JMIR Publications

ABSTRACT

Advances in digital medicine now make it possible to use medical cyber-physical systems (MCPS), which combine (i) extensive patient monitoring through the use of multiple sensors, and (ii) personalised adaptation of patient care through the use of software. After the artificial pancreas system already operational in children with type 1 diabetes, new MCPS could be developed for real-time monitoring and management of children with chronic diseases. Just as providing care for children is a specific discipline - paediatrics - because of their particular characteristics and needs, providing digital care for children also presents particular challenges. This article reviews the technical challenges, mainly related to the problem of data collection in children; the ethical challenges, including the need to preserve the child's place in their care when using MCPS; the legal challenges and the dual need to guarantee the safety of MCPS for children and to ensure their access to MCPS; and the societal challenges, including the needs to maintain human contact and trust between the child and the paediatrician, and to limit MCPS to specific uses to avoid them contributing to a surveillance society, and at another level, to climate change.