If the Health sector wants to see more official support given to connected health initiatives, a proper regulatory framework will have to be set up, plus guarantees of user data privacy.

Reimbursement for connected health tools on the way in France?

Now that the benefits of connected objects and applications for both individual and community health have been assessed and duly recognised, the logical consequence would be for society to take on the costs.” These are among the findings of a report on e-health and connected health by CNOM, the French National Medical Council, published early this year. In this paper, the Council has clearly come out in favour of reimbursement for connected health tools under the national health insurance system, as long as their benefits can be demonstrated. This statement, which was quickly welcomed by the connected health industry, is likely to stimulate further efforts in research and demonstration in this field.  However, e-health expert Dr Nicolas Postel-Vinay, who edits the Automesure.com® medical website, argues that other issues – such as reimbursement for new hepatitis C treatments, where health insurers are already paying out millions – ought to be taking priority in the social security system. If we take an area such as measuring one’s own blood pressure, patients can find blood pressure monitors which are nowadays reasonably priced due to economies of scale, so any moves to make such devices reimbursable under the national health scheme would only serve to further burden the overstretched French social security system needlessly. But the main issue that Dr Postel-Vinay is keen to raise is the phenomenon of the ‘digital divide’: ‟How can we accommodate in our hospitals and provide protection to those whose are not connected?” he asks.  Such important questions are rarely discussed.

Regularity framework a priority

More pressing than the question of reimbursing connected health tools under the social security system, says the French National Medical Council in its report, is the urgent need for an EU regulatory framework in this field. This implies drawing up and agreeing standards covering sensitive topics such as privacy and health data security. Information on connected device functionality and conditions of use must be ‘clear, trustworthy and detailed’. A regulatory framework would provide a guarantee of security and also convince doctors of the usefulness of these technologies so that they could gradually be made available to the general public, not just technophiles and ‘geeks’, underlines Alexis Normand, Healthcare Development Manager at consumer electronics company  Withings. On the other hand however, it is vital not to hamper development with too much red tape as this would increase connected health companies’ costs – not least the cost of insurance, stresses Dr Postel-Vinay. 

Les objets connectés et les applis

Data confidentiality, a key issue for connected health

Connected objects and health apps generate masses of data on patient-users. Once this data has been rendered anonymous it can serve to produce highly useful statistics. At the Startup Europe Summit in Berlin in January, Hans Raffauf, co-founder of Clue, which has developed a health app specifically for women, explained that, using the data gathered by the app, Clue was able to highlight trends in women’s menstrual cycles that had never been observed before. Of course the questions around data privacy start piling up fast as soon as one starts to comprehend just what could be at stake if this kind of data were in general use. The issues here are all about data storage and authorised use, given that medical data is protected by confidentiality laws: it is strictly prohibited under European Directive 95/46/EC to sell or divulge this type of information. The CNOM also wants to encourage advances in ‘digital literacy’. It is therefore now a must for connected health startups to act in an open manner so that everyone can understand what happens to private medical details. This highlights the clear need to educate all relevant stakeholders: patients, health tech players and medical practitioners. E-health and m-health are potentially ways of making it easier for people to obtain treatment, of improving the way patients are cared for and fostering self-reliance, but it is nonetheless important to ‟raise people’s awareness of data issues”, stresses Alexis Normand.


By Pauline Canteneur