Tele-medicine and e-health: digital technology is shaking the foundations of traditional medicine

While medicine had long been considered as a science with limited possibilities, recent decades have led to the emergence of previously unimaginable feats and advances. These remarkable achievements include the advent of tele-medicine and e-health. However, despite the desire to develop and provide a framework for these new practices, recent developments have weakened certain fundamental principles of medical practice.

Since 2009, tele-medicine has been considered as “a form of distance medical practice using information and communication technologies”. For its part, the WHO defines e-health as a discipline using “digitized information production, transmission, management and sharing tools for the benefit of both medical and medical-social practices”.

Easier healthcare access

In a society in which the supply of care and the growing demand of patients are out of sync, tele-medicine is intended to improve the organisation of treatment systems.

According to OECD data, the number of trained and active physicians has grown steadily in recent years, even as the phenomenon of medical deserts has increased in parallel.

Faced with this challenge, many companies have innovated in order to make new tools available to healthcare professionals and patients.

Tele-medicine has made its way into the field of consultation, appraisal, monitoring and assistance, notably within the framework of outpatient surgery.

A new application has recently appeared within the landscape of smartphones and other connected tablets. Selected as the application of the week at the start of May 2016, the success of EPIDERM is undeniable; it can be used to quickly obtain the opinion of an online dermatologist, to ensure monitoring over several days and, if necessary, to direct the patient towards healthcare professionals.

Looking beyond diagnostics, the SANOFI group also entered the field of tele-medicine a few years ago by creating the DIABEO application, intended to help patients monitor their diabetes on a daily basis.

With the emergence of tele-medicine booths that provide for patient-physician contact via 
a videoconferencing system, the company HEALTH FOR DEVELOPMENT aims to provide “access to a physician, anywhere and at all times”.

If the development of tele-medicine is intended to develop and facilitate healthcare access, many questions are also being asked surrounding the emergence of this discipline.

What about medical liability and data protection?

Looking beyond the issue of unfair competition condemned by certain specialists because of the prices charged by some applications, there is also the question of medical liability.

Indeed, in a physician-patient relationship dominated by technology, there is reason to wonder about the place of the clinical examination that used to dominate the medical relationship, and that still remains of crucial importance with regard to orienting the medical decision.

Faced with constant news about the risks of hacking, that continue to grow with the development of technology, there is also the question of data security, which is a crucial component of sacrosanct medical secrecy.

While healthcare professionals and companies specialising in the field of e-health and tele-medicine must certainly provide a response with regard to the safety of medical information, the DeepMind Company, a Google subsidiary specialising in artificial intelligence, and three London hospitals recently signed an agreement that will allow the start-up to access the medical data of 1.6 million Britons.

Like IBM in the development of Watson, as well as Apple and its HealthKit application that should continue to develop, the praiseworthy objective of DeepMind is to create an application that will assess the stage of an illness even before the appearance of the first symptoms.

However, the means required in order to do so unquestionably violate the very principle of medical confidentiality established by Hippocrates.

Moreover, with the creation of new diagnostic tools using artificial intelligence, the subject of medical liability once again arises: in case of a medical error, who is responsible?

The development of dematerialized medical diagnoses and the involvement of private companies in the treatment of medical data are resulting in new risks that should progressively call into question the current system of medical liability.

Stéphanie Dumoulin
Casualty liability loss adjuster, GM Consultant Group