The European Commission is launching EU4Health, a programme it will endow with €9.4 billion. It seems like a good time to republish the “vision” part of the article “Public Health 2020-2030: a New Quantum Leap” taken from the May GEAB of this year.
” All of these situational considerations, combined with the vision presented by Jaap Maljers during the interview, help us to envision a possible future health system.
At the beginning will be the patient and his/her data: the implementation of the data mining systems we’ve just been talking about makes the patient, not the doctor, the primary data holder! If we combine this revolution with the fact that big data debates will give patients control over their medical data, we obtain an automatic rebuilding of the health system based on patients instead of doctors.
Education and training: The explosion of available global data will accelerate the applications of its processing in AI and will inevitably lead to a quantum leap in medical research (as well as discoveries). The 10-fold increase in medical publications mentioned above could turn into a 100-fold increase, transforming all the knowledge transfer aims of medical schools into ‘mission impossible’. Indeed, medical training will be obliged to evolve both towards the reinforcement of the acquisition of redefined fundamentals and towards the learning of information accessing and processing techniques on the one hand and medical coaching on the other, following the principle of permanent training that blurs the border between medical studies and activity even more than it does already.
Legal rationalisation: To enable a stricter (zero tolerance) scenario, the question of legal responsibility could be more evenly distributed between medical advisors, surgeons, medical institutions and even co-decider-patients. Physicians who are more supported by a collectively responsible system will thus regain control that legal constraints had taken away from them.
Standardisation and collectivisation: The advent of a global system of medical data will go hand in hand with the long-awaited standardisation (uniformity of language, measurements, coding, use of signs…) enabling the world’s hospital institutions to work together (this would have enabled much faster, more resolute and effective action by Western health systems in December-January). ‘For example, if there were to be 10-20 major breast cancer institutes in Europe, all interconnected through strong knowledge networks (applying a standardised approach to registration and exchange of diagnosis and treatment), then the whole learning cycle for breast cancer would speed up tremendously. In that environment, research is not a major and time-consuming effort but an integral part of ‘how things are done’. All medical professionals tap into the same knowledge system and offer feedback into that same system. (Micro) improvements are implemented constantly and immediately and on a large scale.’ (JM)
The issue of international standards is the topic of the decade. It explains why the Germans already favoured Google over their own medical data collection project; it is of course because of its global nature – the only one that makes sense in the scientific field.
Medical democratisation: E-medicine will reduce congestion in hospitals, which could decrease in number and which will evolve into specialised hubs for training and more exclusively surgical activity. Each person will own their centralised medical file, of which they will be the sole holder and to which they will give access according to their needs and wishes to doctors and care and research services who will use and fill them in. This file may be AI managed in order to alert the person to follow-up examinations and consultations to be carried out. It could be fed continuously with easy-to-collect data on weight, mobility, heart rate, etc., with all these health indicators enabling anonymous and secure AI applications to introduce principles of lifestyle and prevention, to monitor the development of identified pathologies (diabetes, depression, cancer, etc.) and to trigger the required healthcare actions (additional examinations, consultation, treatment). All this in cooperation with the general practitioner.
Feedback, benchmarks and learning processes: The optimisation of the medical scientific ecosystem surrounding patients and doctors will make it possible to optimise feedback on the right (supranational) scale and to restore the evaluation systems (benchmarks) necessary to restart the same kind of learning processes for which the major public hospitals of the 19th century provided the basis, resulting in the scientific leap forward of our time. The same idea – that of enlarging the sample being observed – must be applied today making the most of the potential for open-mindedness provided by a digital planet. It is now possible to observe on a collective basis almost all of humanity by applying AI tools for the analysis of these mega-samples.
In the end, it is indeed human beings and not the machine who will translate these observations into concrete medical progress; just as it is the human being and not the machine that will benefit. Let’s not forget that the blockchain is based on human beings. It was the old system that diluted the human being into large dehumanising organisations… for lack of anything better.
Just one example: this decompartmentalisation and the change in scale of the data produced by our patients and health systems allow us to hope for the disappearance of the concept of rare disease. ‘Rare diseases around the world, join hands!’ (but in the field of cancer, too, the countless peculiarities identified will be able to be connected).”
 Like the teacher with the student, the doctor will have to sit next to the patient and accompany him/her throughout their health journey.
 ‘Remember all the down-playing in December/January? “The Chinese registered in a different way, had different definitions, more research was needed, testing was faulty etc.” A disastrous initial reaction as we now know. However, it’s the same response as always! The medical field IS about local definitions, local registration, local insights (if they even exist). Doctors and institutions are so used to complying only with their own rules that nobody even considered taking the Chinese signals seriously.’ Jaap Maljers