Les innovations technologiques - E

Les innovations technologiques:
principal levier vers une médecine 4P
Philippe A. COUCKE
Médecine 4P ?
•
•
•
•
P = Prédictive
P = Préventive
P = Personnalisée
P = Participative
Medicine for the common good,
is not good enough …
Personalized & Participative ==> 4P’s
Personalized medicine:
Time for one-person trials
Nicholas J. Schork
29 April 2015 Nature / Comment
Precision medicine requires a
different type of clinical trial that
focuses on individual, not average,
responses to therapy, says Nicholas J.
Schork.
Precision Medicine Initiative (2015)
Evolution vers une médecine 4P
•Préventive
•Prédictive
•Participative
•Personnalisée
Precision Medicine Spreading Among US Hospitals
Ken Terry September 07, 2016 MEDSCAPE
Nearly a third of healthcare organizations are engaged in some kind of
precision medicine research, according to a recent survey that focused on larger
hospitals and healthcare systems.
The survey defined precision medicine as "an approach for disease treatment
and prevention that takes into account individual variability in genes, environment
and lifestyle for each person."
Pourquoi changer ?
Les 4 chiffres clés de la médecine
Quality
&
Safety
in Health Care
50 – 35 – 10 - 5
On a toujours fait comme cela !
L’innovation disruptive ?
L’accélération de l’innovation disruptive
Schumpeter studied and adapted this long wave curve in his book ‘Business Cycles’
(1939), proposing each curve would not be uniformly shaped, lasting around 50 years, but
as time passed each curve would get shorter, and also the complexity of the innovation
would increase.
4ème Révolution Industrielle WEF
Klaus Schwab Fondateur Forum de Davos
Numérique
Robotique
Internet Industriel
Automatisation
Biotechnologies
Cette 4ème Révolution industrielle est
Inéluctable / Indispensable
Innovations technologiques disruptives
•
•
•
•
Le patient: un « objet » connecté.
Le changement de paradigme: eHealth
La force du « big data »
L’organisation des soins
Aujourd’hui il ne faut plus se poser la question si le domaine de la
santé sera « disrupté » mais quand le sera-t-il?
Le patient un « objet » connecté
Mobile Health
Le patient connecté
•
•
•
•
Mesure ponctuelle
Mesure en continu
Du « wearable » au « forgettable »
Les « wearables » intelligents
Reports: 559.6M wearables, 87M activity trackers will ship in 2021
March 08, 2016 MOBIHEALTHNEWS
“While fitness is the overwhelming driver for wearables today, there are a number
of micro-segments emerging, ranging from kids’ watches to smart footwear to new
healthcare devices like wearable patches, that will drive this market forward.”
Life style
Wellness
Instant ECG. 50% off AliveCor Heart
Monitor + free ground shipping =
$99.50.
Kardia ECG Band for Apple Watch Unveiled
MARCH 16TH, 2016 MEDGADGET
AliveCor, makers of
popular smartphone
powered ECG
devices, has unveiled
an ECG band for the
Apple Watch. The
Kardia band still
needs to be cleared
by the FDA before
going on sale, but the
firm promises clinical
grade results that
may help patients
identify arrhythmias
with assistance from
their physicians.
As you record the ECG
by placing a finger over
the electrode, the app
lets you record a voice
memo stating any
symptoms you’re
feeling and any exigent
circumstances you’re in
that may be causing
issues. These are
saved next to the ECG
chart and can be
replayed at any time.
Business Card with a Built-in Electrocardiograph
MARCH 2ND, 2016 MEDGADGET & DIGITALTRENDS.COM
The developers of MobilECG, an
upcoming open source
electrocardiography system, are
gearing up with pretty cool business
cards any cardiologist would be jealous
of. The team’s business card crams a
one lead ECG, including the digital
display and battery, into the smallest
package we’ve ever seen. It’s
technically not a diagnostic device,
having not received any regulatory
approvals. Nevertheless, we’re
confident the technology inside works
just like any simple ECG device.
Wing, Sparo Lab's FDA-cleared, app-connected lung function monitor,
now available to consumers
By Heather MackNovember 21, 2016 MOBIHEALTHNEWS.COM
Wing is a pocket-sized spirometer with a
cloud-connected companion app that
measures and tracks lung function, ultimately
aiming to reassure parents of children with
asthma and help them proactively manage
the condition.
The sensor and app work to measure the
fastest speed and maximum volume a
person can exhale in one second (forced
exhalation and peak flow volume), and the
results are displayed on the smartphone
screen with a “stoplight zone” system,
displaying a green, yellow or red indicator
and an explanation of how the lungs are
doing in that particular moment.
SpiroCall Puts a Spirometer Inside Any Mobile Phone to Measure Lung Function
MAY 3RD, 2016 MEDGADGET
Luckily, researchers at the
University of Washington have
developed a way of using just about
any phone, not just smartphones, to
fairly accurately measure lung
function.
L’examen clinique
Mesure ponctuelle versus mesure
en continu
• Contact médecin - patient = <10 heures/an
• Contact maladie – patient = 8760 heures
Qui est réellement l’expert?
Cardiogram gets $2M to see if the Apple Watch can detect Afib
By Jonah Comstock October 20, 2016 MOBIHEALTHNEWS
Cardiogram has been working with UCSF since March to collect user data in a
study called mRhythm and use it to develop an app for detecting atrial
fibrillation based on on Apple Watch data.
Sensimed receives FDA clearance for Triggerfish, connected contact
lens that tracks glaucoma progression
By Aditi Pai March 28, 2016 MOBIHEALTHNEWS
Switzerland-based Sensimed announced
it received a de novo FDA clearance for its
connected contact lens, Triggerfish, which
helps physicians track the progression of
glaucoma in patients.
Triggerfish is a sensor-embedded contact lens that will record continuous
ocular dimensional changes for 24 hours. The data is sent from the lens
wirelessly to a recorder that users wear around their neck. After the recording
period has ended, the data is transferred from the recorder to a physician’s
computer via Bluetooth -- meaning the patient needs to return to the
physician's office to upload it.
Checkme Pro “Medical Tricorder” Green Lit by FDA
DECEMBER 14TH, 2015 MEDGADGET
The Checkme Pro portable health monitor from
Viatom Technology, a company out of
Shenzhen, China, has been cleared by the FDA.
The device performs one-lead ECG recording,
pulse oximetry, temperature measurement, and
movement sensing. There’s also cuffless systolic
blood pressure measurement that relies on
calibration, but this part has not been included in
the U.S. version.
Holst Centre Introduces Next Generation Health Patch
NOVEMBER 18TH, 2016 MEDGADGET
The health patch is equipped with multiple
sensing capabilities. It incorporates an
accelerometer to monitor physical activity,
ECG technology to record cardiac
electrical activity, and is also able to track
body temperature, respiratory rate, and
body composition. All of this critical data
will be transferred to the user’s mobile
device using wireless Bluetooth
technology, and can be easily shared with
the user’s healthcare provider for
immediate review. Also, the wireless nature
of the patch allows users to move freely
and without restrictions while continuously
being monitored.
Introducing The Battery-Free Electronic “Skin Patch” That Can
Monitor Your Health
August 5th 2016 FUTURISM / San Diego Jacobs School of Engineering
Rogers says, “we believe that these systems
represent the next generation of wearable
technology, where thin, skin-like devices can
interface with the body to provide clinically
relevant data on health status.”
Medgadget @ CES 2016: Profusa Unveils Long-Term Implantable Biosensor
January 12th, 2016
Profusa showed off an upcoming
injectable sensor that can be used to
continuously monitor oxygen levels in
tissue.
An optical reader placed on the skin
measures the fluorescence and relays the
data to a smartphone. The biosensor can
last as long as two years
Senseonics receives CE Mark for implantable continuous glucose
monitoring system
By Aditi Pai May 11, 2016 MOBIHEALTHNEWS
Senseonics, a Germantown, Maryland-based
company working on a longterm implantable
continuous glucose monitor, has received a CE Mark
for its Eversense Continuous Glucose Monitoring
(CGM) System.
L’observance thérapeutique
On estime que 90 % des personnes atteintes de maladies chroniques seraient
non observantes à un moment ou un autre de leur traitement.
Les effets d’une mauvaise observance thérapeutique se traduisent par :
 des conséquences médicales : accroissement des risques de complications
liées à la pathologie.
 des conséquences économiques et sociales : plus d’un million de journées
d’hospitalisation et près de huit milles décès par an, et un coût de 2 milliards
d’euros pour l’assurance maladie.
Tricella Pillbox Gives Smarts to Old-fashioned
Drug Container
MARCH 16TH, 2016 MEDGADGET
The Tricella app monitors which pills were taken and
when, comparing those events to the pre-defined schedule
that the person should be following. Any misses or
mistakes, such as opening the wrong chamber, will warn
the user or any family member whose info is added within
the app.
The system will soon be available on Amazon and Target
for about $75.
Proteus Swallowable Smart Pills FDA Approved to Measure Medication Adherence
July 6th, 2015 MEDGADGET
The underlying technology has been approved by the FDA since 2012, but the ability to
accurately record when every pill was swallowed has only now been FDA-sanctioned to be
used to measure medication adherence.
The patch then uses its built-in Bluetooth antenna to share when every pill was swallowed with the matching
smartphone app, which in turn passes the readings to family, caretakers, and the patient’s physician.
Texas hospital testing Proteus's ingestible sensor with pediatric organ
transplant patients
By Jonah Comstock August 22, 2016 MOBIHEALTHNEWS
Proteus Digital Health is working
with Children's Health in Dallas,
Texas in one of the first trials of its
ingestible sensor technology in
pediatric patients, The Dallas
Morning News reports.
The trial involves patients
recovering from an organ
transplant, a group that typically
needs to take a lot of medications
on a fairly strict schedule. Fifteen
patients are using the Proteus
platform now and Children's Dallas
ultimately intends to enroll 75.
Major step for implantable drug-delivery device
MIT spinout signs deal to commercialize microchips that release therapeutics
inside the body.
Rob Matheson | MIT News Office June 29, 2015
An implantable, microchip-based device may
soon replace the injections and pills now needed
to treat chronic diseases
Now Microchips Biotech will begin co-developing
microchips with Teva Pharmaceutical, the
world’s largest producer of generic drugs, to
treat specific diseases, with licensing potential
for other products.
While its first partnership is for treating chronic
diseases, Microchips Biotech will continue work
on its flagship product, a birth-control microchip,
backed by the Bill and Melinda Gates
Foundation, that releases contraceptives and
can be turned on and off wirelessly.
Les « wearables » intelligents
Study: Smartphone app that listens to breathing, determines respiratory
diseases is 89 percent accurate !
April 4th 2016 MOBIHEALTHNEWS
A smartphone-based system for diagnosing respiratory diseases achieved an
accuracy of 89 percent in a recent clinical study of 524 pediatric patients
conducted by the company at Joondalup Health Campus (JHC) and Princess
Margaret Hospital (PMH) in Perth, Western Australia.
For the differential diagnosis of croup, viral pneumonia, bronchiolitis and upper
respiratory tract infections ResApp’s algorithms achieved accuracy levels
between 90 and 98 percent.
Voice Used as Diagnostic Biomarker for Coronary Artery Disease
NOVEMBER 15TH, 2016 MEDGADGET
Beyond Verbal, a company that provides voice analysis software, has
announced that its algorithms were used successfully to help detect the presence
of coronary artery disease (CAD) in a group of patients. Results of a study
conducted at the Mayo Clinic show that voice can be used as a biomarker for
CAD
Vitals set includes:
Blood pressure
Electrocardiography (heart rate)
Body temperature
Respiratory rate
Oxygen saturation
Disease set includes:
Anemia
Urinary tract infection, lower
Diabetes, type 2
Atrial fibrillation
Stroke
Sleep apnea, obstructive
Chronic obstructive pulmonary disease (COPD)
Otitis ("ear infection")
Leukocytosis
Hepatitis A
Absence of conditions
Mononucleosis
Strep throat
Pneumonia
HIV screen
Tuberculosis
The World’s First “Artificial Pancreas” Will Be Hitting the Market in 2017
September 29th 2016 FUTURISM
The MiniMed 670G is
the first device to
combine an automated
glucose monitor and an
insulin pump.
It could help the more
than 1.25 million
American children and
adults with type 1
diabetes manage their
disease.
Scientists Created Smart Contacts That Can Monitor and Treat Diabetes
June 6th 2016 FUTURISM.COM
Researchers from the Pohang University of Science and Technology in Korea
(POSTECH) found a new way to monitor diabetes and deliver
medication…through a smart contact lens-eyeglass combo.
The Military Is Making Implants That Monitor The Health of Soldiers in
Combat
July 22nd 2016 / IOT Newsletter
Profusa’s vision is to replace a
point-in-time chemistry panel
that measures multiple biomarkers, such as oxygen,
glucose, lactate, urea, and
ions with a biosensor that
provides a continuous stream
of wireless data
The Defense Advanced Research Projects Agency (DARPA) and the U.S.
Army Research Office gave a $7.5 million grant to biotech company Profusa,
to further develop its implantable biosensors that will continue monitoring
multiple body chemistries.
Multiples problèmes à résoudre…
Le challenge de l’intégration
Le challenge de la réglementation
Le challenge de la validité
Health and medical app landscape becoming crowded, harder to monetize,
report finds
By Heather MackOctober 11, 2016 MOBIHEALTHNEWS
In the land of digital health
apps, space is becoming
limited. According to a new
study by Research 2
Guidance, the number of
health and medical apps is
still surging – 259,000 such
apps were listed on major
app stores in 2016 – but
downloads are starting to
slow down, indicating an
increasingly crowded and
competitive market.
Unified Microchip for Processing Multiple Body Signals
OCTOBER 6TH, 2016 MEDGADGET
A collaboration between IMEC of
Belgium and Holst Centre in The
Netherlands: a new integrated systemon-a-chip that can accept and process
data coming from a variety of body
monitoring devices.
It can natively accept a three channel
analog ECG signal, convert it into
digital, and perform signal processing
all within the single chip.
The full list of channels the chip can
process is three ECG channels, photoplethysmography (PPG), galvanic skin
response (GSR), two multi-frequency
bio-impedance (BIO-Z) channels
for newly applied technologies such as
impedance-tomography, body fluid
analysis, and stroke volume
measurements.
New Efficient Techniques for Health Monitoring Using Multiple
Wearables
NOVEMBER 18TH, 2016 MEDGADGET.COM
Researchers at North Carolina State University have been working on making
sure that such sensors only transmit important readings and organize these
readings within data structures that will provide the most utility to clinicians.
Their approach is to continuously classify different states that the wearer is in,
whether it be walking, running, or sitting, and to then transmit only data that
doesn’t seem to fit what the person seems to be doing.
The team will be presenting
their research titled
“Hierarchical Activity
Clustering Analysis for Robust
Graphical Structure
Recovery,” at the 2016 IEEE
Global Conference on Signal
and Information Processing,
Dec. 7-9 in Washington, D.C.
Cohero Health raises $9M for integrated, connected approach to chronic
respiratory disease
By Jonah Comstock November 02, 2016 MOBIHEALTHNEWS
i
Cohero Health argues that their ntegrated
approach, which includes controller
medication, rescue medication, and a
spirometer for measuring lung function,
sets them apart from competition in the
smart inhaler space.
Catalysts that are really driving adoption:
1.Shifting reimbursement models that are really allowing for adoption of these
kinds of continuous monitoring technologies,
2.Adoption of smartphone-based technologies that can be the hub of these
disparate sources of biometric data,
3.Interoperability.”
AliveCor Now Combines ECG, Omron’s BP Data In Single App
SEPTEMBER 12TH, 2016 MEDGADGET
Dr. David Albert, Founder and Chief
Medical Officer at AliveCor, in a statement.
“With this combined data, patients can
change their most important modifiable risk
factor, blood pressure, and seek the right
care that could improve heart health and
prevent a stroke. Today we are one step
closer to achieving our mission of making
the ECG a vital statistic for not just
cardiologists, but patients, physicians and
caregivers.”
AliveCor is Expanding The Role That Mobile Applications Play in Cardiac
Care
NOVEMBER 15TH, 2016 MEDGADGET
We recently covered AliveCor’s inclusion of Omron blood pressure data in their
Kardia mobile application (iOS/Android) and they are quickly expanding their
offering by integrating weight and activity tracking.
These metrics are modifiable risk factors for cardiac care and stroke prevention
– this is likely only the tip of the iceberg for AliveCor. They are also working
toward clearance of their Kardia Band which will deliver clinical-grade
electrocardiography on the Apple Watch.
Study tests accuracy of heart rate monitors in Apple Watch, Fitbit, Basis,
and Mio
Satish Misra, MD | October 13, 2016 iMEDICALAPPS
In a recent study
published in JAMA
Cardiology, researchers
from the Cleveland Clinic
tested the accuracy of
heart rate monitoring in
several popular wearables
including the Apple
Watch, Fitbit Charge,
Mio Alpha, and Basis
Peak.
Overall, it does serve as a
useful reminder of the
limitations of consumer health
wearables that are worth
considering if you’re going to
incorporate them into
recommendations for
patients.
New Generation PKG Watch for Tracking Movement Disorders FDA Cleared
SEPTEMBER 22ND, 2016 MEDGADGET
Global Kinetics
Corporation won FDA clearance
for its new, second generation
PKG (Personal KinetiGraph)
watch, a tool that can help monitor
patients with movement disorders
such as Parkinson’s and essential
tremor.
Big Data
« Habit » - omics
A PERSONALIZED NUTRITION COMPANY WILL USE YOUR DNA TO TELL
YOU WHAT TO EAT
IS A DIET BASED ON YOUR GENOME THE FUTURE OF NUTRITION?
By Claire Maldarelli October 25, 2016 popular science
“We have always taken a one size-fitsall approach to dieting, and most
[dieters] try and fail,” says Alan
Greene, a pediatrician and physicianadvisor to Habit. He says
understanding the complexities of our
biologies first and figuring out the
blueprint that fits it best will lead to
success in an industry that has most
often failed.
Campbell's Soup invests $32M in personalized nutrition startup Habit
By Jonah Comstock October 26, 2016 MOBIHEALTHNEWS
Data-driven personalized nutrition
service Habit has raised $32 million
in an investment from Campbell's
Soup, according to a report in the
Philadelphia Business Journal.
Campbell's CEO Denise Morrison
told the Journal the investment was
"part of our broader efforts to define
the future of food, which requires
fresh thinking, new models of
innovation, smart external
development and venture investing
to create an ecosystem of innovative
partners."
Big data … médicotechnique
Watson to Gain Ability to “See” with Planned $1B Acquisition
of Merge Healthcare
Merge’s technology platforms are used at more than 7,500 U.S. healthcare sites. The
vision is that these organizations could use the Watson Health Cloud to surface new
insights from a consolidated, patient-centric view of current and historical images,
electronic health records, data from wearable devices and other related medical
data, in a HIPAA-enabled environment.
CHICAGO - 06 Aug 2015: IBM
Pigeons diagnose breast cancer on X-rays as well as radiologists
When "flock-sourcing," they do better, with 99 percent accuracy --- and they
work for seeds
November 19, 2015
The pigeons were able to
generalize what they had learned,
so that when we showed them a
completely new set of normal and
cancerous digitized slides, they
correctly identified them,”
Levenson said. “The pigeons also
learned to correctly identify
cancer-relevant microcalcifications
on mammograms
Pigeons (Columba livia) as Trainable Observers of Pathology
and Radiology Breast Cancer Images
Published: November 18, 2015
DOI: 10.1371/journal.pone.0141357
Artificial Intelligence Reads Mammograms With 99% Accuracy
September 25th 2016 FUTURISM
A team from the Houston Methodist
Research Institute says they have
developed artificial intelligence software
capable of analyzing mammograms for
breast cancer with 99 percent accuracy.
The technique involves scanning patient
charts and cross-checking them with
results from mammogram X-rays and
clinical reports.
“We figured out you can mine a clinical
report for additional information,” said lead
researcher Stephen Wong
This Artificial Intelligence was 92% Accurate in Breast Cancer Detection Contest
June 21st 2016 FUTURISM.COM
Scientists trained an AI machine to detect
breast cancer in images of lymph nodes.
A group of researchers from Beth Israel
Deaconess Medical Center (BIDMC) and
Harvard Medical School (HMS) have
developed a way to train artificial
intelligence to read and interpret pathology
images.
It turns out it can detect breast cancer
accurately 92 percent of the time and won
in two separate categories during the
contest.
Dossier Médical Informatisé
IBM deal to buy Truven will add 8,500 clients and boost data trove to 300 million
patients
By Joseph Conn | February 18, 2016
Those Truven clients include hospitals, clinicians, health plans, employers, life
science companies, and state and federal government agencies. Data brought over
from the deal will also swell IBM's existing health-record data set to about 300
million patient lives
In addition to the company's client list and its
data, IBM will be getting one more valuable asset
with the Truven acquisition—talent—from
epidemiologists to consultants, creating a “dream
team” that “will bring our global footprint of talent
to 5,000
TECHNOLOGY NEWS 29 April 2016
Google AI has access to huge haul of NHS patient data
The document – a data-sharing agreement between Google-owned artificial
intelligence company DeepMind and the Royal Free NHS Trust – gives
the clearest picture yet of what the company is doing and what sensitive data it
now has access to.
The agreement gives DeepMind access to a wide range of healthcare data on the
1.6 million patients who pass through three London hospitals run by the Royal
Free NHS Trust – Barnet, Chase Farm and the Royal Free – each year. This will
include information about people who are HIV-positive, for instance, as well as
details of drug overdoses and abortions. The agreement also includes access to
patient data from the last five years.
IBM’s Watson AI Recommends Same Treatment as Doctors in 99% of
Cancer Cases
October 28th 2016 FUTURISM.COM
Human experts at the University of North
Carolina School of Medicine tested
Watson by having the AI analyze 1,000
cancer diagnoses. In 99 percent of the
cases, Watson was able to recommend
treatment plans that matched actual
suggestions from oncologists. Not only
that, but because it can read and digest
thousands of documents in minutes,
Watson found treatment options human
doctors missed in 30 percent of the cases.
The AI’s processing power allowed it to
take into account all of the research
papers or clinical trials that the human
oncologists might not have read at the
time of diagnosis.
Vous êtes
inondés de
données ?
Big data en santé
Big data en santé
Partnership on AI: Tech Giants Unite to Develop Synthetic Intelligence
for Humanity
September 30th 2016 FUTURISM
Consider it one of humanity’s first coalitions for the development of artificial
intelligence. This week, tech bigwigs Google, Microsoft, and IBM are joined
by Facebook and Amazon—teaming up to form the Partnership on Artificial
Intelligence to Benefit People and Society.
Le changement de l’organisation
des soins
Télésanté
Des cabines de télémédecine dans les pharmacies
15/03/2016 Médiplanet / Libération
Siège incliné, écran d'ordinateur pour guider le patient ou organiser une téléconsultation, instruments
de mesures "pour peser, mesurer, calculer l'indice de masse corporelle, prendre la tension, le pouls,
connaitre le taux d'oxygène dans le sang", mais aussi stéthoscope, dermatoscope, rétinographe, la
cabine créée par la société française H4D (Health For Development), est présentée par ses
promoteurs comme un véritable "petit cabinet médical connecté".
PORTAL:TELEMEDICINE HEADSET ASSISTING REMOTE COMMUNICATION
WITH YOUR DOCTOR
BY B.J. MURPHY APRIL 24TH 2016 / SERIOUS WONDER
Riding on top of this technological wave, designer
Jonathan Stewart believes his concept design could help
provide a more direct line of communication between
doctors and their patients. Say hello to Portal – a
telemedicine headset that will assist you with remote
contact with any doctor you choose.
The Portal telemedicine headset comes equipped with a
detachable stethoscope, an integrated high definition eye
camera, an ear pulse oximetry sensor, and a tympanic
thermometer. This wearable device wouldn’t just provide
your body’s basic vital data, but would also have the
capability of integrating with subsequent data collected via
other wearable devices.
Chinese web company Baidu launches medical chatbot for doctors and
patients
By Heather Mack October 11, 2016 MOBIHEALTHNEWS
Chinese search engine Baidu is
introducing Melody, an AIpowered conversational bot.
Melody gathers information,
responds to patients about
medical conditions and gives
feedback to the real-life doctors.
The service is available
immediately in China.
Patients can open the app and
ask a question, and Melody will
respond with context-relevant
questions to clarify information
such as symptom frequency or
duration.
USB Stick Measures HIV Levels Within Half Hour
NOVEMBER 17TH, 2016 MEDGADGET.COM
Researchers at Imperial
College London and DNA
Electronics, a company
with offices in London,
UK and Carlsbad, CA,
developed a computer
USB stick that takes a
drop of blood and
measures the amount of
HIV particles. The chip
produces results within
30 minutes, while the
average in a test of
nearly 1000 samples was
only 21 minutes.
HAD
Hospitalisation à Domicile
Patient of the Future New 'smart' tools will empower millions to diagnose and manage
their condition at home.
September 2nd 2015 USNews.com
All of this data generated by smart, hyperconnected patients represents a serious challenge
to medical paternalism.
One of the NHS’ goals is to have
25% of chronic conditions like
hypertension and diabetes
monitoring their health remotely
by 2020
UK NHS to spend nearly 6 billion$ to go digital including remote care &
health apps
February 12th 2016 iMedicalApps
NHS to offer free devices and apps to help people manage illnesses
June 17th 2016 The Guardian
Millions of people will receive devices and
apps free on the NHS to help them
manage conditions such as diabetes and
heart disease in an major drive to use
technology to reduce patient deaths.
A New Smartphone is Launching—And It’s Only $4
February 17th 2016 FUTURISM.COM
The device is
called Freedom 251 and
was just very recently
unveiled. Specs aside,
the most impressive
thing about the
Freedom 251 is, by far,
its price. The pricing
strategy and
development of the
technology was
anchored on Narendra
Modi’s intent to
‘empower India to the
last person
Who needs beds? New ambulatory centers offer everything except inpatient care
By David Royse | September 12, 2015 Modern Healthcare
The Children's Hospital of Michigan
Specialty Center, which opens in February,
will have a 24-hour pediatric emergency
room, operating rooms for a range of
pediatric surgeries and outpatient care in
several specialties… without inpatients
beds
Similarly, Montefiore Medical Center in
New York opened a “bedless hospital” last
year in the Bronx. The $152 million, 12floor, 280,000-square-foot tower features
12 operating rooms, exam rooms, a
headache clinic, imaging facilities and,
eventually, a full-service pharmacy—but no
inpatient beds.
Robots Could Be Performing a
Third of U.S. Surgeries by 2021
August 3rd 2016 FUTURISM.COM
As robotic surgery continues to grow,
experts predict that, within the period of
five years, robots will dominate the
operating rooms in the United States. In
fact, they could be conducting one of
every three surgeries.
CRISPR-Cas9: des ciseaux génétiques pour le cerveau
03.05.2016, par Léa Galanopoulo Journal CNRS
First Human Tests of Memory Boosting Brain Implant—a Big Leap Forward
By Shelly Fan Nov 15, 2015 Singularity Hub
Memory loss seems to be inescapable. But
one maverick neuroscientist is working
hard on an electronic cure. Funded by
DARPA, Dr. Theodore Berger, a biomedical
engineer at the University of Southern
California, is testing a memory-boosting
implant that mimics the kind of signal
processing that occurs when neurons are
laying down new long-term memories.
The revolutionary implant, already shown
to help memory encoding in rats and
monkeys, is now being tested in human
patients with epilepsy — an exciting first
that may blow the field of memory
prosthetics wide open.
Today patients ask their doctor.
Tomorrow they may ask their data.
Les 4 constats clés
•
•
•
•
L’inefficience ubiquitaire du système actuel.
La déferlante des technologies disruptives
La transparence par les réseaux sociaux
L’OPA par les GAFAMA et NATU sur les
soins de santé (investissent massivement
dans les NBIC).
Quelles sont les plus-values apportées
par l’E-Santé « aujourd’hui »?
• Une médecine en continu (par rapport à une médecine
ponctuelle).
• Une approche quantitative multi-paramétrique.
• Une approche Préventive plutôt que curative.
• Une approche Prédictive (Precision Medicine Initiative)
• Une approche Personnalisée & Participative.
• Une accessibilité ubiquitaire.
• Une efficience majorée.
• Une amélioration de la compliance.
Uber-Like Innovation Is Coming: Are Physicians Ready?
March 04, 2016 MEDSCAPE.COM
"Uber's message for health care is
clear," they write. Providers have three
choices:
•Ignore innovators and hope for the best.
•Call for increasing regulation to make it
harder for innovators to enter the
market.
•Compete on quality and efficiency,
disruptive though that might be.
They suggest providers take the last
option and hop on the innovation bus
before it drives off without them.
Principe de précaution
Principe de pro-action
•
•
• Le progrès est inévitable!
• Les 5 principes:
•
•
•
•
Manque d’objectivité.
Oublie les risques majeurs liés à
l’immobilisme!
Ne prend pas en considération les
intérêts de toutes les parties en
cause; ignore le coût et les effets
secondaires de la réglementation!
Impose la charge de la preuve
d’innocuité dès l’énoncé de
« possibilités » de dégâts.
Echec de compromis entre
différents risques.
Vulnérable à la corruption
– Objectif, compréhensif
structuré et explicite
– Priorisation des différents
risques
• L’inaction est potentiellement
aussi dangereuse que l’action
– Inputs diversifiés (toutes les
parties concernées).
– Réponse (négative et
restrictive) proportionnée aux
risques (probabilité et
sévérité).
– Revoir et réévaluer.
Hélas ! combien de temps faudra-t-il vous redire
À vous tous, que c'était à vous de les conduire,
Qu'il fallait leur donner leur part de la cité (savoir),
Que votre aveuglement produit leur cécité (ignorance) ;
D'une tutelle avare on recueille les suites,
Et le mal qu'ils vous font, c'est vous qui le leur fîtes.
Vous ne les avez pas guidés, pris par la main,
Et renseignés sur l'ombre et sur le vrai chemin ;
Vous les avez laissés en proie au labyrinthe.
Ils sont votre épouvante et vous êtes leur crainte.
Extrait de « A ceux qu’on foule aux pieds »
Victor Hugo
Le message positif ?
Retour vers les vraies valeurs humaines!
Empathie / Partage / Communication /
Explication / Equilibre « écologique » /
Développement durable