Better known on the French-speaking blogosphere as “Pharmageek”, Lionel Reichardt, who is very active on Twitter and his blog, is a leading figure in the digital healthcare ecosystem. After working in the pharmaceutical industry for a number of years, he now offers strategic and operational assistance to eHealth players.
How has digital health changed the relationship between patients and healthcare professionals? How do you sort through the multitude of health apps on offer? Will doctors prescribe connected devices in the future? Lionel Reichardt answered these and more questions.
After spending fifteen years in the pharmaceutical industry, LionelReichardt saw users’ and patients’ behaviour transform with the advent of digital. This is partly why, three years ago, he decided to take an MBA in digital marketing. He then set up Pharmageek, a “playing field” that attracts thousands of visitors a month and has become a reference in the world of digital healthcare.
In 2013, Reichardt went to the States to explore the ecosystem of the digital transformation of healthcare. When he got back to France, he bought out two startups: Umanlife, a 2.0 digital health record that aggregates health and wellbeing connected devices, and Medappcare, which evaluates mobile healthcare apps. He also set up a company called 7c’s Health.
What exactly is digital healthcare?
Lionel Reichardt: The term digital healthcare covers a wide range of very different activities, from hospital IT systems to connected health devices, and from big data and serious game to telemedicine.
“What influences the digital transformation of healthcare, and of any sector, is consumer empowerment. In our case, it’s patient empowerment: patients are taking an active role in their health instead of being in a paternalistic relationship with doctors and carers: thanks to digital, patients are better informed and can have a say in the choices that concern them.”
The first instrument of health transformation is the patient. The second is a change in rationale resulting from the population ageing, the decreasing number of healthcare professionals and the economic difficulties of healthcare systems.
Today, our healthcare systems focus on managing illness rather than managing health in general. What we should be focusing more and more on is prevention, particularly preventing chronic diseases such as high blood pressure and diabetes, conditions which can be prevented through changes in diet and lifestyle.
With this change in the industry, new players, particularly from the tech sector, will be trying to pre-empt the market, for example with IoT and Big Data.
ABOVE AND BEYOND connectED DEVICES: DATA MANAGEMENT
We are now in the second Internet revolution. The first one involved connecting people to each other, via dating websites and social networks. With the second one, we’re being connected to devices, connecting devices with other devices, and retrieving data.
“I prefer the concept of the Modified Self to the Quantified Self.”
A connected device on its own isn’t much use. A smart watch can tell you that you walk an average of 6,000 steps a day or sleep five and a half hours a night… But you don’t really need a smart watch to tell you you haven’t had enough sleep or aren’t eating properly. Abandonment rates are huge for wearables: half the users give them up after six months.
Connected devices become useful once the user wants to change their behaviour, reach a goal or improve a condition. Let me stress at this point that I’m not talking about patients because it could be a fitness or wellbeing device: I’m using the term health as defined by the World Health Organisation, i.e. your general wellbeing, as opposed to just the absence of illness.
With connected devices, what will make a difference is the platform that manages the data, gives information and allows people to keep track of their goals, for example through a coaching programme.
With so many platforms and applications, how can you separate the wheat from the chaff?
On the onehand we’ve got a plethora of connected devices: just look at CES in Las Vegas, the MedPI expo in Monaco or the Sante Autonomie expo. On the other hand, since the advent of app stores, a multitude of health and wellbeing mobile apps have been launched: around 100,000.
In the States, the FDA (Food and Drug Administration) regularly reviews these. For example, it withdrew mobile apps that treated acne via an iPhone. But you can still find anything and everything. Also, reviewing mobile medical apps is doubly complex: on the one hand you have to assess them from a scientific standpoint to see if they have any medical basis and then you have to rate them from a technical vantage to see how they work and how to retrieve, store and send the data collected. Everything has to be secure and clear for the user, so there’s a very rigorous evaluation and approval process. A real issue in the future will be whether or not these healthcare apps and connected devices will be prescribed or even free.
Are there any applications that have really caught your attention lately?
The most interesting applications, and the ones which get the most downloads, are the ones which are really targeted and address a very specific need. With psoriasis, for example, there’s an app that lets you track the outbreaks through a simple quantified self system.
Psoriasis 360: free app, available from Google Play and App Store.
Another very interesting example is made by the American company Omada Health. Through a 16-week programme, patients with diabetes mellitus type 2 can change their health habits. For $130 a week, they can join a team of around ten people led by a coach. Users also have some connected weighing scales and an activity tracker to help them eat healthily and exercise.
In France, MSD has developed iChemoDiary, a great app that enables patients undergoing chemotherapy keep track of their symptoms and medication. That said, it’s not that spectacular because health apps on the whole aren’t that popular.
ASSISTING DOCTORS WITH NEW digitaL usages
How well-informed are doctors?
Almost half the doctors in the United States have recommended websites or apps to their patients. In the UK, meanwhile, the National Health Service (NHS) has the NHS Choices website which features an app store.
In France, however, healthcare professionals are somewhat behind on that score, due to insufficient training and assistance. Where eHealth is concerned, they are constantly hearing patients say: “I saw on the Internet that… I think I must have this disease … I think I need this treatment.”
“A lot of doctors still either have a very negative attitude to digital or just haven’t taken the time to see what the benefits could be. There’s a lot of work to be done to show them what the point of digital is in terms of what they do and their relationship with patients.”
“WE HAVE A VERY THEORETICAL VIEW OF eHEALTH”
Nowadays, we have a pretty good idea of how to handle prevention and we know that people should take control of their own health by using tried and tested tools. So, ultimately, doctors will prescribe applications and solutions to help patients manage their health. But at the moment, we’re a long way from that and we don’t know whether it’ll take five years, ten years or twenty years.
That said, more and more doctors and other healthcare professionals are talking about and trying to understand these issues and thus help build the healthcare of the future.
Another important issue: Data security
There are different kinds of use of data. On the one hand, there’s all the public healthcare data. Personally I like the idea of “data for good”: it can help us get a better understanding of diseases, treatment, the healthcare system, etc.
And then there’s the question selling and protecting data, a very complex issue which the CNIL (Commission nationale de l’informatique et des libertés, an independent French administrative body in charge of ensuring that data privacy law is applied, Ed) is tackling head-on. We have to educate users, particularly where mobile apps are concerned: are people really aware that their telephone is like an informer who follows you everywhere and collects vast amounts of data?
So we need to look at data from both angles, and the most important thing is to know who gets hold of it: government researchers or private businesses? Because the level of risk is completely different.
Photo credit: opensource.com – Open Health: stethoscope / Flickr.com / Licence CC BY-SA 2.°