Health and digital
Digital transformation is affecting all economic sectors and, not surprisingly, the pharmaceutical and healthcare industries are also affected. How do we view these innovations that are profoundly revolutionizing our relationship with health or healthcare, and is it always to our benefit?
In this article, I’ll just paint a picture based on a few innovations that raise questions about the benefits and drawbacks of digital transformation.
Digital transformation and the pharmaceutical industry
Some people would date this digital transformation to very recently, linking it to the unique arrival of new web technologies, cloud, smartphone, big data and Artificial Intelligence. But, it has been several decades since, following the evolution of information technologies, many business processes, especially in the R&D branch of this industry, have been digitized, going from paper processes to dematerialized processes.
I started my career in the pharmaceutical industry, in clinical research, and I was able to experience this transformation: from memos sent by mail to email. Or the collection of clinical research data from paper observation books (triplicated) to electronic observation books. These are just a few anecdotal examples but they show that the digitization of this industry started as soon as the technologies were reliable and validated for the pharmaceutical field. The pharmaceutical industry is a very regulated and demanding environment. Those who forgot this and wanted to do things in spite of common sense have sometimes had to pay dearly, by losing the pharmaceutical license that allowed them to produce and distribute their products…
The various technological evolutions on the digital side have raised many hopes, especially in the field of research and development, given the increasing difficulties in producing new molecules that allow a strong return on investment. As is often the case, the arrival of these new technologies was seen by managers in this industry as the answer to the lack of results from their R&D. The observation was correct, but the biased conclusion, in my opinion, was to believe that technology would be the only answer to this stagnation, whereas this problem is complex and includes other factors such as the lack of investment in our fundamental and university research and the lack of synchronization with industrial applied research… We could also question the policy of abandoning entire sections of the industrial and R&D activity to subcontractors (manufacturers, CROs, etc.) or partners (Biotech).
In any case, digitalization projects have flourished and, as expected, without reflection or long-term thinking, we often end up with flawed projects that do not always live up to expectations. Digitalization is part of a strategy, not a substitute for it. And even when the strategy is clear and the project well thought out, several obstacles remain to be overcome: one of the problems is not so much the technological solutions but their use in an adapted way. Moreover, one element remains underestimated in Big Data or Artificial Intelligence projects: the quality of the data needed to complete the project, because as our Anglo-Saxon friends say, “garbage in = garbage out”.
In addition, new challenges are also raised, especially in terms of security and legal issues…
To summarize, if digital transformation can, in the pharmaceutical industry as in many other sectors, bring productivity gains, new and more efficient processes, we must not forget that we have to manage the technical debt – we never start from a blank sheet of paper – and not forget the regulatory constraints in which this industry must work, especially under the pretext of bringing “disruptive” technologies… We must not forget that although there is a wealth of data from very old trials, not all of this data can be used as it stands, given the legal framework in which it was collected…
Digital transformation and health and well-being
The pharmaceutical industry is not the only field to have been affected by the massive digital transformation of its uses. There is, of course, the broader field of healthcare, which raises just as many questions.
The hold of digital technology on our most frequent medical acts has been reinforced by the covid-19 pandemic, but also in some territories, by medical desertification. Its most visible aspects are online appointment booking, with a major player in this sector, DoctoLib©, which is now almost unavoidable, but also teleconsultation, where the medical appointment is virtualized.
This telemedicine exists in more specialized sectors such as surgery, all operated by robotics. And the exploits of digital technology do not stop at these most visible symbols. There are a myriad of applications and devices made more efficient by digital technology, such as pacemakers, connected blood pressure monitors, holster, oximeter, thermometer, fall detector, etc.
A French player in this field, on the borderline between wellness and medical, is Withings, which offers equipment validated for medical use, allowing for monitoring facilitated by what are called connected objects, claiming good data protection. For health data use of French cloud players. On this sector we find of course the Samsung, Apple and Google, but on the issue of data protection, for them we know that we give up the property …
Of course, this development entails the need to collect and amass a lot of sensitive data that must be analyzed and allow doctors to diagnose or assist in diagnosis for the benefit of patients. What about the security of this data, where is it hosted, who has access to it, under what legal regime? The other question is the security of communications and access to these connected objects (are the communication flows protected, are the updates of the embedded software frequent enough to correct possible flaws, etc.), what happens if a malicious person takes control of a connected pacemaker or an insulin pump?
In view of the proven therapeutic interest and the ease of patient monitoring, do we not underestimate their security and the security of their data?
Other questions assail me: is this technicization of medicine really for the benefit of the patient? If we take the example of telemedicine, which provides an undeniable service to medical deserts for example, is it not a technical solution that avoids answering the lack of doctors and the reasons for this lack in these territories?
Doesn’t the general practitioner only have a technical medical role, isn’t he also and above all there to create a human link of trust with his patient? Can telemedicine replace contact? Can we replace clinical observation, auscultating, seeing and hearing the patient, with technical examinations?
In this article, I do not question technical and digital progress, neither in the pharmaceutical industry nor in health care. However, this progress must not only be mastered to be used for the best needs of patients. Medicine is not only a set of techniques, but it is also an art, and above all a human practice. It is important not to reify the patient, and thus deny his human nature.
And what we have just discussed for health is just as true for other fields, it is important not to let ourselves be invaded by the Technician System (Jacques Ellul), but to keep our link with our natural environment.