value and challenges of data sharing in the cloud

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smart health connected health and wellness devices are constantly collecting data. Given the need to exploit them and the risks of cyber attacks, it is necessary to take stock of the challenge of sharing this sensitive information.

Today, smart health connected health devices or dedicated towell-being designed in French and international startups flourishon the market. Whether electrocardiograms, sphygmomanometers,weighing scales or even blood glucose meters, these devices collecthealth data often via the Internet of Things (IoT). Then arises thequestion of the best solution for storing and using this informationsensitive. In France, if the storage of this type of data is external, in thecloud, it must be done at an "authorized hosting provider" andis subject to the General Data Protection Regulations (GDPR).Legislation, data security and the use that can be made of it,what are the issues and uses that flow from this crucial point?

Personal data: the right to share and to liveprivate

Since May 2018, the RGPD in Europe has further strengthened theprotection of health data by defining and including in legislationthe notion of privacy by design, "respect for private life fromdesign ". This raises the question of storing datacollected by the smart health connected devices and the obligation for their designersto ensure security. While it is well known that mutuals,Insurance or Occupational Medicine are stillthe impossibility of being able to access this so-called sensitive information, theusers can choose to share certain informationwith other organizations. Personal data relating to themental and physical health of a person available under theShared Medical Record (DMP) allow for example to health staffimprove the management of patients. The data that is stored onthe devices of well-being and medical follow-up are not taken into accountin specific cases but could perfectly complement the files withthe data recorded on a daily basis in the case ofcharge, subject of course to the consent of the persons being followed.

Pooling gives full value to the data

Big data and recent advances in artificial intelligenceare a major vector of medical progress, especially in the field of developmentIoT technologies. But still it is necessary to be able to access easily andsafely to all of this data! In systemshospitals and health organizations, application silos anddata are very present. The digitization projects have paradoxicallyincreased these silos, especially by the proliferation of formats, interfaces, butalso against the growing danger of cyberattacks. These impose theset up of firewall compelling the circulation of data. In fact,immense possibilities offered by the sharing of information, even onceanonymized in accordance with the guidelines of the RGPD, are reduced or even annihilated.

The choice of the cloud: the points of vigilance

The cloud offers almost infinite storage capabilities andcost-controlled, it seems ideally suited to receive the massive flow ofdata collected both via health and well-being devices and viahealth facilities. On the devices themselves, storage remainsnecessarily limited when they are not smart health connected. Cloud side however,it should be remembered that in case of failure and in the absence of redundancy, a breakeven temporary access to data represents a potential danger topatients who use them daily.

This is for example the case of type 2 diabetics whopractice self-monitoring glycemic. The devices of well-beingallow to limit the number of bites (sometimes 4 / day): dependingresults, the patient or the medical staff can better measure theamount of insulin required at a time T of the treatment. It is in these casesprecise that the level of service must be guaranteed and double storage (cloudand devices) is recommended as well as the security andredundancy.

Conclusion

To summarize, the conditions for the data ofwell-being and health are used wisely, based on threecriteria:

• agreement, accountability and good informationpatients regarding the use of the data they agree to share,

• maximum anonymization of the stored data,

• guaranteeing access and securing data fromhealth and well-being collected and stored in the cloud.

These conditions will be met once a unified standardand readable on IoT standards and cloud security and standardizationfor data sharing will be established at European level. Sothe mass analysis of health data will allow the discovery and implementation ofmore efficient treatments and therapies for such pathologiesthan hypertension or diabetes.

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