toring 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 largely contribute to a restructuring of the medical landscape, technology replacing human expertise in many cases. We are entering there straight into the field of prediction, with all the risk involved in exercise. But whatever the degree of substitution, the spread of ICT in health will represent a credible alternative in the coming years to make up for future shortages of doctors, as American politicians have already pointed out.
Finally, third highlight, better knowledge of risk factors, in particular through genome analysis, should help to specify preventive actions based on the profile of each individual.
By associating this possibility of developing new prevention services with the previous observation, a curative system based on health paths, digital health is invited to an enlarged conception of the health system. In this conception, taking charge of health would no longer be limited to the curative stage alone, but would be conceived throughout life. The line between health and well-being is also increasingly being drawn. At each stage of life, the citizen would develop an increased awareness of the maintenance of good health. You could protect yourself from the risks of illness, cultivate a certain state of well-being, and if he ever fell ill, be taken care of within integrated care networks. It would no longer be a question of a course of care or health, but of life: that is to say a “tailor-made” management of his health course throughout your life.
.Two factors challenge
In the coming revolution, two factors seem to have to be taken into account to explain the possible pace of change.
The first is the question of the interoperability of information and communication systems. Other sectors (such as air traffic control, for example) illustrate the difficulty that this dimension can represent in large systems, and the time that the search for efficient solutions can take: years, sometimes tens of years. Today, almost all of the institutional and human players in health networks have information system