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L’ère de l’intelligence artificielle et de la multiplication des capteurs semble menacer la médecine. Un secteur jusqu’ici protégé par la complexité des diagnostics et la nature intime de la relation avec le patient.

Depuis plusieurs années, des initiatives ont été lancées afin de « disrupter » la médecine en s’appuyant sur les nouvelles technologies. Cette volonté est dans certains pays une nécessité sociale, car son accès est difficile, onéreux et représente une grande source d’inégalité. Néanmoins, aucune solution technologique n’a jamais sérieusement porté atteinte à cette profession.

L’ère de l’intelligence artificielle compte de nouveau s’attaquer à ce secteur, porté par l’augmentation des capteurs, le perfectionnement des algorithmes et par l’inflation de données disponibles.

Une dynamique ancienne à la réussite relative

La volonté d’automatiser le secteur de la santé n’est pas récente. Depuis les prémices d’internet, une myriade de forums se sont développés sur ce domaine, témoignant de l’intérêt du public pour ce sujet. Des forums comme Doctissimo réunissent encore aujourd’hui des millions d’internautes inquiets de leur santé.

De nombreuses initiatives d’automatisation de diagnostiques ont aussi vu le jour depuis le début des années 2000 avec un succès mitigé, peu fiables et trop simplistes, ils s’appuyaient sur les déclarations du patient, sans réellement l’ausculter. De plus, l’absence de matériel médical du côté du patient limitait la qualité de l’auscultation.

Ainsi, le web s’est jusqu’à présent contenté de réunir des communautés ou de faciliter les interactions entre les médecins et le public, à l’aide d’annuaires interactifs. La faible adoption de la technologie tient aussi à la nature de ce secteur ou la confiance aveugle à l’ordinateur ne va pas de soi. Néanmoins, la démocratisation des capteurs et la généralisation des algorithmes d’intelligence artificielle annoncent une nouvelle ère et la médecine s’apprête à vivre une révolution d’ampleur inégalée

Un nouvel élan lié à la Data Science et au développement des capteurs

Depuis plusieurs années on observe la multiplication de capteurs de santé comme les indicateurs de suivi d’activité présents dans les montres intelligentes et les bracelets connectés. Ces derniers permettent de suivre la distance marchée, le nombre d’étages montés et le rythme cardiaque de son porteur. Ces statistiques ont un intérêt médical, car l’importance de l’exercice physique dans la lutte contre d’obésité ou la réduction du risque d’infarctus a souvent été démontrée.

Mais ces statistiques ne représentent que les prémices de l’évolution des capteurs. Il est à présent possible d’effectuer des prises de sang et de demander à l’appareil de traiter ces résultats ou encore de suivre la tension artérielle. Aussi, les prix du séquençage de l’ADN (environ 100 euros) se sont effondrés et laissent entrevoir une démocratisation massive de ce processus.

L’analyse de l’ADN et le suivi des signes vitaux sont particulièrement efficaces pour analyser à chaque instant la probabilité de contraction de maladies chroniques, comme les crises cardiaques ou le diabète. Or, ces maladies représentent plus de 80 % des 3 000 milliards dépensés chaque année dans les frais médicaux aux États-Unis.

Mais la technologie permet aussi d’offrir aux médecins d’appliquer différemment leurs leur expertise. En témoigne l’évolution des opérations à distance, depuis l’opération Lindberg en 2001 qui permit à un médecin français opérant de New York de traiter un patient à Strasbourg.

Pour les opérations plus bégnines, ce système s’est largement démocratisé. En effet, le site américain DoctorOnDemand permet de prendre rendez-vous et de recevoir la consultation d’un médecin à domicile par la vidéo. Ce service est moins cher et peut être une réponse aux salles d’attente trop remplies.

De nombreuses dérives possibles

Si la digitalisation de la médecine semble bien répondre un besoin sociétal, on ne peut nier que cette révolution technologique ouvre la porte à de nombreuses dérives. C’est dans le domaine de l’assurance que ces dérives peuvent être les plus sérieuses. Certains assureurs ont d’ailleurs lancé des initiatives pour mesurer la santé de leurs clients (et donc le risque financier) grâce à leurs comportements. Ainsi, des capteurs sont installés dans les voitures, donnant des primes aux bons conducteurs et des pénalités aux autres.

Mais cette initiative d’apparence inoffensive peut prendre une tout autre dimension avec l’arrivée de capteurs physiologiques. Une assurance médicale pourra ainsi modifier ses tarifs selon les risques de maladies chroniques visibles dans l’ADN, ou conditionner l’octroi d’un prêt à l’acceptation d’une opération chirurgicale réduisant un risque héréditaire.

Le défi de l’acceptation par les patients

Mais la volonté des patients d’interagir avec les médecins sera au cœur de la dynamique d’adoption de ces technologies par le grand public. Si l’utilisation de docteurs virtuels peut en inquiéter certains, il en rassurera sûrement d’autres, intimidés par le médecin, et rassurés par l’apparent anonymat de l’application.

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