E health: connected objects, we balance the pros and cons

The professionals

A future and a market in top shape. Connected bracelets or watches (but also glasses, belts and soon rings, etc.), smart scales, electronic blood pressure and glucometers, etc. The list of connected objects linked to wellness and health continues to grow thanks to technological advancement in a market that is in insolent shape. How they work: they are connected to the internet through a wireless system and thanks to their electronic components they can communicate with a tablet, a computer, a smartphone. Many are so-called health wearables, that is, wearables, such as watches or bracelets.

In the medical context, better monitoring and care. Thanks to their data sensors, they are capable of collecting various health data from an individual, processing it, transmitting it to professionals and giving an alert in case of an emergency. They are connected objects for purely medical use, allies of practitioners – those irreplaceable and necessary women and men – for the medical follow-up of patients. We are thinking in particular of electronic glucometers and blood pressure monitors, which allow diabetic or hypertensive patients to monitor their blood sugar level or blood pressure, send the data to their doctor, evaluate a treatment and react in the event of an alert. Let’s add the pulse oximeter (which measures pulse rate and pulsed oxygen saturation, useful in case of asthma or chronic lung disease) or… the smart pillbox, which allows you to correctly respect your treatments (it alerts you if you forget or make a mistake grip). ).

All this does a lot of good in terms of remote monitoring of patients, or prevention in chronic patients. We can also point out a utility for an early diagnosis: cardiac arrhythmia, hypertension, sleep apnea. Some tools – helmets, bracelets – have even been designed to diagnose depression or detect some of its symptoms.

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Multifunctional and multifaceted personal trainers. Attention, this category of tools should not be confused with connected objects “for personal use” (based on the “quantified self”, that is, we measure ourselves), without medical support. It’s up to you to follow, or not, your “coaches” who can help you control your weight, monitor your physical activity, improve your sleep…

These range from scales that calculate your body mass index (BMI) and your daily calorie requirement, to bracelets that count your steps and other heartbeats. More surprising, the digital fork that vibrates if you eat too fast (but yes), the connected toothbrush that indicates the duration of brushing and neglected areas, or the sensors slipped under your mattress, which will analyze your sleep and help you to wake up. gently and at the right time… Other “wearables” are quite unexpected, such as backpacks, jackets, pants, swimsuits, shoes and even… baby pacifiers.

Against

Information, regulations, data protection. For multiple objects that rely on “self-measurement” without medical support, be careful not to get sick by misreading certain parameters. Hypochondriacs, abstain. Is the user well informed, are the promises of the manufacturers respected? And what about the protection of personal data collected? These are the type of questions raised by the DGCCRF (General Directorate of Competition and Consumer Fraud), which closely examines this issue, carrying out controls in establishments, stores, on the Internet.

It also investigated to verify if certain objects should not be subject to the regulations on medical devices, guaranteeing safety and protection in very high doses, included in the Public Health Code. The DGCCRF thus shares surveillance with the National Agency for the Safety of Medicines and Health Products (ANSM).

Regarding the commercial use of personal data or the risks of piracy, Fraud recommends, among other things, to inform yourself before buying about the operation of the object -as for all those that are connected-, its characteristics, its protection devices, etc. .; then, it is necessary to ensure the connection with other devices, carrying out regular security and software updates. Also remember to change passwords frequently.

Expensive and rarely reimbursed by social security. On another level, it is necessary to guard against certain abuses, in the face of a huge connected health market, which whets the appetite of behemoths or many start-ups: according to a McKinsey study, it could reach 22,000 million euros a year in France . year. Economically, its tools are not within the reach of all pockets, especially since Social Security reimburses homeopathic doses. To be covered by health insurance, the connected object must belong to the very closed circle of regulatory medical devices. Get out, for example, electronic scales or bracelets that control heart rate. Properly listed, they must also be prescribed by a doctor. Like all novelties, of course, they should be democratized, but it remains to be seen at what pace.

inaccessible to many. The Observatory of uses of digital health has already pointed out that more and more general practitioners recommend these tools to their patients, prescribing blood pressure monitors, pedometers, glucometers and others. For them, it is about facilitating patient care and follow-up. But also to fight against certain evils such as medical deserts, chronic diseases linked to aging, the associated increase in health costs. And this is also where the shoe tightens: the most vulnerable, those who would most need these digital assistants, are usually older people, uninitiated, disconnected, isolated in white areas and suffering from economic precariousness. In its opinion issued in 2017, a citizen workshop at the head of the subject recommended, among other remedies, “the elimination of white areas so that e-health is accessible to all.”