must also integrate this new mode of follow-up in his daily professional practice. This results in a complete change in perspective for patients, as for doctors, and will hopefully lead to more effective care while better controlling the costs for the healthcare system.
You mentioned connected watches that can help make people healthier. Wristbands offer the general public the most visible IoT applications. But do they really belong to IoT health?
R. C.: Yes and no. No, because these objects weren’t originally designed for medical purposes. And yes, because with the increase of telemedicine they can offer valuable information to a doctor in some cases. But for an object to go from being used for personal well-being to being used by a doctor it needs to meet the right specifications in terms of reliability and inherent risks; they need to comply with data use regulations. For example, some consumer heart rate monitors don’t give the same measurements depending on the ambient temperature. Hosting health data must also be secure as well, as well as any data transfer. There must be a guarantee that data is restricted to the specific context you have previously been informed of and consented to. We could therefore distinguish IoT from IoMT (Internet of Medical Things): the medical nature is defined by what we’re using the device for and in which context.
Do standards exist already for these objects?
R. C.: Working groups in Europe and France, including Orange, are studying the possibility of creating a standard (or “label”) to provide a maximum guarantee for the consumer items that promise they are “good for your health”. This would help individuals and industry health professionals to position themselves clearly in this specific market with safe products and guarantees regarding personal data protection.
So, personal data protection is one of the main challenges for IoT. How can you guarantee patients that their medical data will remain confidential?
R. C.: The new European regulation (RGPD), which will come into force in May 2018, will increase personal data protection for European citizens. In France, health data must be hosted with an approved provider to ensure a maximum level of protection for this very sensitive data. Although this regulation doesn't specifically apply to health data, at Orange, we believe that any personal health data should benefit from the best level of protection, so we offer our customers and partners the highest guarantees.
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