From the art of divination to the realm of e-health

The researcher noticed, however, that most of the users of ELIZA got caught up in the game of discussion with the robot, entrusting it with intimate information as if it were a real psychiatrist. This experience is allegorical of the current spread of so-called predictive medicine: through the dream of medicine centered on the patient, the human being once again plays out the fantasy of Pygmalion. Through biometric surveillance technologies, direct care interactions between human beings would thus be limited to a minimum, offering the patient the dream of paranoid control over his health. And to manufacturers, the dream of an economy of surveillance and individualization of risks that is morally acceptable to the greatest number.

E-health: let’s increase the dose!

Industrialists in the sector would indeed be wrong to deprive themselves of such manipulation of our most intimate anxieties. The Institut Montaigne and the McKinsey firm estimated in their June 2020 study ” e-health: let’s increase the dose ! » between sixteen and twenty-two billion euros per year the amount of the potential e-health market in France. According to this same study, the decision support tools based on artificial intelligence alone would represent between 3.3 and 4.2 billion potential euros per year.

The various French governments have so far accompanied the movement, seeing in it a double advantage. The first relates to the control of health costs thanks to computerized patient flow management tools, diagnostic decision support software or by means of centralized platforms for the management of “care pathways”, allowing to reinforce the ambulatory shift and reduction of hospital care time.

The second relates to the growth potential which, in their minds, would make it possible to compete with the Sino-American digital hegemony thanks to the quantity of data produced by our generous social systems. This double solutionist trap – a problem would by default have a simpler and more effective technical solution than conventional political arbitration – nevertheless seems to strengthen every day a little more the stranglehold of GAFAM on our lives, as the lively controversy surrounding the Health Data Hub could testify.

The data economy is based on principle, as has been shown Soshana Zuboff, on the ever-increasing extraction of astronomical amounts of behavioral data. From the sensors present on our phones, connected watches, to the information entered in medical management software, pharmacies, city doctors and hospitals, this data from the point of view of the private sector, of predictive medicine, has there is every interest in being centralized and crossed between them, in ever larger storage bases, to optimize their economic value. Leaving the governance of the digitization of health policies to the initiative of a private sector that is also under American hegemony nevertheless poses several major problems for the French medical system.

Surveillance capitalism in ambush

Foremost among these problems is the incompatibility between the fundamentals of the data economy – sometimes called “surveillance capitalism” – and cybersecurity, which such sensitive information requires: the massive centralization of data mechanically increases the risk of hacking or flaws. The Interhop collective propose Conversely a decentralized model of this information in which the data would be managed as close as possible to their place of collection, by hospitals and the local economic and technological fabric.

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From the art of divination to the realm of e-health

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