Aftre a survey of digital technologies impacts on medical practices, we present 4P medicine (Prevent, Personalize, Participate and Predict) as the conjunction of biology progress, patient empowerment (using social networks) and the digital disruption.

1. How digital affects the world of
health
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1. Digital Health technologies
2. The changing world of health
3. P4 Medicine
Table des matières

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Impact of Digital Technology in Health
The digital impacts the society:
Access to information, automation, e-education, e-
commerce, e-administration ....
-> Faster & Cheaper
-> Changing behavior
In health, the impact may be much larger and
will intervene in the therapeutic process:
Teleconsultation, telemedicine, e-health, connected
health, big data.

4. Medical Imaging

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History of medical imaging
1895 Discovery of x-rays
1897 First radiography
1951 First ultrasound
1971 First clinical scanner
1975 First MRI
1992 First images of the brain in
opération
2008 First use of interventional
MRI to treat a brain tumor

6. Full aortic image in 4 s
• IMAGES COURTESY OF Dr. J-L SABLAYROLLES, CENTRE CARDIOLOGIQUE DU NORD, SAINT-DENIS, FRANCE
• Dose Rx < 1
an irradiation
naturelle

7. Discovery IGS 740

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Valve Assist 2
Trans thoracic aortic valve implantation
Plan Guide Control

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Medical Imaging exam
Stereo radiography Equipment low dose ALARA (As Low
As Reasonably Achievable)
3D modeling and clinical biomarkers
Station dedicated to images computing, enabling 3D
visualization and calculating 3D anatomical measures of
the patient in the functional position
3D software tools for personalized treatment
Application Portfolio profession based on data and 3D patient
biomarkers for personalized treatment
-> The image becomes a data set
Medical Imaging evolutions

10. Digitalization

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Opposable
Directory
RPPS
Registration
Authorities
(Professional
Associations,
MSA, ARS)
annuaire.sante.fr
Access to e-health, exchange and sharing
medical personal information :
DMP, secure messaging, telemedicine,
paperless declarations (e-fit, Cert-DC,
e-DO ...), access to collaborative sites
(Health networks ..)
RPPS : Shared Directory of Health Professionals
National health trust space
CPS card
wide variety of authentication solutions
Data from RPPS
is deemed to be reliable and enforceable:
they take the place of supporting documents
Annuaire MSSanté
(avec PS Adeli, BAL MSSanté..)
SI RASS
Annuaire.sante.fr :
publication via web-services,
1,2 Billion of
dematerialized care sheets
per year

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French National Medical IT System
12
Interoperability Security
RPPS /
annuaire
santé
INS PGSSI
Health data
hosting
Cadre
d’interopérabilité des
SIS
Identification
Authentification
(carte CPS..)
Service hospitalier
+ Social PAERPAUrgences
Radiologue,
biologiste Pharmacien
Para-médicaux
Médecin traitant
Médecin spécialiste
Patient
INTEROPERABLE
CONFIDENCE SPACE
national, regional, territorial
services…
MOS/NOS
Co-ordinated
care digital
services

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More than 1 million healthcare professionals (22 regulated professions)
and 60 000 health facilities (including 3,000 medical facilities)
Very different conditions of medicine practice and often mixed or
multiple hence a need for exchange and sharing of data:
Computer equipment variability
High sensitivity to the privacy of personal health data but a IT security
culture SSI actually to improve
Multiple devices (and multiple interfaces) adapted to the different
conditions of practice
Different operating systems (and OS versions)
Changing modes of "implementation" [installation, integration,
maintenance, ...]
French situation

14. Gamification

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3 types of Serious Games use in healthcare
Prevention / Awareness
Ex: Public awareness on young excessive alcohol
consumption.
Healthcare insurance companies provide online simulators
Therapeutic education & "Train Games"
Ex: Educate children with psoriasis
Connected toothbrush
Rehabilitation of the elderly
Digital Simulation in Health
Ex: Training by the error of the medical teams,
adaptive learning, multimodal evaluation
of medicine practice

16. IoT Technologies for
HealthCare

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Pregnant women Monitoring
Research project between:
• Marrakech Regional Directorate of Health
• Marrakech University Hospital
• Virtualcare
• A GSM operator
to demonstrate , in rural areas, the benefits on
mortality of pregnant women of health monitoring
with connected objects.
A public health problem throughout the African
continent

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Pregnant women Monitoring

19. The changing world
of health

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HealthCare is changing
Technological developments raise the cost of treatments
Telemedicine is a reality
Deadlines for treatment by contracted specialists are growing.
E-health
"The radical changes generated by the e-health market
in the health sector open
the ability to upgrade the current system
towards a more preventive model. "
(Digital Renaissance)
E-health market is estimated at 2.4 billion euros (source Xerfi
Precepta), it should increase by 4 to 7% per year by 2017.
Medicine evolution

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Traditional medicin
the doctor treats the disease doctor heals the sick
Auscultation / Diagnostics / Prescription or surgery
Health 2.0: Patient support his illness
The patient connects to patient associations via Internet to
understand, complete or correct the information given to him by
his doctor.
Risk: Auto diagnosis and self medication
Health 3.0: Virtualized Illness
With the aging of the population Patient / Cured dichotomy no
longer works.
The doctor treats the disease and the person manages his
health
Medicine evolution

22. P4 Medicine

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P4 Medicine

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P4 Medicine

25. Contact :
Alain Tassy
Club Télécom Paristech Santé
+33 619 902 209
alain.tassy@telecom-paristech.org
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