Always more digital and closer to the patient

The practice of tomorrow’s medical biology will require several possible repositionings. These will be the conjunction of different underlying trends – social, economic, technological, political – to which increasing digitalisation brings a particular dimension.

Social trends will be a pivotal point in potential positioning in biology. The digitisation of services and products in everyday life over the past ten years has introduced new forms of mobility and connectivity present in the population at all ages. The patient is always more mobile and/or connected: smartphone, tablet, watch and other connected sensors.

It is therefore the patterns of behaviour in the consumption of care that, with digitisation, are changing. Towards greater convenience of use in order to facilitate prevention and medical follow-up, for example. Patients whose biological data (collected or captured) are increasingly accessible to the biologist for, potentially, an increasingly personal interpretation. With the paradox that these patients are more distant and less in face-to-face contact with the laboratory. This signals the entry into precision medicine, which is characterized by the “4P” formula: personalized, preventive, predictive and participatory.

Economic developments will continue to be a major driver of change in biology activity. The health financial resources allocated to medical biology by the health system (compulsory and complementary) tend to be capped or even reduced wherever possible in a Europe-wide economic market environment1.

As a result of technological developments, an increase in individual uses in biology is likely to develop. Up to now, advances, mainly in analytical miniaturization, have allowed the emergence of delocalized biology, enshrined in the ISO EN 22870 standard
, which has taken a place closely linked to the needs of clinical activity practice. It should be noted that it is centred on institutions, within which the health care team includes biology laboratories. It is up to the latter, experts in analytics, to check the correlation of values with those of their technical platforms.
The increase in the number of possible unit analyses on autonomous devices will continue to increase (blood glucose, INR). The arrival of the Internet of Things in biology data offsets the use of the object from the scale of the institution, the collective of health professionals, to the individual scale of the patient.

To converge this information with biological laboratories, these objects will need to be able to communicate with their information systems. We then find the need for their interoperability so that the flow of information is maintained in its integrity and in the consistency of its content from the patient to the laboratory.
The other need, given the porosity of the information system boundaries between the inside and outside of the biology laboratory, is data protection and security. It is an essential pillar to extend the trust of patients today, but also of healthcare professionals, in all the digital health services of tomorrow. The strategy of health care and medical services producers should include management aimed at continuous improvement in both regulatory compliance and cybersecurity. Historically very operational, meeting each need with a dedicated production tool (SGL, middleware, expert systems, quality software, procurement software, HR software…), the architecture of information systems will have to become more coherent and integrated in order to ensure data protection and security.

The objective of public authorities, through their developments in health policy, will be to determine the characteristics of interoperability that will be required in health between services, connected objects and digital applications. The counterpart for the citizen/patient is therefore to be able to manage his or her health data independently. Over time, there has been a refocusing of digital services promoted by the public authorities. Launched in 2014, the TSN (Digital Care Territories) experimentation program aimed to better support patient pathways, particularly through better coordination between healthcare professionals through data sharing within digital platforms. From a new perspective, the refocusing of the National Health Strategy 20222 on the patient will be based on the Digital Health Space, a real citizen’s personal health account. It is intended to be the privileged and personalized tool for digital interactions between users and the health system (see box above). Many new and existing devices such as equipment for the disabled, hoyer lift, will be established on the agenda to make way for medical innovation.

These underlying trends are not without financial challenges. Moving from a health system where invoicing is strongly oriented towards unitary care acts and episodes to a continuity of care system, integrating medical and technological innovation, requires a new economic model that remains largely to be explained.

This ultimately places the biologist in new perspectives, amplifying his role as guarantor of biological data. It is also a change of scale from point biological data linked in analytical anteriorities to an almost continuous flow of data produced always as close as possible to the patient. And, more broadly, this role would therefore be oriented towards a rethought purpose: to ensure the updated coherence of clinical-biological results obtained within the framework of the continuity of patient-centred care.