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 ?

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.

L’accélération de l’innovation disruptive

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 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.

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.

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

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.

Profusa’s vision is to replace a

point-in-time chemistry panel

that measures multiple bio-

markers, such as oxygen,

glucose, lactate, urea, and

ions with a biosensor that

provides a continuous stream

of wireless data

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 system-

on-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, photo-

plethysmography (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

Cohero Health argues that their integrated

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-fits-

all approach to dieting, and most

[dieters] try and fail,” says Alan

Greene, a pediatrician and physician-

advisor 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

Published: November 18, 2015

DOI: 10.1371/journal.pone.0141357

Pigeons (Columba livia) as Trainable Observers of Pathology

and Radiology Breast Cancer Images

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 AI-

powered 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

All of this data generated by smart, hyperconnected patients represents a serious challenge to medical paternalism.

Patient of the Future New 'smart' tools will empower millions to diagnose and manage their condition at home. September 2nd 2015 USNews.com

UK NHS to spend nearly 6 billion$ to go digital including remote care &

health apps February 12th 2016 iMedicalApps

One of the NHS’ goals is to have

25% of chronic conditions like

hypertension and diabetes

monitoring their health remotely

by 2020

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.

NHS to offer free devices and apps to help people manage illnesses June 17th 2016 The Guardian

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, 12-floor, 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

• 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

Principe de pro-action

• Le progrès est inévitable!

• Les 5 principes:

– 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