1. EHDEC BUSINESS SCHOOL DOES NOT EXPRESS APPROVAL OR DISAPPROVAL
CONCERNING THE OPINIONS GIVEN IN THIS PAPER WHICH ARE THE SIKE
RESPONSABILITY OF THE AUTHOR.
CONNECTED HEALTH:
WHAT ARE THE POTENTIAL BENEFITS
FOR USERS AND SOCIETY?
LOIC RICCI
EDHEC GLOBAL MBA PROGRAM
JUNE 2016
THESIS TUTOR: PROF. MICHELLE SISTO, PHD

3. ABSTRACT
THESIS: Connected health: what are the potential benefits for users and society?
STUDENT: Loïc RICCI
DEGREE: Master of Business Administration
SCHOOL: EDHEC Business School
DATE: June 2016
PAGES: 52
What is the aim of somebody’s life? This philosophical question may be a counterintuitive
way to begin an MBA thesis report. Nevertheless – and despite the fact that there is no short
answer for this question – we can at the very least say that one such aim is maximizing human
life in terms of length and quality. Can connected health help us to achieve these goals? Or
might connected health be a technology that in fact disrupts healthcare and the process of
improving quality of life standards?
Connected health: the promise of a brilliant coach and doctor who tracks you all the
time, who aims to be as invisible as possible, and who would do anything he or she can to
look after your health and well-being. Connected health is not only a doctor who cares about
you and remains by your side every second of the day. It is rapidly becoming possible to say
that connected health is the physician who has consulted more patients than any other doctor
in the world. He or she has collected more data about health than any other doctor, hospital or
research or governmental institution. He or she can extract live trends, analyze them,
determine if something isn’t right and advise what to do.
The following thesis report explores the rapidly growing field of connected health, its
applications and the various actors currently fighting for or against the appearance of this
technology within the market. The project provides a comprehensive discussion of the

4. benefits for patients who use connected devices, describes the latter’s functioning and range
of applications, and examines whether connected health can be a cost effective solution for
governmental planning and public health. I argue that connected health is a promising
solution that can be beneficial both for end users as well as for health insurance companies
and related governmental organizations. Despite this great potential, it is also important to
consider the issues that may arise from such a technological turn: How will the patient learn
how to interact with the system (the technological barrier)? What will be the impact on jobs
within the market? What security and technological issues might be raised by this new
technology? While this thesis will finally argue in favor of connected health deployment
within healthcare systems, it will also attend to the various issues and challenges raised by its
utilization.

5. To my family, for giving me a great starting point in life,
along with a balanced training set.

6. ACKNOWLEDGMENTS
To my adviser, Michelle Sisto Doctor of Philosophy and EDHEC global MBA director.
Thank you for your generosity and guidance.
This research is a part of a MBA program at EDHEC Business School. The views and
conclusions contained in this document are those of the authors and should not be interpreted
as necessarily representing the official policies, either expressed or implied, of this
organization.

7. TABLE OF CONTENTS
Abstract
Acknowledgements
Abbreviations used
List of illustrations
Statement of the problem
1. Introduction
1.1 Healthcare: a historical overview
1.2 The current healthcare system
1.3 Health and healthcare
1.4 Connected health
2. Today’s connected health
2.1 Range of products currently available
2.2 Remote patient monitoring solutions and linked technologies
3. Understanding the market
3.1 Segmented market and trends
3.2 Market worth and predicted growth
3.3 Pure player vs. traditional industry
4. Connected health and perspectives
4.1 Fitness and workout monitoring
4.2 Medication analysis
4.3 Disease prevention

8. 5. Connected healthcare in public institutions
5.1 What are the benefits and issues raised?
5.2 Cost effectiveness
6. Big data and connected health
6.1 What is big data?
6.2 Challenges and opportunities in the healthcare market
6.3 Data privacy and legal issues
7. Twenty-second century healthcare: the over-connected period
7.1 Forecast for human health in the next century
7.2 Opportunities in the healthcare market
Conclusion
Appendices
Bibliography

9. ABBREVIATIONS USED
 WIMD: Wireless implementable medical devices
 GPS: Global positioning system
 DNA: Deoxyribonucleic acid
 RPM: Remote patient monitoring
 IoT: Internet of Things
 DCPN: Disease Control Priorities Network

10. LIST OF ILLUSTRATIONS
Figure 1: The healthcare system – its infrastructure and personnel
Figure 2: how it works, example
Figure 3: Health care monitoring dashboard from Fitbit
Figure 4: Illustration of mHealth market growth in the world.
Figure 5: Picture of the Healthbox kit posted on Underarmour
Figure 6: Leading causes of preventable death worldwide as of the year 2001.

11. STATEMENT OF PROBLEM
Through the centuries, the ways human beings have looked after their health has evolved.
This evolution has gone through many stages, from the link between human health and
spirituality, the birth of medicine and physician care, to modern medicine as we know it
today. If there is one key characteristic of contemporary healthcare, it is that has clearly
entered a period dominated by science and technology.
Many types of professionals are involved in practices relating to healthcare and well-
being. Leading the day-to-day work of healthcare in modern medicine are general
practitioners. Meanwhile, some of the most cutting-edge healthcare is performed by surgeons.
Other kinds of specialized doctors related to modern medicine, such as psychiatrists, dentists
or heart specialists complement the work of generalists and surgeons. While all of these
activities are framed by the government through licensure and research funding, there also
exist practitioners whose work is not recognized or organized in any way by governments:
Mental or sport coaches, for example, or traditional practitioners whose work is often linked
with belief and religion, and who have no scientifically respected proof of relevance and
efficacy. These differences aside, all these professionals do essentially the same thing: they
find an appropriate solution to a specific problem presented by the patient. The choice
remains to the patient to follow the advice provided or not.
Connected health can do exactly the same thing. In fact, it can do it better. What is
connected health and how does it work? In general, we can say that this technology collects
health information from individuals through electrical sensors and stores it in one or many
computers where it will be available for access and review. The aim is to care for health
remotely. In other words, such systems are capable of monitoring a patient’s health twenty-
four hours a day, all throughout the year, monitoring health risks even when one isn’t sick.
Complex diagnostic reporting allows information to be displayed to both patients and

12. healthcare professionals. Any detected diseases or health risks will be immediately signaled.
Connected health reacts instantly and helps take action to maximize chances of survival in the
case of life-threatening illness and, more generally, to prolong life expectancy.
The healthcare industry is a well-established market. Despite the range of applications
and the supposed benefits of connected health, there are a number of obstacles to overcome in
order to prevent connected health from interfering with standard healthcare. Principal actors
within the industry are powerful and they cultivate close relations with government, which is
much of the time the end user. While technological advances within the health care market
face difficulties, they also promise a bright future. This is a young market, and currently there
is no single solution or entity leading it. Indeed, none of the big players in this industry is yet
taking full advantage of its possibilities and potential. The question is to know which kind of
company in this field will enjoy the first-move advantage for bringing this kind of innovation
to the public and private sectors: a pure player such as Google, Apple or IBM? Or one of the
current leaders in the health industry, such as Sanofi or Novartis?
Connected Health brings with it many advantages in terms of organization, disease
prevention, health monitoring and so on, but deployment of this technology at the national
level raises several important issues: the question of the different features that should be
implemented in the devices according to disease trends, data security and the question of
determining who is to be in charge of computing it. The legal framework for this activity has
yet to be defined in France, in Europe or worldwide. The needed investment for developing
pertinent solutions is unknown, as is a clear view of the return on investment. Finally,
connected health will make many jobs in the health industry obsolete, including those of
physicians who diagnose patients based on analyses: very soon, connected health will be able
to provide a diagnostic more quickly and accurately than even the best physicians.
Thus, many challenges have to be overcome before connected health can realize its
potential. The global penetration of the connected health market cannot be driven by patients

13. and individual consumers alone, but will reach its first major significance when national
governments decide to invest in this technology. It will fall to the first to do so to face the
earliest challenges brought by this innovation: to debug the systems, ensure information
security, and so on. We don’t yet know when this technology will be available for
implementation or how national governments will handle this technological turn in healthcare.
None are for the moment able to say what new jobs might be created or made obsolete.
While connected health poses both challenges and problems to our notion of
healthcare, the benefits for both health and well-being, and for this emerging market, far
outweigh the disadvantages. The general aim of the following pages is to present the
framework in which this technology evolved, to discuss the issues for development and
implementation, and to consider the benefits of using this technology for both end users and
economies responsible for healthcare. Finally, I predict that, despite many challenges facing
this new technology, connected health is destined to become the Facebook of twenty-first
century healthcare.

14. 1. Introduction
1.1 Healthcare: a historical overview
Before examining the current healthcare system and gaining insight into the arrival of
connected health, it is necessary to briefly review the history of healthcare. As far as we have
information, the beginnings of medicine and healthcare go back years before the Common Era
to prehistoric times, during which sickness was linked with spirit attack, the gods or divinity
madness and the breaking of rules and taboos.1
During this period, the belief was that
recovery was linked to prayer and exorcism. After these years of spiritualist health, these
primitive practices were replaced by an archaic medicine with the introduction of writing and
clinical observation. This change took place in the Israelite and Mesopotamian civilizations
around 1500 BCE.2
Archaic medicine was seen as medicine mastered by people, and not by
gods or religious belief. Causal relation was introduced, describing a process for diagnosing
and treating disease and sickness. The modern notion of personal hygiene was also born at
this time, as most diseases were thought to be caused by a lack of proper self-care.
A few centuries before the Common Era, Greek medicine was born with Hippocrates.
Hippocrates De Cos is still considered the father of modern medicine. At that time, medical
treatment was considered an art, and Hippocrates its master. Hippocrates introduced
principles such as the diagnosis of disease based on endogenous or exogenous phenomena,
and created the “clinic” of Hippocrates. This clinical approach involved a process in which
treatment was prescribed with a list of actions or checks, defining the treatment that would
help the patient recover. In the meantime, other civilizations, such as the Byzantine or
Arabian cultures, were making major medical advances. For example, these civilizations
introduced the concept of mental illness, creating specific facilities for the treatment of
1
Dr Nouredine AYADI - Cours d’histoire de la medecine –Université de Sfax –– Année universitaire 2007 -2008
– Chapter II B http://www.dematice.org/ressources/PCEM1/psychiatrie/P1_psy_007/co/Histoire_medecine.html.
2
Ibid., Chapter II C.

15. afflicted patients. These civilizations also introduced a critical stance toward medical
knowledge, frequently reviewing and challenging their own principles and techniques.
Significantly for the purposes of this thesis, this critical stance can be said to be the beginning
of the capitalization of medical information, based on the need to share clinical experience in
order to improve the ways we treat people. Medicine in Europe during same period (the
Middle Ages) was not very advanced by comparison, and treatment there remained guided
primarily by belief, rather than self-critical process.
We have to wait until the eighteenth century to find the birth of the modern medicine
we currently recognize in Europe.3
In this context, health and medicine saw the introduction
of many fields, such as psychiatry, immunology and bacteriology, which revolutionized
medicine as we know it. This specialized approach to medicine radically changed healthcare
because of discoveries made at that time relating to anatomy and the body’s functioning. The
notion of infection arose, and new discoveries brought out nuances in illness, for example,
distinguishing bacteriological infection from viral infection. Great advances were made in the
nineteenth century in the field of microbiology with the works of renowned French Louis
Pasteur and his germ theory. Pasteur brought many innovations to modern medicine such as
vaccination against rabies and cholera. He also introduced concepts such as homeostasis (the
permanent equilibrium necessary to sustain human life), as well as the process of
pasteurization. In Pasteur’s system, three major elements became the principles for disease
cure: diagnosis based on the patient’s feelings and on observation, the proposal and
application of an adapted treatment, and advice in order to prevent any relapses.
We can see how rapidly medicine and healthcare have evolved in past centuries, and
this evolutionary pace has set significant standards for current and future growth, in particular
in the field of experiment and information sharing. The linking of technology and medicine
represented by connected health must be seen in part as a response to this standard of rapid
3
Ibid., Chapter VIII.

16. development. Before examining the impact of the technology on health and well-being today,
we should first provide an overview of contemporary healthcare systems.
1.2 The current healthcare system
The healthcare system aims through modern medicine, as Hippocrates suggested, to maintain
and improve human health. This complex system brings together many fields, such as the
human sciences, medicine, drug development, finance and research. Despite much overlap in
terms of structure and technique, each nation has its own specific system and approaches.
These differences and points of overlap can be observed in the fact that every nation has its
own health culture based on its history, while every nation also has the support of the World
Health Organization (WHO), which is a part of the League of Nations and is deeply involved
in global healthcare issues and standards. On July 13 1920, the first French Health Ministry
(Ministère de la Santé) was founded. Prior to its creation, healthcare was administratively
associated with the national social planning efforts (prévoyance sociale), which were included
as part of the Labor Ministry (Ministère du Travail), founded in 1906.4
Within any healthcare
system, one finds hospitals, emergency services, private doctors and clinics. The following
chart describes the typical distribution of infrastructure and personnel in most typical
healthcare systems:
4
M. Dupont, C. Esper, C. Paire, « Droit hospitalier », 4e
éd., 2003, no
10.

17. Figure 1: The healthcare system – its infrastructure and personnel5
This system is composed of (1) hospitals and clinics, either private or funded by the
government, (2) physicians, specialists and nurses, (3) universities and research institutions,
(4) the drug and device industries, (5) insurance companies and mutual funds, and finally, (6)
specialized private treatment, including personal coaches, psychological professionals and
nutritionists.
While connected health potentially impacts every element of the above system, it
pertains first and foremost to the last category mentioned, which includes sports and fitness
coaches, wellness experts, yoga masters, and so on. Previously excluded from such lists and
diagrams, the past forty to fifty years have seen a rapid development in this field, based on
increasing evidence that lifestyle is correlated with health and life expectancy. Nowadays,
most all health professionals agree on the importance of exercise and a balanced lifestyle to
human health.
1.3. Health and Healthcare
A healthy lifestyle is a way of living in which one avoids things that can be harmful for one’s
health, while engaging in activities and practices seen to improve health and increase life
expectancy. It is composed of many different aspects: nutrition, exercise and sport, meditation
and relaxation, and a balance of daily activities, among others – activities which are
5
Google image search – Iconarchive.com - http://www.iconarchive.com/tag/doctor

18. increasingly seen to prevent disease and improve overall health. Several studies from the
beginning of the healthy lifestyle movement from the 1970s demonstrate that there is a close
relation between personal activity and nutrition, and diseases such as heart conditions or
diabetes. For instance, a 1973 study conducted by the Human Population Laboratory revealed
the importance of avoiding harmful behaviors – such as inactivity or lack of exercise,
nutritional issues (lack of vitamins, excess of fat and sugar, etc.), as well as stress – in order to
increase life expectancy.6
Another study, conducted by Oxford University, exposed the link
between sport and health, and the many related benefits of regular physical activity and
anaerobic exercises.7
As a consequence of such pathbreaking studies, it is now impossible to
think about a specific healthcare system without also considering lifestyle categories such as
nutrition, sports and wellness. Such studies have in this way given rise to an entire industry,
with its fashionable aspects as well as its elite expression in boutique treatments, high-end
gym memberships and, as we’ll see, personal devices and other elements of what is now
referred to as connected health.
1.4 Connected health
Most studies related to connected health do not provide any global, representative or concise
definition of the phenomenon, which is most often defined by a list of associated
technological trends or a list of its benefits. The University College Dublin (UCD), agrees that
“there is no standard accepted definition of connected health”. In the absence of any
consensus regarding its definition, we might take that used by UCD, whose Connected Health
program brings together training, research and industry developments. For UCD, connected
health is quite simply, “a new model for health management. It puts the correct information,
6
Nedra B. Belloc – « Relationship of health practices and mortality » - Human Population Laboratory,
California State Department of Public Health, Berkeley, California 94704, USA, March 1973
7
Steven Allender – « Understanding participation in sport and physical activity among children and adults: a
review of qualitative studies », Public Health, University of Oxford, Rosemary Rue Building, Old Road Campus,
Oxford OX3 7LF, UK

19. in the right hands, at the right time.”8
Connected health brings together individuals, medical
health professionals and technology through live, targeted information, often drawn from
patients through wearable electronic devices, which can be transmitted via the internet to the
healthcare practitioners. But it is not only this. Connected health also entails what is referred
to as mHealth, or mobile health, which includes the vast amounts of health information
available on today’s internet, with which connected health interacts, as well as virtual
meetings with healthcare professionals. Connected health is one of the main healthcare
innovations of the century, and one of the most promising. As the late Steve Jobs observed, “I
think the biggest innovations of the twenty-first century will be at the intersection of biology
and technology. A new era is beginning.”9
With its roots in the earliest historically
documented medical advances, and propelled by the rapid evolution of medical technology
and research in the twentieth century, connected health has potential beyond our imagination
and implies a massive number applications from urgent healthcare, to genetics, to preventive
health or wellness and fitness.
8
UCD Dublin – « What is connected health ? » - http://www.connectedhealthireland.com/what-is-connected-
health/
9
Luke Timmerman, December 5th, 2011, « Steve Jobs’s Dying Realization About Biology and Technology » -
http://www.xconomy.com/national/2011/12/05/steve-jobss-dying-realization-about-biology-and-technology/#

20. 2. Today’s connected health
Connected health is a generic term that can refer to a number of individual designations such
as telehealth, eHealth services, telemedicine, mHealth, telecare, digital health, and so on. No
matter the particular field of application, all of these technologies seek to monitor and
improve health remotely. This activity might range from a single application for one user with
basic constant health monitoring, to a complex global system including social health data
sharing and comparison. For instance, connected health can move data from individual diet
monitoring or wearable tech for fitness, to a second, more complex system or integrated
system where data is connected via cloud technology, where it can be compared with national
healthcare systems, or within a social networks, and finally, within databases which use
collected information for decision and policy making. In this way, connected health means
linking the most particular units of health data – individual users – with the highest levels of
research and governmental policy.
2.1. The different products available
Connected health is not just a concept, but includes many solutions that are already
commercialized and used in many ways within the healthcare market. As a first example of
the range of connected health products currently available, we might take health websites.
Instead of going to the doctor in order to seek information regarding health, the patient now
can go directly to the web in order to read articles, blogs and posts in search of information
and comparative viewpoints relating to specific diseases, treatment, well-being practices and
nutrition. What is often referred to as telemedicine personalizes this virtual medical approach
by putting patients in contact with healthcare professionals through the web. Patients can
arrange online meetings with generalist physicians, or with specialists, in order to discuss
nearly any health-related issue. In this way, websites and blogs come together with

21. telemedicine to provide both health information and personalized consultation and follow-up
– all of this online, and available at the patient’s convenience.
Another important aspect of connected health includes wearable monitoring devices.
Typically, these systems are composed of at least four main subsystems that allow health
monitoring and improvement remotely. The first is a sensor that detects and draws
information from the body. This component serves to transform physiological data into
electrical signals. Many micro-technologies assist in this first function, such as thermocouple
sensors, piezoelectric sensors or electromagnetic induction sensors. The second key element
of wearables is an electronic component capable of transmitting the signal from the wearable
device to a computer, tablet or smartphone. This process involves many other wireless
technologies, such as Bluetooth and Wifi. A third component of wearable monitoring system
is the hardware and software which collects, computes and displays data and results. This
element uses databases and algorithms which compute the data and analyze associated trends
using statistical or mathematical formulae. A fourth and final element of wearable consists in
a display system that shows data and results to the user, popping up the relevant information
extracted from the entirety of data collected. The following illustration provides an overview
of the steps necessary for remote health monitoring with a wearable device.
Figure 2: how it works, example.10
10
Google image search – W.ME wearable technology - http://webdesobjets.fr/objets-connectes/wme-bracelet-
bien-etre/wme_bracelet-connecte_power/

22. Despite similarities in basic functioning, the application of wearables is vast. Smartcap, for
example, is an intelligent cap which follows the fatigue rate for automobile drivers.11
This
product uses the electroencephalogram technology known for sleep studies. Fitbit surge is one
of the most advanced wearable wristlets on the market, which seeks to improve athletic
workouts by monitoring parameters such as heart rate, GPS position, sleep analysis and daily
activity tracking.12
Sugarbeat is a glucometer that takes a single measurement every five
minutes, and is comprised of a non-invasive one-mm thick patch (Appendix, Figures 1-3).13
These three examples, a sampling from among thousands of products now available,
demonstrate the range of wearable fields of application, each with its unique aim. Smartcap,
for example, detects your body parameters and signals if you have a posture that may lead to
an automobile accident, thus warning drivers against the potentially harmuful behavior of a
long drive without taking any rest. Fitbit surge, by contrast, functions as a super coach or
monitoring system that reminds you to remain active and encourages you to exercise. And
finally, Surgarbeat works to remind users to regulate glucose rates in order to prevent
faintness or other issues related to low or high blood sugar. Three systems: one for avoiding
auto accidents, another for improving your sport performance and a third for monitoring
issues related to a specific disease. Indeed, the range and specificity of wearables’ basic four-
element set-up seems limitless.
2.2 Remote patient monitoring solutions and linked technologies
The most common existing systems able to capture human physiological data are referred to
as remote patient monitoring (RPM) technologies. RPM solutions embrace all the system that
remotely monitor one or many parameters of one’s health. The choice of the way to transfer
information from sensor to device depends on the application in question and the information
11
Smartcap - http://www.smartcaptech.com/our-product/
12
2016 Fitbit, Inc - https://www.fitbit.com/fr/surge
13
2016 Nemaura.- http://www.nemauramedical.com/sugarbeat

23. sought. Most new wearable devices use wireless technology to transfer data to applications on
smartphones or directly to cloud storage resources. These wearable devices integrate two
essential features: physiological sensors and wireless technology. The physiological sensor
will transform physical constants such as temperature or heart rate through an electrical
signal. The transformation of this constant into an electrical signal implies the use of an
electronic subsystem capable of distinguishing a single, or several, mechanical, biological or
physical properties that are directly related to the targeted health constant. Heart rate sensors,
for example, can use different options to accomplish this transformation. First, such sensors
can be positioned in chest-straps, can be finger-based or can be placed in wristbands. The
beating of the heart is caused by an electrical signal within the body that is sent from the brain
to the heart through nerves. Blood flow is created by the blood vessel contractions and
expansions. Vessel shape modification is captured by a light emitting system and a
photodetector, both of which will capture the continuous quantity of incidence light when the
vessel contracts or expands. This modification of the light quantity is associated with the heart
rate. The signal is treated after being captured by an electronic system which adapts the signal
in terms of intensity and phase in order to be used by the larger electronic system. The
electrical signal is then transferred to devices or to remote clouds for storage and computing.
After being sent by the sensor through a communication solution, all captured information has
to be computed and stored before being displayed (the algorithms and the databases involved
in this process are explored in greater length in Chapter 6). Displaying the right information to
the right actor is the final aim for the RPM, evoking the previous definition of connected
health (“the connect health puts the correct information, in the right hand at the right time”).
Technical advances in wireless technology thus directly impact the possibilities of this
healthcare equipment. For instance, the larger the device’s data output, the larger the system
can be in term of quantity of features. This was an important conclusion drawn by
Muhammad Ikram and his team, and presented in the study “Implementation issues for

24. wireless medical devices.”14
Other technical advances can impact the development of this
wireless equipment such as the miniaturization of sensors that accelerate the development of
complex solutions and the deployment of large wireless network such as 4G networks, or
WiFi in hospitals and clinics that will impact these health solutions. Also, all the maintenance
systems used to assure the availability of the wireless systems even in case of system crashes
will play a role. When monitoring someone’s health, the connection has to be infallible in
order to believe that such a solution can be implemented. Such systems can be wearable or
can be inserted directly into the body. When directly implemented in the body, such devices
are referred to as wireless implementable medical devices (WIMDs).
Most of the existing result display solutions on the market are applications for
smartphones. These solutions are crucial in order to take advantage of the data and processing
that takes place “invisibly” between the device and its wearer. First and foremost, applications
display and advise users on how to improve health and wellness. As not every user of a
wearable monitoring device is a doctor or health specialist, the way in which data and advice
is displayed is a crucial factor for a given system’s success. The system cannot simply display
the body parameters and their evolution during the day without referring to established norms
for given parameters, for example. Such norms provide a frame of reference – the typical
values for given parameters that most users should be aiming for. The system does not adapt
its advice regarding the particular functioning of wearer’s bodies, or their own unique values,
though some particular data is taken into consideration, such as weight, height and age.
Having displayed collected and processed data in a readable and understandable format,
wearable devices can suggest alterations to activity, such as an increase in the quantity of
activity during the day in order to prevent weight gain, or an increase in the amount of time
spent sleeping because the system detects a lack of sleep in comparison with the norm. Of
course, some people need more sleep than others – and not always in function of their age. By
14
Muhammad Ikram Ashraf, Santtu seppänen, Rafal Sliz, Matti Hämäläinen and Carlos Pomalaza-
Raez.ISMICT’07 – « Implementation issues for wireless medical devices ».

25. itself, the system will adapt the targeted amount of sleep according to the age of the user, but
it will not adapt such targets in relation to the wearer’s genetic makeup, or a specific disease
or injury of the user.
In the following example of the Fitbit dashboard, we can see a display of the results of
health monitoring with a wireless bracelet that records heart rate, temperature, activity, sleep
and so on. We can also see the advice, suggestions or goals, set by the user or by the system
itself.
Figure 3: Health care monitoring dashboard from Fitbit15
.
This data is stored in an online database or cloud. As an introduction to the potential benefits
of using this information beyond their current uses and after being computed, we can imagine
sending this information to a physician or other health professional, who might wish to follow
his or her patients’ health remotely. This might help, for example, in suggesting different
ways of improving patient health at a lower cost, particularly where preventative
considerations are involved. With the rapidly rising cost of healthcare, this type of
communication could result in extraordinary savings for the industry and for consumers.
Remotely stored wearer information could also be used by national governments as statistical
15
https://blog.fitbit.com/wp-content/uploads/2014/07/new-dash-12.jpg

26. data for projects of disease prevention, such as those related to obesity or heart dysfunction.
Finally, drug industry players could also access such data, providing important information
about the market and related trends. This data could help researchers and manufacturers to
determine which types of medication to invest in, and also provide data relating to drug
efficiency. One of the challenges for data analysis is the sheer number of existing systems, the
multiplicity of used languages, the multiplicity of databases, and so on.
Data computing and results display comprise the third aspect of the RPM system, after
wearable and WIMD devices, and data storage and treatment. It is also the least developed
aspect, due to the lack of available data. Analysts agree on the fact that, in the future, data
collection and analysis will be the most profitable element of connected health, from a market
perspective.

27. 3. Understanding the market
The connected health market thus exists at the intersection of quotidian existence and the
internet of things (IoT). The demand of connectivity impacts this market, and the demand is
increasing. Among the many studies having established this demand is the one from the
consulting firm Grand View Research, which has predicted that the global healthcare market
will be valuated at hundreds of billions in less than a decade.16
The different factors
explaining this figure include the constant aging of the international population, the increasing
general demand for connectivity and the prevalence of certain diseases such as diabetes and
obesity.
3.1 Segmented market and trends
As the variety of technologies and applications discussed above suggests, the connected
health market is divided into many sub-categories: wearable devices and the associated
mobile applications, online services, and data management and exploitation. Consumers of
these solutions are, on one side, the society leaders through decisions made by the
government to deploy connected solutions. Health professionals will also use these connected
healthcare solutions to provide remote care. They can decide to use these solutions without
government support, as in the cases of fitness coaches or psychologists, or they can follow the
regulations established by governments which have decided to implement any connected
health solutions. Finally, the patient will become a customer: he or she will become an
empowered user with access to live data and online information, and will be able to choose
what is best for his or her health.
The trends that explain the promise of this market and its many opportunities are
multiple. First there is an increasing demand for connectivity and health applications. A
16
Grand view research - Connected Health And Wellness Devices Market Analysis By Type, By product, By
End-Use And Segment Forecasts To 2024 - August 2016 - https://www.grandviewresearch.com/press-
release/global-connected-health-wellness-devices-market

28. Deloitte report presents several figures relating to technology’s penetration of the healthcare
market, noting that “Top pharma companies have 63% more unique apps in 2014 vs 2013,”
and that “the number of health apps has more than doubled in less than three years to over 100
000.”17
A report from Top Pharma shows that today, “70% of people search for information
online when experiencing new symptoms.”18
Such trends clearly illustrate the increasing
demand for health information and diagnostics. Still in the category of health and mobile
applications, the quantity of downloads has tripled from 2013 to 2014, exceeding nearly seven
million downloads in 2014.19
That the availability of 3G and 4G networks makes the
deployment of connected health anywhere easier is also a point that will facilitate the
deployment and the penetration of connected health within the healthcare market. Clinicians
and care professionals are also demanding remote health control. According to a PwC report
on connected health in the USA, “A 2015 HRI survey, found that most consumers are willing
to share their health data with a doctor (88%), or local health system (78%), but fewer are
willing to share this information with a drug company (53%)”20
Also, “38% of clinicians use
email to stay connected with their chronic disease patients, while 58% of them would be
favorable to the implementation of virtually care.”21
Such trends make it clear that connected health will be a part of healthcare’s new
DNA for many years to come. However, it is difficult to extrapolate the pace of implementing
connected solutions in this market because the latter is so well-installed, a market in which
states have a significant level of participation, and where there is a great heterogeneity when it
comes to the way these different healthcare systems function in particular countries
worldwide.
17 19
Deloitte UK - April 2015 - http://www2.deloitte.com/uk/en/pages/life-sciences-and-
healthcare/articles/connected-health.html -
18
Pharma 3D – « Rewriting the script for marketing in the digital age. Executive digest by Google – McKinsey –
Wharton »
19
Pharma App Benchmarking, research2guidance, 2014
20
PwC Health Research Institute – December 2015 – « Top health industry issue of 2016. Thriving in the New
Health Economy »
21
PwC, « HRI Consumer survey and HRI clinician workforce survey », 2014 and 2015.

29. 3.2 Market worth and predicted growth
According to studies from Deloitte and PwC, “the global mHealth market in 2013 accounted
for $2.4 billion and at an increasing growth rate of 54.9% will be worth $21.5 billion in
2018.”22
The following BCC chart shows the increasing revenue in the market worldwide and
the evolution by geographic area:23
Figure 4: Illustration of mHealth market growth in the world.
This chart covered revenues from connected medical devices, healthcare applications and
related mobile technology. According to the Deloitte study, by 2018 the European mhealth
market is predicted to overtake the North American market, and it will become the world’s
largest mHealth market in the world, also in front of Africa and Asia24
. Another study from
Grand View Research states that “the connected health market will be worth $612 billion in
22
Deloitte center for health solutions – “Connected health. How digital technology is transforming health and
social care.”.
23
PwC and GSMA – « Touching lives through mobile health – assessment of the global market opportunities ».
24
Cited in Deloitte center for health solutions – “Connected health. How digital technology is transforming
health and social care.”

30. 2024.”25
This huge valorization is explained, according to Grand View Research, by the
preference shifts of customers towards healthier lifestyles. This forecast is also linked with
other factors such as early investment in technology and the increasing deployment of
connectivity (with wireless networks, inexpensive smart phones, and so on). Because of the
market’s enormous potential for growth, a strategic battle for market dominance is ongoing.
3.3 Pure player vs. traditional industry
Who are the main players in the rapidly emerging connected health market? On one side there
are the traditional health industrial companies, such as Sanofi, Novartis or GE Health – well-
known healthcare brands which already have a strategic advantage by being representative of
healthcare, and thus well-known to professionals.
On the other side, we find the new big players in the digital market, such as Google,
Facebook and Apple, who already invest in health. These pure players have the advantages of
data capture ability and data science. For instance, Sanofi is one of the biggest companies in
the world, with $38.7 billion in revenues in 2015. The company raised more than $3 billion in
cash from its investors in order to invest in connected health.26
On the other hand, Novartis
created a dedicated fund of $100 million in the San Francisco Bay Area to support innovation
and investment in this sector.27
The startup Fitbit remains the leader in wearable devices for
fitness monitoring. Novartis is one of the actors which has already invested in Fitbit and its
products. This kind of partnership has helped the startup to enjoy all the expertise of Novartis
in the healthcare sciences and also helps the startup to raise funds. The PwC study of
connected health referenced above suggests the importance of future M&A in this market.
25
Sherry James – Connected Health And Wellness Devices Market Analysis By Type - Grand View Research,
Inc.
26
Arthur L – 2016 March 30th – Objectconnecte.com - http://www.objetconnecte.com/sanofi-e-sante-fonds-
3003/.
27
Par Armelle Bohineust - Mis à jour le 13/01/2015 à 17:39 – Lefigaro.fr
http://www.lefigaro.fr/societes/2015/01/13/20005-20150113ARTFIG00123-sante-novartis-mise-sur-les-
technologies-numeriques.php.

31. These mergers, more than having a profit interest in the short run, will “be key to attract
consumers in a consolidated ecosystem” that will lead the connected health market.28
The pure players have incredible projects under research and development in their
boxes. For instance, in 2014 the BBC declared that Google was developing a new sort of
detector that will be able to detect heart attack and cancer in its GoogleX lab.29
Apple has
already launched its Apple Watch which, among many features, monitors the fitness and the
wellness of the person who wears the watch, and displays the results both on the watch and
through a mobile application. According to Grand View Research, Microsoft is dominating
the connected health market. They hold with a few others the biggest part of the investment in
that sector.30
Finally, Facebook is also working on health. The group is developing various
projects with other companies, from genomics to organ and blood donation.31
That said, we
can easily see that all these actors understand the interest to invest in the health market, and in
different segments of the market. It is an exciting race to see who will develop the new top
solution that will disrupt the market, and which leading company will be able to win the first-
move advantage.
28
PwC – 2016 – Top health industry issue of 2016, page 2.
29
http://www.bbc.com/news/technology-29802581.
30
Grand view research - Connected Health And Wellness Devices Market Analysis By Type, By product, By
End-Use And Segment Forecasts To 2024. August 2016.
31
http://medcitynews.com/2016/01/facebook-healthcare-ambitions-4-areas-to-watch-in-2016/.

32. 4. Connected health and perspectives
4.1 Fitness and workout monitoring
Fitness is the first application in which connected devices emerged in the health market.
Many players, such as Apple, Fibit and Garmin, had already commercialized devices to
monitor health. The success of these products can be attributed to the increasing importance
of wellness and fitness in disease prevention. It has been proven that fitness and wellness are
the first steps for disease prevention, as indicated by the National Institutes of Health:
“Studies have shown an association between increased physical activity, reduced
inflammation and body blood pressure.”32
A related study argues that exercise, “produces
both a short-term inflammatory response and a long-term anti-inflammatory effect. Physical
activity reduces inflammation in conjunction with or independent of changes in body weight.
However, the mechanisms linking physical activity to inflammation are unknown.”33
The history of wearable devices begins with the watch: the first wearable device which
provided specific information to a user. The first trace of a wearable device for activity
monitoring arrived in 1965 with the 10,000 Steps/Manko Kei pedometer, which was
developed by Dr. Yoshiro Hatano, a professor at the Kyushu University of Health and
Welfare.34
This technological advance emerged at time from a study on how to fight against
obesity within the country. The first heart rate monitoring system was developed by Polar in
1982, and was called the PE2000 (Appendix, Figure 4) and commercialized at that time as the
most advanced activity recorder for athletes.35
Many years later, more generalist products
32
http://www.ncbi.nlm.nih.gov/pubmed/15209647
http://www.wareable.com/fitness-trackers/the-origins-of-the-fitness-tracker-1234
33
Fairey, Adrian S.; Courneya, Kerry S.; Field, Catherine J.; Mackey, John R. (2002-01-15). "Physical exercise
and immune system function in cancer survivors: a comprehensive review and future directions". Cancer. 94 (2):
539–551, based on wikipedia search.
34
Jon Axworthy – 2016 - http://www.wareable.com/fitness-trackers/the-origins-of-the-fitness-tracker-1234 -
March 9 2016
35
Jon Axworthy – 2016 - http://www.wareable.com/fitness-trackers/the-origins-of-the-fitness-tracker-1234 -
March 9 2016

33. appeared, the development of a new solution called “Nike+iPod fitness tracking device” in
2000, based on the collaboration of two giants in the technology and sporting goods industry,
Apple and Nike (Appendix, Figure 5).36
Other different solutions have followed in the market,
illustrating the increasing demand for fitness monitoring devices. For instance, the company
Underarmour has developed a new complete kit called the Healthbox. This kit is the ultimate
fitness tracking device. It tracks people’s general feeling of well-being, while monitoring
specific body information such as weight, heart rate, temperature, sleep and so on.
The demand for these products is increasing, and in the near future the technology
developed for these fitness activity trackers and monitoring systems will be used to develop
wide-ranging healthcare solutions.
36
A brief history of wearable tech - From pigeons to Pebbles: How wearable tech has evolved over the centuries
- http://www.wareable.com/wearable-tech/a-brief-history-of-wearables - Henry Winchester - May 2015

34. 4.2 Medication analysis
Connected health has potential to analyze the penetration of any medication into the body,
thus determining the efficiency of a specific treatment. If for instance there were a lack of a
given vitamin in your body, a sensor could determine present quantities of this vitamin and,
while the patient take medication, determine if this lack is made up for by the treatment. For
the moment the example of such vitamin sensors is a fiction, but many advances are on their
way, and it is possible that in the not distant future we will see this kind of device
commercialized to improve population nutrition. One example of this forthcoming application
comes from a Massachusetts hospital where doctors implemented the MedSentry system.38
The MedSentry system is developed to monitor drug treatment for heart disease and is also
used as a reminder. There are no sensors installed within the body of the patient, or WIMDs,
but this is certainly a start. The conclusions of the report are positive, although a long list of
points of eligibility make the system difficult to implement. The following is the first
conclusion drawn from the report that shows the promise of this technology: “The MedSentry
medication monitoring system is a promising technology that merits continued development
and evaluation. The MedSentry medication monitoring system may be useful both as a
standalone system for patients with complex medication regimens or used to complement
existing HF telemonitoring interventions. We found significant reductions in risk of all-cause
hospitalization and the number of all-cause length of stay in the intervention group compared
to controls.”39
Some similar systems already exist, or are still in R&D or project development
with startups and are on their way, and it is sure that medication analyses will one day be
introduced into every household, just as computers were a few decades ago. In addition to
determining the efficiency of a specific drug based on the lack detected and parallel adapting
of the quantities, connected health for medication analysis can also remind the patient to take
38
Kamal Jethwani, Massachusetts General Hospital, July 2014
https://clinicaltrials.gov/ct2/show/study/NCT01814696
39
Kamal Jethwani, Massachusetts General Hospital, July 2014
https://clinicaltrials.gov/ct2/show/study/NCT01814696

35. his or her pills with an application installed on the smartphone. Such development projects
and current advances are certain to improve the efficiency of any health care system in terms
of drug spending and also on in terms of patient health, verifying that the administrated dose
of drug is relevant to cure the targeted disease.
4.3 Disease Prevention
Preventive healthcare consists of measures taken for disease prevention, as opposed to a
disease treatment. Considering that, globally and according to research conducted by the
Disease Control Priorities Network (DCPN) and the World Health Organization (WHO) more
than thirty million people died during the year 2001 from preventable death, we can imagine
if these parameters leading to death had been monitored, rates of mortality could have been
limited.40
The following chart provides a list, organized by cause, of the number of
preventable deaths per year:
41
Figure 6: Leading causes of preventable death worldwide as of the year 2001.
Connected health technology is capable of minimizing preventable mortality by monitoring
and following the patient’s lifestyle. If for instance, a patient who suffers from hypertension
40
« Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data »
and http://globalhealth.washington.edu/disease-control-priorities-network-dcpn
41
Chart extract from https://en.wikipedia.org/wiki/Preventable_causes_of_death

36. has a connected system which both reminds him or her to take the treatment, while also
sending emergency signals when constant trends show a risk of heart failure, this would
increase the chances saving lives and may also decrease the cost of caring for such patients.
Daily recording of all parameters will obviously impact the appearance of any disease, while
computing all this information can make possible signaling any trends or habits that increase
risk. For instance, we know that obesity can lead to heart disease. Such systems can record a
patient’s weight evolution, and his or her activity and nutrition, and warn the patient if there is
a bad trend which is computed by the system and which may increase the risk of obesity and
therefore the risk of heart attack. If we consider the possibility of collecting information such
as localization, health data and so on, from many users, such technology could also
revolutionize the study of the development of specific deceases in particular geographic areas,
and therefore help to prevent their evolution.

37. 5. Connected health in public organizations
Integrating connected health and public health would have significant consequences. As
discussed above, the health market has a close bond with government and insurance
companies in many countries. Medical devices and drugs are developed and bought by both
governmental and end users. The market could see a strong increase if national governments
decide to deploy connected solutions in hospitals. Insurance companies also have a strong
bond with the market and will be impacted by any large scale deployments. Moreover, the
risks of working for government are less significant than those associated with working for
other industries, particularly in developed nations. We can imagine that investment in markets
where established state governments are engaged would be less risky. However, there are
already strong traditions of interaction between public health and healthcare, and the
acceptance of connected health into these fields will take time. Several factors will impact the
timing of the deployment of connected health. These factors – both challenges and future
benefits of connected healthcare in public health and government organization – are
developed in the next section.
5.1. Benefits and issues
Healthcare in developed countries plays one of the most significant roles in terms of
employment and GDP. For instance, Healthcare in the US economy is one of the largest
sectors. “It accounts for 17 percent of the national GDP and employ 11 percent of the country
workers”.42
“The cost of health in the US has been increasing at a constant pace over the last
decade, at a rate of 5% and account for 5.5% of increase in 2014”.43
This trend is similar in
nearly every developed country, as the cost of healthcare increases. Populations worldwide
42
McKinsey Global Institue – Big data : The next frontier for innovation, competition, and productivity.
43
Louise Radnofsky, Wall Street Journal – « U.S. Health-Spending Growth Jumped to 5.5% in 2014 » -
http://www.wsj.com/articles/u-s-health-spending-growth-jumped-to-5-5-in-2014-1438114020

38. are getting older and the appearance of chronic diseases is increasing at a significant pace,
two of the explanations for the rapidly increasing cost of healthcare.
That shown, we can easily understand the benefit to any government of investing in
solutions which would decrease the cost of healthcare. Connected healthcare is one of these
solutions. One report from Deloitte explains that implementing only remote patient
monitoring (RPM) technology – which, as outlined above, consists in collecting data from
patients outside of conventional clinics and transmitting it to another location where the
health professionals can remotely manage this information – can have tremendous benefits in
terms of cost. The report estimates that this technology, implemented only in the US, “could
save up to $200 billion over the next twenty-five years and decrease by 25% the cost of senior
care in rural zones”.44
Further, GSMA and PwC, reporting on mobile health, indicate that “in
2017 mhealth could potentially save $99 billion in healthcare costs in the EU”.45
The cost efficiency of connected health is clear, but the time factor has potential to
trouble this data. It is difficult to assess the amount of time necessary to develop and deploy
such solutions, particularly at the government level, as well as the required investment to roll
out such solutions in the market. One of the other advantages of connected solutions over
traditional healthcare institutions is the ease of use of connected health for healthcare care
professionals. Connected health can be applied at any stage of the patient’s journey, from
preventive care to wellness, through diagnosis and treatment decision. As mentioned above,
such systems can also be advantageous for planning drug development. They help, by
collecting and computing large amounts of data from drug users, to have a better
understanding of the effect of particular drugs on specific populations.
Connected health is also an opportunity for patient empowerment. The patient is not
driven by the system anymore as he or she has access to his or her own data, and can compare
it with random data from all over the city, the country and so on. Connected health thus shifts
44
Deloitte – Accelerating the adoption of connected health
45
GSMA and PwC – Touching lives through mobile health – Assessment of the global market opportunity –
february 2012.

39. the balance of powers from the public to the private sphere. By monitoring their own health,
patients could have the power to determine when it was necessary to organize an appointment
with physicians only when data reflects potential problems. The notion of necessary
appointments is significant. According to an article from LePoint, “$40 billion are wasted
every year online in France” by physician consultations with no real medical purpose.46
And
this cost is endorsed by government and health insurance companies. The data captured
through connected health will also have a benefit for public institutions. Complete and live
health data from the population makes it possible to understand patient behavior and thus
organize the system efficiently.
On the other hand, there are many issues or obstacles that could slow down connected
health deployment. First of all, the lack of evidence of cost effectiveness. If strong evidence
had been brought to the table, showing that such solutions are cost effective and that the
return on investment is validated without any considerable risks, many countries and
governments would have deployed these solutions already. However, no country has today
implemented a complete solution of connected health and no wide-ranging evidence exists
that we can refer to. The difficulties evaluating the cost of the potential risks associated with
connected health will also slow down its deployment. Implementing these solutions in a given
national healthcare system will mean dealing with the heterogeneity of information, from
heart rate statistics to drug efficiency. Also at play is the necessity of an open market where
many devices would be commercialized, giving rise to the need for a common language in
terms of data. Other questions: Who will pay for the system and infrastructure required? Will
the state provide the equipment or will the patient have to buy it? And what about the
inequality of patient access to technology? How would elderly people be able to understand
the functioning of such systems (“What can I do with this? Can I trust this equipment? Is my
46
Anne Jeanblanc – Lepoint.fr – February 2014 – « Stop aux actes médicaux inutiles en France » -
http://www.lepoint.fr/editos-du-point/anne-jeanblanc/stop-aux-actes-medicaux-inutiles-en-france-14-02-2013-
1627370_57.php

40. data safe – who will have access?”)? Such questions won’t be restricted to the elderly, of
course, but will certainly occur to all users of a newly deployed connected health framework.
Some healthcare professionals also fear connected health because they are aware that
their jobs could disappear with the deployment of this technology. As mentioned above, if the
function of any physician is broadly based upon collected “intra” information (heart rate,
blood pressure, temperature) and “extra” data (feeling, pain, emotions), leading to diagnosis,
treatment and cure – why couldn’t connected solutions such as those we’ve been discussing
be able to provide the same diagnostic? This justified fear will also contribute to frustrating
the rapid deployment of connected solutions. Finally, a general lack of trust in IoT solutions
remains in many markets. Sceptics will demand, “Can I trust this system? What will they do
with my information? Is it safe? Will my information go public?” Current standards for data
protection and security have done little to reassure such sceptics, meaning that a lot of work
remains to be done before connected health is fully embraced on a social level.
5.2. Cost effectiveness
The worldwide population is increasingly aging, global resources are more and more rare and
costly, and medical procedures within the current system are intense, time-consuming and
thus expensive. The healthcare cost for government is increasing and the need of cost-
efficient innovation is high. Our supposition is that connected health is the only known
solution that could create a cost-effective healthcare system around the world. The cost
decreases for any country which implements connected health via mHealth, RPM or
telemedicine, would be in the billions. A recent study from Deloitte demonstrates this cost-
efficiency and savings. As mentioned in the previous section, “RPM technology could
decrease the cost of healthcare by $200 billion, and using RPM in rural areas can decrease the
cost of care in such areas by 25%.”47
The same study also reveals the advantages of using
47
Deloitte – 2015 – Accelerating the adoption of connected health

41. telehealth, only applied to patients with heart disease. Its use, the study claims, “could help
save $5 to $10 billion every year in the United States alone.”48
Similar trends are certain to
effect the areas of preventive and emergency care. According to a report of the McKinsey
Global Institute, “the US can capture nearly $300 billion of potential annual value by
implementing connected health and big data in a broad way.”49
48
Deloitte – 2015 – Accelerating the adoption of connected health
49
McKinsey Global Institue – Big data : The next frontier for innovation, competition, and productivity

42. 6. Big data and connected health
6.1 What is big data?
Big data is a field related to massive data treatment. The objective is to extract and capture
pertinent information from large-scale batches of data. This technique is possible because of
the explosion of computer capabilities in terms of speed, and also because of the massive
quantity of data nowadays exchanged. The market possibilities of this new technology are
endless, as one of the head advisors at Microsoft claims: “Data are becoming the new raw
material of business.”50
As Bernard Marr writes, “The quantity of data is increasing everyday
and is changing the business landscape. For instance, our current digital universe accounts for
4.4 zettabytes (which corresponds to 4.4 trillion gigabytes).”51
By 2020, the quantity of
accumulated data will equal 44 zettabytes, ten times the quantity of accumulated data from
the beginnings of the internet. Continuing, Marr observes that, “In 2015, a staggering 1
trillion photos will be taken and billions of them will be shared online.” Because only 0.5% of
all existing data is currently exploited or analyzed, it’s not hard to understand why, by Marr’s
estimate, “73% of all corporate organizations have already invested or plan on investing in
big data.”52
Big data is often related to different notions such as data mining or deep learning, but,
as with connected health, the definitions are not always clear – even for technical and IT
experts. In general, we could say that data mining is the art of extracting, from large bunches
of data, pertinent information that is useful for research, business and decision making. Data
mining experts are multi-skilled experts who are essentially trained to play with data.
Compared with software developers, for example, they are not simply experts in one specific
field. Data scientists who do data mining have to master mathematics and statistics, and have
50
Craig Mundie, Senior Advisor to the CEO at Microsoft
51
Bernard Marr - Big Data: 20 Mind-Boggling Facts Everyone Must Read – 2015 September 30th
http://www.forbes.com/sites/bernardmarr/2015/09/30/big-data-20-mind-boggling-facts-everyone-must-
read/#51e201a66c1d
52
Bernard Marr - Big Data: 20 Mind-Boggling Facts Everyone Must Read – 2015 September 30th
http://www.forbes.com/sites/bernardmarr/2015/09/30/big-data-20-mind-boggling-facts-everyone-must-
read/#51e201a66c1d

43. to understand and transform problematics into a data mining workflows. They must master
ongoing developments in computer sciences, as every day new advances and techniques are
introduced for extracting information from large-scale bunches of information. Deep learning
is different from data mining. Deep learning characterizes the capabilities of computers to
adapt and evolve, according to defined rules, while exposed to a specific workflow of data.
This science has seen its most evolved application using neural system functioning. It is after
observations made upon the neural system functioning from the human brain and from
animals, that these applications have been developed. The aim is to create smart computers,
capable of adapting to various environments based on live data.
Big data is already used in many fields, such as marketing (in order to achieve a better
understanding of customer expectations), finance (for market and trends analyses), or in
businesses (for process optimization). Big data is presented as the new competitive advantage
within companies and already brings many advantages. For instance, Macy’s, one of the
largest retailers in the United States, uses big data analytics for its online retail platform. By
using the data and segmenting the customers, they have reached an improvement in customer
subscriptions, “reducing by 20% the rate of unsubscribing by targeting customers through
data analytics.”53
Another example of big data benefits can be found in automobile
manufacturing and development at Volvo. The company has invested in big data since 2007,
resulting in many advantages including manufacturing improvement, cost reduction, and
marketing analysis. But the brand wants to go further with the data. As 90% of the
manufactured cars use connected technologies for safety and warning reasons, the brand
wants to collect and use more data: they will soon collect data from nearly every element of
car functioning, as well as data from the driver, and especially his or her behavior.54
Finally,
as a final example of big data application: the cross-selling robot used by Amazon. Amazon,
which is one of the leaders in online retail, uses collaborative filtering to generate its
53
http://www.centrodeinnovacionbbva.com/en/news/practical-examples-big-data-use
54
http://www.usine-digitale.fr/article/volvo-investit-dans-le-big-data-pour-simplifier-l-utilisation-de-ses-
voitures.N357716

44. obligatory “you-might-also be-interested-in” product pages. Amazon reports that 30% of its
sales come from the recommendation engine, and that the company generated $107 billion in
revenues in 2015.55
In light of these examples, we can easily imagine the enormous potential
that big data represents for the healthcare industry.
6.2 Challenges and opportunities in the healthcare market
It is clear that big data can have tremendously beneficial impacts upon today’s healthcare
system, a claim supported by many recent studies and trends. The Department of Veteran’s
Affairs in the United States has implemented RPM technology and other connected health
solutions, thus “achieving greater rates of evidence-based drug therapy.”56
Other examples
exist around the world: in Italy, in United Kingdom or California, where the applications of
big data to healthcare are relevant.
Within the healthcare market, especially where there is wide internet access, people
are increasingly turning from patients to customers. Due to the increasing availability of
information about health and related treatments, patients are taking the lead. They expect
more from the healthcare system, and their attitude has turned into a consumerist attitude. For
instance, the website doctissimo.fr is the most frequented health website in France, with “nine
million unique visitors each month.”57
According to the Journal Dunet, “One out of every five
people in France visited the website in December 2011” – and the figures keep increasing.58
People who are visiting this website seek information about health, disease, related symptoms
and treatment. The website is of course not the only way to connect health-related information
with seeker. Complementing such websites are social networks such as Facebook or Twitter.
55
McKinsey Global Institute – June 2011 – Big data, the next frontier for innovation, competition and
productivity.
56
McKinsey Global Institute – June 2011 – Big data, the next frontier for innovation, competition and
productivity, page 41.
57
http://www.lefigaro.fr/medias/2013/01/09/20004-20130109ARTFIG00599-le-site-doctissimo-lance-un-
mensuel-papier.php
58
http://www.journaldunet.com/ebusiness/le-net/audience-sites-sante/doctissimo.shtml

45. The patient also seeks information about the risk of given treatments and alternative options,
making the patient a proactive engine in his or her own healthcare. These information seekers
represent the large band of the customers between healthy lifestyle addicts and the chronically
monitored. Big data will have an increasing impact for information seekers as the quantity of
shared information increases.
Another challenge of big data applied connected health is the deep learning of IT
systems: these polymorph algorithms which “learn how to do something” according to
information and data available. For instance, deep learning makes it possible for computers to
colorize black and white images, to add sound to silent movies or to classify objects.59
Deep
learning can also recognize facial emotion or highly deformed objects.60
This deep learning
applied to the healthcare and monitoring uses recognition patterns to predict risky behaviors
of certain people, and also to create corresponding diagnoses. For instance, the Massachusetts
General Hospital announced that they will implement a supercomputer that uses deep learning
to improve their functioning. It will provide an extraordinary asset in diagnosis while sharing
information related to each patient’s symptoms.61
The most advanced applications of deep
learning in this area are linked with Alzheimer’s disease, the challenges for facilities and the
prediction of disease evolution.
In connection with disease prevention, big data is able to act on modifiable risk factors
that contribute to a large proportion of chronic diseases. Physical activities, tabacco, nutrition,
and other factors can be detected. Two main elements are necessary to leverage big data in
terms of disease prevention.62
The first involves capturing within the population the risky
factors that may lead to the appearance of disease. This includes qualification of the risks and
59
https://www.quora.com/What-are-the-practical-applications-of-deep-learning-What-are-all-the-major-areas-
fields
60
« EmoNets: Multimodal deep learning approaches for emotion recognition in video » - Kahou, S. E.,
Bouthillier, X., Lamblin, P., Gulcehre, C., Michalski, V., Konda (2015).
« Pose and category recognition of highly deformable objects using deep learning. In Advanced Robotics »
(ICAR), 2015
61
https://insights.samsung.com/2016/07/12/deep-learning-the-next-step-in-applied-healthcare-data/
62
Meredith A. Barrett, Olivier Humblet, Robert A. Hiatt and Nancy E. Alder « Big data and disease prevention,
from quantified seft to quantified communities » – September 2013

46. also quantification. Quantification is highly important because it is linked with probability of
occurrence. This quantification data has to be correlated with individual characteristics in
order to be relevant. Meaning that a certain quantity of exposure to a certain risk may lead to
a different probability of appearance depending on the person who is exposed to the risk. For
instance, the risk of death when drinking alcohol is more significant when the concerned
person suffers kidney disease than when he does not. The element of leveraging big data for
disease prevention involves detecting high-risk behavior and exposure. When a factor is set as
a risk factor and statistical figures are associated, in order to prevent disease one needs to act
when the person is exposed to the risk. This means capturing the risk quickly. For instance,
we saw in the section 4.3 that the riskiest factor of preventable death is hypertension. Big data
will help to prevent the appearance of death associated with hypertension only if big data first
knows that hypertension is a risk factor, and second, if we capture live information about a
patient’s heart to allow big data to compute and communicate regarding the situation when
some risks are present.
6.3 Data privacy and legal issues
All of this computed data is information extracted from the physiology and activity of human
beings. Most of the time, this information is private. The exploitation of this information is
regulated by the law, however, most people don’t trust the security of their online
information. According to an Accenture study about people and their digital trust, “54% of
digital consumers are cautious about the information they share due to lack of confidence in
the online security that protects their personal data.”63
Big data in the healthcare industry
represents both large risks of hacking and data violation and significant challenges in term of
data privacy. At the same time, according to a PwC report from fall 2015, “88% of patients
63
Robin Murdoch, Paul Johnson – « Digital trust in the Iot era » – Accenture 2015 report

47. are willing to share their information with doctors and 78% with the local health system.”64
Medical privacy is crucial in order to protect people’s personal health lives from public
judgment or aggression. Health is one of the most important parts of one’s private life. The
data security associated with healthcare is a huge challenge to overcome before massively
deploying connected health.
For instance, in France the CNIL (Conseil National de l’Informatique et des Libertés)
is in charge of data transfer regulation and security in France. The CNIL has to fight against
privacy violations and must create the rules necessary to protect online users. Companies such
as Google and Facebook agree to respect the rules that regulate the uses of data by companies.
Still, this doesn’t prevent cases between these companies and the government. Take, for
instance, the case where the CNIL attacked google and ordered the company to apply
delisting on all domain names of the search engine. Here, Google was forced to modify many
things according to data privacy, but the battle is not over and Google still has modifications
to make, according to the Court of Justice of the European Union decision.65
We can easily
understand why Google defended its data, as nowadays the market valorization of IT
companies relies upon the quantity of available data, especially data about customers. A lot of
work remains on data privacy within countries where, according to the results of a study from
the United Nations conference on trade and development, only 55% of investigated countries
have implemented a legislation, 18% have a draft of legislation and 13% have no draft of
legislation – remaining countries have no data available.66
Governments are trying to protect
users from data privacy violation, but most of the time even in the most highly developed
countries, big players are one step ahead of the government in terms of regulation. And in
many countries, no regulations even exist, which exposes the population to violations of
privacy that could originate from anywhere in the world.
64
PwC report - Top health industry issues of 2016 - Thriving in the New Health Economy Chapter 8
65
« CNIL orders Google to apply delisting on all domain names of the search engine » - 12 juin 2015 -
https://www.cnil.fr/fr/node/15790
66
Data protection regulations and international data flows : Implication for trade and development – 2016 –
United nation conference on trade and development.

48. Google, Facebook, IBM and Apple are the companies which capture the most
significant quantities of data in the world. But what are they doing with our data? There are
many discussions about who owns the data on Facebook or Google. The question is still open,
but one thing is sure: free websites have to find a way to create value. Facebook sells targeted
advertising to companies. According to your data and your behavior, Facebook will propose
targeted advertisements that are sold to companies. This is one of the many ways the company
creates revenue. Google is doing the same but on a larger scale. They create a specific answer
or list of answers for specific Google searches (the results of the search engine based on
relevance). Data and trends are thus monetized, and companies which seek to advertise and to
promote their products in search results after a specific key word searches will have to pay.
The stakes in the data industry are enormous, and as we now, it is only just the beginning:
again, worldwide, only 0.5% of data is used for big data analyses. We can easily imagine the
value of the worldwide population’s health data if captured by a private company. The danger
here is how such market forces will affect the role of the patient in relation to his or her
treatment and data. The following French expression captures well what is at stake in data
privacy: “Si c’est gratuit, c’est que vous êtes le produit” (If it’s free, it’s because you are the
product).67
67
Guilhem Fouetillou , directeur général de Linkfluence http://www.sciencespo.fr/edc/fr/blog/si-c-est-gratuit-
vous-etes-le-produit

49. 7. Twenty-first century healthcare: the over-connected period
This chapter is composed of two different parts. The first part is a fiction describing three
different people living in the late twenty-first century. In the context of this fictional account,
connected health has been largely deployed within the national healthcare system. We will
examing all the advantages of wearing non obstructive monitoring devices and being
connected to a global health IT system. The second section of this chapter aims to describe
the innovation opportunities existing within the connected health market, discussing existing
launched startups and financial projections.
7.1 Forecast for human health in the next century
John is 65 years old. He lives in the south of France, where he is enjoying his retirement from
the industry back in the years where he was managing many manufacturing teams for the
automotive industry. John was diagnosed with heart deficiency three years ago, just one year
after celebrating his retirement. His doctor at that time suggested the necessity of using a
remote health monitoring WIMD. The advantage for this system is that the doctor can
remotely control the evolution of the electro cardiogram, and if necessary launch a new heart
procedure which consists in creating a favorable context to save John’s life depending on the
situation of his heart. If the emergency is low, the system, after validation by the doctor, will
send an emergency message and email to the patient saying that he has to be present at a
specific time at the nearest hospital, where the appointment is already set. If the heart
situation is an absolute emergency, such as cardiac arrest, the system will automatically send,
without the need of the doctor’s validation, a message to the emergency services describing
the situation. John at that time accepted using this system. It entailed having a surgery to
install the microsystem within the body. After that, his heart was connected with the
international heart cloud. All of John’s heart data was stored and compared with people using
the same system. This large-scale database is used by the international health organization,

50. where specialists deploy data in their study the population’s heart health and diseases
evolution. This system had no cost for John, as it was covered by the national health system.
Fifteen years ago, evidence of the cost efficiency and risk reduction in terms of the security of
this system was brought to the table, encouraging the government to accept its deployment
within the system, resulting in enormous increases in cost efficiency for health insurance.
Sonia is 43 years old and has been married to Peter for seventeen years. They are the
proud parents of three beautiful children: 11, 13 and 16 years old. Sonia was diagnosed as
insulin dependent two years ago. At that time, she decided with her husband to connect her
family to the international health cloud. That solution consisted in implanting a non-invasive
microsystem within the body of each member of the family, thus connecting their health and
the wellness data to the international health cloud. Through a specific application, this allows
the remote monitoring of Sonia’s health, as well as that of her family. In Sonia’s case, she
uses a blood sugar sensor to prevent dangerous lacks of sugar within the body due to its
insulin dependency. The application can automatically send information to the family doctor,
or an emergency call to appropriate urgent care services if body signal is negative. Sonia has
never physically met her doctor. The global health care system automatically assigned a
doctor to Sonia according to the kind of health issue she was facing. Advice is offered
through an online meeting when necessary. Sonia also subscribed to the remote family control
option. This option allows her to monitor and impact her children’s health and wellness.
Nutrition, weight, exercise and much other health information is available, allowing Sonia to
look after her children’s health remotely.
Finally, Rose is a 24-year-old Italian student, who dreams of studying data science
applied to health industry. Many devices exist, each adapted to specific diseases, and all the
information is connected by the World Health Organization, which deals with data and
extracts live trends relating to disease propagation. In order to live close to her dream job
field, she decided to be connected to the system and to see in her daily life where it can be

51. optimized. She subscribed to the system of remote health control. She had to get a surgery in
order to be connected, and had to follow online tutorials on how to use the connected system,
while a doctor also coaches her regarding how to use the system and describe all its
possibilities.
7.2 Opportunities in the health care market
The investment of startups in the digital health industry is rapidly increasing. “At $1 billion in
2010, startup investment will account for $4.5 billion at the end of 2015 only incluings U.S.
deals over $2M.”68
This is certainly a promising market, in which many brilliant startups have
evolved. A protheses manufacturer, Project IO has decreased by 100 times the cost of any
prosthesis.69
Medisafe is a new solution that will help medication tracking.70
Medwand helps
telemedicine, taking basic vitals and transfering them through Bluetooth connectivity. The
product “captures vital clinical data in a private video consultation with your doctor, wherever
you may be.”71
Crowmedis an online platform for people seeking diagnoses on specific
uncured diseases. Its mission is “to solve every medical mystery in the world. We've already
helped over 1,000 patients.”72
And Skinvision is helping to prevent melanoma, the most
dangerous type of skin cancer.73
Other innovations are on their way, such as Middleware, which is a technology that
collects health data in a unique location with a single format. Innovative sensor development
will certainly change the market as new features appear, such as biometric sensors and skin
patches, detecting Parkinsons disease or epileptic activity. Ingestible sensors are under
development, and may help medication analyses, determining if it is necessary for patients to
70 https://rockhealth.com/reports/digital-health-funding-2015-year-in-review/ Rock - Health Funding Database
Note: Only includes U.S. deals >$2M; data through December 8, 2015
69
http://www.cio.com/article/2926436/healthcare/10-startups-that-are-disrupting-healthcare-it.html#slide2 - 10
startups that are disrupting healthcare IT – Sarah K. White
70
http://www.medisafe.com/
71
http://medwand.com/index.html
72
https://www.crowdmed.com/
73
https://skinvision.com/ - http://www.skincancer.org/skin-cancer-information/melanoma

52. take their medication. Patches are being developed which monitor children’s temperatures
twenty-four hour per day and can send alerts to parents. The challenge remains to adapt each
system to local regulation, while creating specific and targeted connected health solutions.

53. Conclusion
Connected health is the future of healthcare. Through the centuries, we have seen that the
keys to caring for human health are related to having enough experience and information to
care pertinently. The more data we have about health, wellness, disease and so on, the better it
will be for patients. Connected healthcare is real, and it is one of the most promising
technologies that will drive the necessary evolution of the healthcare industry. The health
system has an enormous fiscal impact on society, and the need for cost efficiency is pushing
the healthcare system towards the IoT and connectivity. Despite the fact that governmental
evolution takes more time than growth in private society and industry, governments have to
drive this change as quickly as possible while managing the risks, in particular for security
and data. The population is aging, more and more people will ask for help from the health
system, the available resources are becoming outdated and expensive. Cost effective solutions
have to arise quickly. The problem is, quite simply, that health is a big deal. Here, we are not
dealing with online fashion retail or Pokémon chasing. National health is one of the most
important subjects served and protected by legislation and interior supervision. The
introduction of new technologies, despite their obvious economic advantages, will not take
place until many associated issues and challenges begin to be sorted out and solved. Data
security is one of the major issues, and until clear and unified solutions are found and
commercialized, no connected care will be implemented on a national scale.
The current development of wellness solutions is a sort of debugging of connected
solutions that may later be applied to national healthcare. The impacts of connected health are
global, and will touch the entire industry, from government to tech and insurance companies,
from healthcare professionals to the patient. Many jobs will face mutations, and this will also
slow the deployment of connected health. We can see that there is not a clear barrier between
wellness and health. Currently the main trend that will push connected health within the

54. market is wellness monitoring. A clear boom is on its way. A market that was estimated at $1
million in 2008 and which is now forecast to be worth more than $612 million in 2024 – the
same scenario which applied to the social network industry or online activity. Facebook was
created in 2004 and was the first online social network. Today, in 2016, twelve years after its
creation, Facebook is valuated at around $200 billion and could one day be worth $1 trillion.
The same growth scenario can be expected within the healthcare market with the appearance
of connected devices and wearables, and especially the related data that gives the IT industry
most of its value. Big data is the most promising field in which huge value will be created and
may be captured by both the market and the healthcare industry with increasing cost
efficiency.
Enormous challenges await the connected health industry and many advances are to
come in the near future. The IT treatment of data is one of the most challenging subjects
involved, and its evolution will determine the way we make decisions and the way we advise
in every part of the industry. There is tremendous opportunity in the connected health industry
for many actors, from drug manufacturers and developers, to hardware device manufacturers
and the healthcare industry. The connected health mutation will be useful as it will change
forever the DNA of the healthcare system, and while this change will be bring with it many
challenges and will take a relatively long time to implement, in the final analysis it will be a
boon for human health and national economies

55. Appendix:
Figure 1: Sugarbeat patch 74
Figure 2: Smartcap75
Figure 3: Fitbit Surge 76
74
Picture from http://www.nemauramedical.com/
75
Picture from http://www.smartcaptech.com/
76
Picture from google image search

56. Figure 4: Heart rate monitoring wrist watch developed by Polar.
Figure 5: Fitness tracker from the collaboration of Nike and Apple77
77
Source: http://www.wareable.com/wearable-tech/a-brief-history-of-wearables

57. BIBLIOGRAPHY:
1. Google image search – Iconarchive.com - http://www.iconarchive.com/tag/doctor
2. https://blog.fitbit.com/wp-content/uploads/2014/07/new-dash-12.jpg
3. Dr Nouredine AYADI - Cours d’histoire de la medecine –Université de Sfax –– Année universitaire
2007 -2008 – Chapter II B
http://www.dematice.org/ressources/PCEM1/psychiatrie/P1_psy_007/co/Histoire_medecine.html
4. Ibid., Chapter II C.
5. Ibid., Chapter VIII.
6. M. Dupont, C. Esper, C. Paire, « Droit hospitalier », 4e
éd., 2003, no
10
7. Google image search – Iconarchive.com - http://www.iconarchive.com/tag/doctor
8 Nedra B. Belloc – « Relationship of health practices and mortality » - Human Population
Laboratory, California State Department of Public Health, Berkeley, California 94704, USA, March
1973
9. Steven Allender – « Understanding participation in sport and physical activity among children and
adults: a review of qualitative studies », Public Health, University of Oxford, Rosemary Rue Building,
Old Road Campus, Oxford OX3 7LF, UK
10. UCD Dublin – « What is connected health ? » - http://www.connectedhealthireland.com/what-is-
connected-health/
11. Luke Timmerman, December 5th, 2011, « Steve Jobs’s Dying Realization About Biology and
Technology » - http://www.xconomy.com/national/2011/12/05/steve-jobss-dying-realization-about-
biology-and-technology/#
12. Google image search – W.ME wearable technology - http://webdesobjets.fr/objets-connectes/wme-
bracelet-bien-etre/wme_bracelet-connecte_power/
13. Smartcap - http://www.smartcaptech.com/our-product/
14. 2016 Fitbit, Inc - https://www.fitbit.com/fr/surge
15. 2016 Nemaura.- http://www.nemauramedical.com/sugarbeat
16. Muhammad Ikram Ashraf, Santtu seppänen, Rafal Sliz, Matti Hämäläinen and Carlos Pomalaza-
Raez.ISMICT’07 – « Implementation issues for wireless medical devices »
17. https://blog.fitbit.com/wp-content/uploads/2014/07/new-dash-12.jpg
18. Grand view research - Connected Health And Wellness Devices Market Analysis By Type, By
product, By End-Use And Segment Forecasts To 2024 - August 2016 -
https://www.grandviewresearch.com/press-release/global-connected-health-wellness-devices-market
19. Deloitte UK - April 2015 - http://www2.deloitte.com/uk/en/pages/life-sciences-and-
healthcare/articles/connected-health.html
20. Pharma 3D – « Rewriting the script for marketing in the digital age. Executive digest by Google –
McKinsey – Wharton »

58. 21. Pharma App Benchmarking, research2guidance, 2014
22. PwC Health Research Institute – December 2015 – « Top health industry issue of 2016. Thriving
in the New Health Economy »
23. PwC, « HRI Consumer survey and HRI clinician workforce survey », 2014 and 2015.
24. Deloitte center for health solutions – “Connected health. How digital technology is transforming
health and social care.”
25. PwC and GSMA – « Touching lives through mobile health – assessment of the global market
opportunities »
26. Cited in Deloitte center for health solutions – “Connected health. How digital technology is
transforming health and social care.”
27. Sherry James – Connected Health And Wellness Devices Market Analysis By Type - Grand View
Research, Inc.
28. Arthur L – 2016 March 30th – Objectconnecte.com - http://www.objetconnecte.com/sanofi-e-
sante-fonds-3003/
29. Par Armelle Bohineust - Mis à jour le 13/01/2015 à 17:39 – Lefigaro.fr
http://www.lefigaro.fr/societes/2015/01/13/20005-20150113ARTFIG00123-sante-novartis-mise-sur-
les-technologies-numeriques.php.
30. PwC – 2016 – Top health industry issue of 2016, page 2
31. http://www.bbc.com/news/technology-29802581.
32. Grand view research - Connected Health And Wellness Devices Market Analysis By Type, By
product, By End-Use And Segment Forecasts To 2024. August 2016
33. http://medcitynews.com/2016/01/facebook-healthcare-ambitions-4-areas-to-watch-in-2016/.
34. http://www.ncbi.nlm.nih.gov/pubmed/15209647
http://www.wareable.com/fitness-trackers/the-origins-of-the-fitness-tracker-1234
35. Fairey, Adrian S.; Courneya, Kerry S.; Field, Catherine J.; Mackey, John R. (2002-01-15).
"Physical exercise and immune system function in cancer survivors: a comprehensive review and
future directions". Cancer. 94 (2): 539–551, based on wikipedia search.
36. Jon Axworthy – 2016 - http://www.wareable.com/fitness-trackers/the-origins-of-the-fitness-
tracker-1234 - March 9 2016
37. Jon Axworthy – 2016 - http://www.wareable.com/fitness-trackers/the-origins-of-the-fitness-
tracker-1234 - March 9 2016
38. A brief history of wearable tech - From pigeons to Pebbles: How wearable tech has evolved over
the centuries - http://www.wareable.com/wearable-tech/a-brief-history-of-wearables - Henry
Winchester - May 2015
39. Kamal Jethwani, Massachusetts General Hospital, July 2014
https://clinicaltrials.gov/ct2/show/study/NCT01814696
40. Kamal Jethwani, Massachusetts General Hospital, July 2014
https://clinicaltrials.gov/ct2/show/study/NCT01814696

59. 42. « Global and regional burden of disease and risk factors, 2001: systematic analysis of population
health data » and http://globalhealth.washington.edu/disease-control-priorities-network-dcpn
43. Chart extract from https://en.wikipedia.org/wiki/Preventable_causes_of_death
44. McKinsey Global Institue – Big data : The next frontier for innovation, competition, and
productivity.
45. Louise Radnofsky, Wall Street Journal – « U.S. Health-Spending Growth Jumped to 5.5% in
2014 » - http://www.wsj.com/articles/u-s-health-spending-growth-jumped-to-5-5-in-2014-1438114020
46. Deloitte – Accelerating the adoption of connected health
47. GSMA and PwC – Touching lives through mobile health – Assessment of the global market
opportunity – february 2012.
48. Anne Jeanblanc – Lepoint.fr – February 2014 – « Stop aux actes médicaux inutiles en France » -
http://www.lepoint.fr/editos-du-point/anne-jeanblanc/stop-aux-actes-medicaux-inutiles-en-france-14-
02-2013-1627370_57.php
49. Deloitte – 2015 – Accelerating the adoption of connected health
50. Deloitte – 2015 – Accelerating the adoption of connected health
51. McKinsey Global Institue – Big data : The next frontier for innovation, competition, and
productivity
52. Craig Mundie, Senior Advisor to the CEO at Microsoft
53. Bernard Marr - Big Data: 20 Mind-Boggling Facts Everyone Must Read – 2015 September 30th
http://www.forbes.com/sites/bernardmarr/2015/09/30/big-data-20-mind-boggling-facts-everyone-
must-read/#51e201a66c1d
54. Bernard Marr - Big Data: 20 Mind-Boggling Facts Everyone Must Read – 2015 September 30th
http://www.forbes.com/sites/bernardmarr/2015/09/30/big-data-20-mind-boggling-facts-everyone-
must-read/#51e201a66c1d
55. http://www.centrodeinnovacionbbva.com/en/news/practical-examples-big-data-use
56. http://www.usine-digitale.fr/article/volvo-investit-dans-le-big-data-pour-simplifier-l-utilisation-de-
ses-voitures.N357716
57. McKinsey Global Institute – June 2011 – Big data, the next frontier for innovation, competition
and productivity.
58. McKinsey Global Institute – June 2011 – Big data, the next frontier for innovation, competition
and productivity, page 41.
59. http://www.lefigaro.fr/medias/2013/01/09/20004-20130109ARTFIG00599-le-site-doctissimo-
lance-un-mensuel-papier.php
60. http://www.journaldunet.com/ebusiness/le-net/audience-sites-sante/doctissimo.shtml
61. https://www.quora.com/What-are-the-practical-applications-of-deep-learning-What-are-all-the-
major-areas-fields

60. 62. « EmoNets: Multimodal deep learning approaches for emotion recognition in video » - Kahou, S.
E., Bouthillier, X., Lamblin, P., Gulcehre, C., Michalski, V., Konda (2015).
« Pose and category recognition of highly deformable objects using deep learning. In Advanced
Robotics » (ICAR), 2015
63. https://insights.samsung.com/2016/07/12/deep-learning-the-next-step-in-applied-healthcare-data/
64. Meredith A. Barrett, Olivier Humblet, Robert A. Hiatt and Nancy E. Alder « Big data and disease
prevention, from quantified seft to quantified communities » – September 2013
65. Robin Murdoch, Paul Johnson – « Digital trust in the Iot era » – Accenture 2015 report
66. PwC report - Top health industry issues of 2016 - Thriving in the New Health Economy Chapter 8
67. « CNIL orders Google to apply delisting on all domain names of the search engine » - 12 juin 2015
- https://www.cnil.fr/fr/node/15790
68. Data protection regulations and international data flows : Implication for trade and development –
2016 – United nation conference on trade and development.
69. Guilhem Fouetillou , directeur général de Linkfluence http://www.sciencespo.fr/edc/fr/blog/si-c-
est-gratuit-vous-etes-le-produit
70. https://rockhealth.com/reports/digital-health-funding-2015-year-in-review/ Rock - Health Funding
Database Note: Only includes U.S. deals >$2M; data through December 8, 2015
71. http://www.cio.com/article/2926436/healthcare/10-startups-that-are-disrupting-healthcare-
it.html#slide2 - 10 startups that are disrupting healthcare IT – Sarah K. White
72. http://www.medisafe.com/
73. http://medwand.com/index.html
74. https://www.crowdmed.com/
75. https://skinvision.com/ - http://www.skincancer.org/skin-cancer-information/melanoma
76. Picture from http://www.nemauramedical.com/
77. Picture from http://www.smartcaptech.com/
78. Picture from google image search
79. http://www.wareable.com/wearable-tech/a-brief-history-of-wearables