June 19, 2018 07:00
The smart phone will be the tool of digital health by excellence, thanks to its versatility, that do not offer the watches and bracelets connected.
The vision is that of Roger Simard, pharmacist-entrepreneur. He is also known for its participation in the program main Entrance of Radio-Canada. On April 18, he participated in the Congress collective 2018, organized by Segic. The Journal of the insurance was there.
Mr. Simard was the first canadian pharmacist to use a software program of pharmaceutical care in 2008, and then to perform tests of pharmacogenomics in pharmacy using the Spartan Rx. In 2014 he founded the Pharmacy 3.0, a solution for mobile health for remote monitoring of biometric parameters in a cohort of persons aged 65 to 89 years.
Reward healthy behaviours
During his presentation, he defined the connected health as a broad range of technologies that makes use of telecommunications. These technologies are intended to facilitate the exchange of data and the provision of health care services, usually at a distance.
They allow to better manage chronic conditions and promote prevention. This approach to health allows you to «reward» people who have healthy behaviors or to motivate them to change behaviors that create a condition or deterioration in their health, said Mr. Simard.
The ecosystem health connected has started with the bracelets and watches that have invaded the market in a few years. «With the advent of smart phones, many of these products will disappear. With the free apps, it becomes more and more the first purpose of capturing biometric data in the population «, observe the pharmacist.
Roger Simard observes that employers have begun to incorporate elements of this connected health approach in their prevention programs. «It is by the employers and the programmes of prevention in the company that we will see the connected health will implement «, he believes.
Mr. Simard says that it is convinced that the smart phone will be the catalyst for this revolution, by its power of analysis and safety data. «It allows access to the artificial intelligence and big data, predictive analytics, something that was impossible five years ago. Virtual reality will be part of the care delivered in digital health. «
A phone is watching you
The pharmacist has also cited a study by the ORGANIZATION, according to which one-third of smartphone users have mobile apps to monitor their health.
The doctors also find their account in their practice. «A study involving people with parkinson’s disease can determine the efficacy of treatment, in function of the tremors recorded by their smart phone when they take it. «
The GPS of a smart phone lets you contact people to optimize their treatment. «You can download apps that allow you to pair a device with your phone, to make a device of connected health. We are no longer in the world of the it portal. We are in the world of the mobile device, » says the pharmacist.
Roger Simard noted that the patients in 100 hospitals in the United States can now directly upload all their biometric data in their smart phones. The evolution of the data can be tracked with connected devices and applications. «These data range from blood pressure to physical activity, through the making of the sugar levels in the blood, the scales connected, and the monitoring of hours of sleep. «
In 2014, Pharmacy 3.0 implements a project with 40 patients 65 to 89 years of age, of which it follows the evolution of chronic health conditions on a dashboard. «For example, the blood pressure is being taken home by a patient with a blood pressure monitor connected automatically transfers it to my dashboard. These transfers of biometric data can be used to take preventive measures to avoid catastrophic incidents, » says Mr. Simard.
The motivational value of these programs is very important, he insists. «People are willing to be monitored by their health professional,» he said. They want to be guided on the right path, especially people who have chronic conditions. The 98 % of the time that we spend outside the health system, we do not have any data. Connected health will fill this void and to have health data on an ongoing basis for those people affected by chronic diseases. «
While the hospitals of the 1960s were created to treat pathologies, acute, chronic diseases evolve at work, at home, and it will be important to be able to follow, » said Mr. Simard. In the United States, he observed that the concept of virtual hospital, capable of handling for example 100 000 patients scattered in different territories, made its way. These programs have the odds at south of the border, where the insurers have an interest in keeping people out of hospitals. «This is not necessarily the case with us «, he says.
«A clinic in New Orleans has begun to use weighing scales connected to people who suffer from heart failure, he observed. When you décompensez, there is an accumulation of fluid in the lungs and you will gain weight quickly. The scale indicates to a pharmacist that you’re décompenser. He will recommend you to double his dose of diuretic for two weeks and potentially avoid a hospitalization. «
More accurate than the hospital
Roger Simard also gives the example of hypertension, a chronic disease which can modify the risk, among others by the exercise and by losing weight. He adds that the pressure is being taken at home with a connected blood pressure monitor tends to be more accurate than at the hospital.
It also notes an evolution frightful in the United States technologies for the treatment of diabetes. «The watch Apple will be able to accurately measure the rate of blood glucose by photo-seismography, without having to stitch every day,» said Mr. Simard.
In pulmonary diseases, a cap with a Bluetooth chip alerts the patient with asthma, if he does not the right pump. «Each time you use one of your inhalers, the application communicates with the cell phone or the iPad, will know where you are, consider the quality of the air depending on the humidity,» says Mr. Simard. The patient may thus receive recommendations on how to better use, as needed.
«A simple text message personalized to the person that we wants to help change the behavior works,» says Mr. Simard. In Boston, people with diabetes who received text messages one-time after data is received from the laboratory have shown a modification in their behaviour.
A request to patients in chemotherapy provide information about their general state of health through text messaging has created a jolt of oncology, says Mr. Simard. It was also revealed that the life expectancy had improved for six months in this population. This also had an effect on the quality of life of these people. Experience has shown that it is very important to interact two-way with patients, particularly for chronic diseases.
One of the examples that should be follow Canada, said Mr. Simard, is that of the English government, which takes the connected health very serious. The National Health Service has developed a library of mobile applications and offers among other things a center of the yard 811 robotic, which decides with the help of artificial intelligence if you will see a doctor or a nurse.
In Japan, the factor can take your biometric data to send to the doctor. In France, the equivalent of Canada Post offers free of charge to the population with a mobile application of connected health.
Few studies exist to demonstrate the return on investment of programmes of connected health, recognizes Mr. Simard. Adopt remains a good idea, according to him.
«In the United States, 64 % of the 100 companies considered as employers the most powerful at the level of health in the workplace have included devices connected health in their programs,» added Mr. Simard.
Many of these employers use telemedicine. «The telemedicine business has been the Trojan horse for connected health. «Mr. Simard noted that she came this way in Canada and Quebec.