Ethics at the heart of France’s digital health strategy

With a plethora of healthcare stakeholders and a growing list of digital tools, it can be challenging to find a starting point for a national digital health strategy. France decided to put ethics at the heart of its approach to creating digital health services.

“In France, we have a patient-centred approach… We want the patients to be a full part of their care team. So we want the patient to be informed, we want the patient to be involved in the digital process, we want the patient to have in control of their data and we want them to be really involved,” said Dr. Brigitte Séroussi, Project Director in charge of Digital Health Ethics at the eHealth Delegation of the French Ministry of Health, during a panel discussion of HIMSS22.

“There are some concerns about the digital health counterparts. Patients are well aware that there needs to be a face-to-face relationship when they ask for it. They want real transparency about the data processing. Who can access their data , when and why? They want AI solutions to be guaranteed to be bias-free. They also want to have digital health that is aware of its impact on the environment.”

The team took into account the four principles of medicine: benevolence, autonomy, harmlessness, justice and the Hippocratic Oath. They then combined these with digital health principals.

“We need to cross the ethical dimensions associated with the digital ethics dimensions. When you have a digital resource, you want a resource that is easy to use, accessible to use, at the service of the user, not vice versa … When you cross these two dimensions, you have information transparency, then you have information transparency with confidence, and then we have adoptions.”

But the government didn’t just look at traditional health ethics. It also examined how digital impacts the environment.

“Digital is not material, but it has an impact on the environment, and this must be taken into account when deploying digital health. We know that the digital economy accounts for 3.5% of global greenhouse gas emissions, and in France we know we think the health sector is 8% of greenhouse gas emissions,” she said.

Now France is helping to spread their digital health practices in other parts of the EU

“It’s about providing the right services to EU citizens,” Isabelle Zablit-Schmitz, eHealth Europe and International Director of the French Ministry of Health, said during the panel.

Séroussi said it is ultimately critical that patients lead the effort and that patients need the assurance of an ethical system.