30/07/2026
Health Technologies 4.0: Promises, Transformations and Points for Vigilance
Corinne GRENIER
Angélique CHASSY
the need for travel and provide access to specialised expertise. For professionals, these tools can improve continuity of information, strengthen coordination, and free up time for tasks of greater clinical value. The term “useful medical time” now refers to time dedicated to relationships with patients or between professionals, freed up from administrative tasks facilitated or carried out by AI.
Another significant potential lies in personalising care and support methods for patients, the elderly, and people with disabilities or chronic illnesses. By cross-referencing biological, clinical, or behavioural data, certain tools can refine diagnoses, anticipate complications, and help professionals adapt treatments. Monitoring applications and other connected devices can help patients better understand their health and become more autonomous in managing their situation.
Within organisations, these technologies are often presented as efficiency drivers. They can support traceability, logistics and the automation of certain administrative tasks, as well as the exploitation and exploration of information that is useful for decision-making.
In a stressed health system, digital technology thus appears to be a means of better organising processes, provided that the tools actually meet the needs of the field.
The transformation of care practices, professions, and relationships
However, the value of technologies 4.0 is not limited to technical efficiency. Their deployment also changes the way we work, cooperate, and make decisions. For example, when software assists with diagnosis or a platform organises the sharing of information, the routines, responsibilities and sometimes the boundaries between professions evolve. While digital technology can strengthen the collective nature of care, it can also introduce new technical dependencies and standardisation.
The care relationship is also changing. Patients often become interface users, data producers, and sometimes stakeholders in their own care (Serafin, 2021).
While this development can strengthen understanding and participation in decisions that concern patients, it can also burden them with new tasks for which they are poorly trained or place them in situations involving social or economic difficulties, which can lead to an overwhelming amount of activity and emotions. It should be noted that even a supposedly more autonomous patient will always require support, explanations and assurances regarding the use of tools.
Photo : Artem Podrez
Major issues not to be underestimated
The first issue is data. Technologies 4.0 are based on the collection, circulation and interpretation of health data, which is among the most sensitive types of data. The acceptability of this collection and processing depends not only on the technical safety of systems and processes, but also on transparency of use, clarity of rules and trust in the institutions and individuals handling the data (Careja and Tapus, 2023).
At the European level, data governance is considered a major issue. The European Health Data Space (EHS) aims to provide a more effective framework for sharing and reusing data in healthcare, research and innovation. However, this framework presents challenges in terms of interoperability, governance, and public understanding. It seems that legal architecture alone is insufficient to build trust.
The second issue is professional and ethical. Although artificial intelligence tools can help to detect weak signals and process large amounts of information, they are neither neutral nor infallible (Duguet et al., 2019). Their performance depends on the data used, design choices, and contexts of use. This raises decisive questions: how can biases be detected, recommendations explained, responsibility assigned in case of error, and the value of human judgement preserved?
The third issue is inclusion. While digital technology can improve access to care, it can also accentuate the divide between those who are proficient in using these tools and those who are not. There is also the issue of digital illiteracy, namely patients’ lack of the necessary skills (or inclination) to use these tools (INSEE, 2021). This could lead to an increase in health inequalities.
The promise of more accessible healthcare therefore presupposes human support, comprehensible interfaces and special attention to vulnerable groups. A tool that is available is not necessarily a tool that is truly accessible.
The real question: how to govern and support the transformation of the health system to accommodate these innovations?
It is not enough to ask whether 4.0 technologies are effective; we must also consider under what conditions they become effective and acceptable.
A useful health innovation cannot be considered solely from a technical perspective. Firstly, it presupposes governance that brings together healthcare providers, patients, institutions, designers, public authorities, researchers and data protection stakeholders to identify needs, assess the actual effects of tools and arbitrate between performance, security, fairness and acceptability (Santos et al., 2024).
The recent French context is moving in this direction, with the authorities increasingly insisting on the training, evaluation, regulation and development of trustworthy AI. This serves as a reminder that innovation has lasting value only if it is governed, understood and meaningfully integrated into care practices.
Useful innovations in healthcare presuppose spaces for debate and experimentation on the conditions and boundaries of their acceptability. It is important to be able to assess the expected gains in terms of the quality of care and support, the quality of relationships between all stakeholders, and the quality and meaning of life at work.
Health technologies 4.0 are neither simple technical progress nor a miracle solution to the weaknesses and complexities (‘administrative mille-feuille’) of the healthcare system. They offer genuine opportunities to improve coordination, prevention, monitoring and personalisation of care. However, they also shift balances and impose new demands on ethics, safety, training, inclusion and governance. Their success will depend less on the power of the tools themselves than on our collective ability to use them to make health care more effective, fairer and more understandable, while addressing major challenges such as an ageing population, social inclusion of disabled people, better-informed and better-supported patients managing chronic diseases, territorial coordination of professionals to improve access to health services, and therapeutic innovation in the face of emerging diseases such as environmental and mental health issues.
References
Careja, A. C., Tapus, N. (2023), Digital Identity Using Blockchain Technology, Procedia Computer Science, 221, 1074-1082. doi:10.1016/j.procs.2023.08.090.
Duguet, J., Chassang, G., Béranger, J. (2019), Enjeux, répercussions et cadre éthique relatifs à l’Intelligence Artificielle en santé: Vers une Intelligence Artificielle éthique en médecine, Droit, Santé et Société, 6.3, 30-39.
INSEE (2021), Compétences numériques des Français en 2021, Paris. Disponible sur : https://www.insee.fr/fr/statistiques/7633654.
Santos, T. R., Dias, E., Scoton, L. (2024), Challenges for Implementing Health 4.0, Preprints, 2024121485. doi:10.20944/preprints202412. 1485.v1.
Serafin, A. (2021), L’utilisation de systèmes d’IA dans la relation de soins suscitant une redéfinition des rôles de patient et de médecin, dans J. Béranger et R. Rizoulières (dirs.), La révolution digitale dans le système de santé (Vol. 2), ISTE Group / ISTE Editions, 93-110.
The Authors
Corinne GRENIER is a senior professor at Kedge Business School (Marseille) and scientific director of the Territories API research and experimentation chair (inclusive and enabling). Her research currently questions the inclusive transition of public policies and health organizations, through issues of participatory and collaborative innovation, experiential knowledge of users and the transformation of professional practices and these organizations.
Angélique CHASSY is an associate professor at the Normandy Business School (Métislab Laboratory). Her research focuses on the social acceptability of public policies related to citizen participation. She It also publishes works at the intersection of health policies, citizen participation and participatory science. His other research concerns the social and solidarity economy, the environment, particularly in the agri-food sector, as well as the legal status of citizens in participatory democracy processes.
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