octors. By predictive models, these analysts can claim a definition of therapeutic strategies as relevant as that traditionally carried by doctors.
On the other hand, the involvement and initiatives that the patient can take to help with the collection and processing of data reinforces the co-constructed nature of knowledge (already mentioned previously with the trend towards patient autonomy), in a permanent, iterative, reciprocal and cooperative process between patients and the medical profession throughout the life course.
Finally, so-called precision medicine commits to a new classification of diseases, as we have seen in the case of cancer. This redistribution in the taxonomy of diseases will also have the probable concern of better personalizing the diseases, and consequently the appropriate therapies, as the movement of targeted therapies is already committing to.
Which health system in the future?
The first level of analysis that we have just closed consisted of identifying major trends based on already observable technological developments. Four main trends on the integration of the care offer, patient autonomy, the development of personalized prevention services by insurers, and the evolution of methods and fields of health research have been identified. A second level consists, on this basis, in studying the impact of ICT on the health system as a whole. In this respect, the evolution that seems to be taking shape is that of a substitution of a hospital-centered system, mainly positioned on curative time by a system giving more space to home care, and to preventive measures, upstream of the disease. All this points towards health paths managed at the different stages of life.
• A system organizing life courses
To start the exercise, it is necessary to take one by one the highlights from the previous parts, and deduce the effects on the health system.
The first of these facts concerns the possibilities offered by ICTs to experiment with more coordinated and personalized paths during illness. Remote monitoring can be envisaged thanks to portals and connected tools, as we have seen. This works in favor of keeping the patient at home, or at least limiting his visits to the hospital. This significant feature of the impact of ICT on the supply of care is part of a general trend, already affirmed: the appearance of medical innovations (such as oral chemotherapy), combined with the will of public policies to shorten the time and hospital contacts for mainly economic reasons tend to keep the patient at home. On the basis of this observation, we can deduce the transformations that the home and the hospital could experience in the near future.
With domomedicine, tomorrow’s hospital room could become the patient’s home room. The latter, full of vital signs detection technology and capable of regulating the individual or issuing alerts, could indeed offer the patient the possibility of staying there as long as possible. Coming to the latter’s hospital would only be considered to obtain expert opinions on very complex problems, or treatments requiring technical platforms that are difficult to transpose. Under these conditions, the annoying drift towards hospital-centrism would also be brought to disappear, or at least to fade, giving way to sophisticated treatment structures, eliminating certain specialties whose management would be outsourced. Conversely, these hospitals of the future would integrate powerful “data centers” to allow the necessary remote monitoring. The painting may seem futuristic. However, some recently built hospitals are already resolutely turned in this direction, such as the Samsung Medical Center in Seoul.
The second highlight concerns the possibility offered to the patient of autonomously managing certain actions of their care using connected objects and community sites. Topol deduces that a large part of the diagnostic and surveillance phases of the disease could be assumed in the future by the patient himself, in place of the healthcare professionals. The development of connected tools could thus 