Brinda Sampat, Assistant Professor, NMIMS Global Access – School for Continuing Education, NMIMS University,Mumbai and Dr Ashu Sharma, Associate Professor, School of Business Management, Narsee Monjee Institute of Management Studies,Mumbai, give an insight about IoT, which has gained popularity in healthcare because of the increasing ageing population and rising costs of healthcare services
Have you envisaged treating a patient for a particular ailment without he or she being physically present? Ever wondered what it would be like to drop a reminder to your patients who has forgotten to take his/ her medicine doze on time? Would it not be great, if you could use your phone to access patients’ medical history or monitor their vital stats and share the same data with your colleagues to take expert opinion?
The fusion of technology and healthcare have made companies produce many innovative devices which can help achieve these results. Healthcare solutions can now be offered to patients sitting in their living rooms. Telemedicine, a practice of connecting doctors and patients remotely across different regions, is practiced in many parts of the world today to provide healthcare at affordable rates to underserved and secluded communities in a timely manner. This enables medical professionals to interact with patients eliminating the barriers of boundary and time. Advancements in technology have radically refined diagnostics, monitoring and tracking of patients. Intelligently interconnected devices have altered the way in which data is being generated and consumed. Real-time diagnosis is now possible with the proliferation of bio – sensors which are connected to smart-phones that relay data continuously.
IoT: The Technology Enabler
The Internet of Things (abbreviated as IoT by many companies), Internet of Everything (Cisco), Industrial Internet (GE) consists of a series of intelligently connected devices which are capable of collecting and monitoring unprecedented level of real time, life critical data. Put it simply, these are nothing but smart sensors. These sensors can be controlled remotely across existing network infrastructures and can share the data with each other and over the cloud. This enables quick data collection, storage and analysis and at the same time automatically triggers certain events in order to take timely, accurate decisions. IoT has gained popularity in healthcare because of the increasing ageing population and the rising costs of healthcare. IoT creates opportunities for more direct integration between the physical world and computer-based systems. ‘Things’ that are not computers will be enabled with the power to collect and process data acting as computers. Medical IoT or Internet of Things for Medical Devices (IoT-MD) is patient centric and concentrates on prevention, diagnosis, treatment and wellness. This eco-system has paved a new way of communication between people, devices and apps that interact with each other. With the help of mobile networks these ‘remote things’ such as a person with a heart monitor transplant, electrocardiograms, temperature monitors or blood glucose levels, empower a series of life changing services. By 2020, there will be a $117 billion market for IoT in healthcare.
IoT opens the doors for doctors and patients to share patient data, lab results seamlessly in real time. In 2020, 25 billion connected ‘Things’ will be in use. With more and more devices being connected each day, large databases would be needed to find correlations between the data generated. Technologies such as Cloud and Big Data enable storing the vast amount of data that is generated and analytics aid in uncovering various trends that emanate from this data. The collaboration between the devices enabled with sensors and the analysis of the data generated by them will facilitate major advances in medical science research. Results thus generated can help improve research outcomes to combat various diseases in the future. Companies such as IBM, Cisco, Microsoft, Google, Amazon, and GE, etc. have invested heavily in IoT.
Smart devices: Enabling connected healthcare
Smart devices play an important role to help achieve this thereby reducing the need for direct patient-physician interaction. While technology continues to develop in this field, there are three key areas of healthcare in which IoT technology has made the greatest impact so far namely, remote monitoring, wearable technology and information exchange. For e g. heart monitoring devices have now made it possible to detect abnormalities and ensure that patients reach the hospital well in time. Sensing devices are able to determine the respiratory rates in children and aid in diagnosing pneumonia. Wearable devices monitor different health markers such as heart rhythms, breathing patterns, temperature, blood pressure, footsteps, physical position and balance, to name just a few. Data generated by these wearable devices will give insurance companies, pharmaceutical companies and the likes the opportunity to capitalise on the data and render services to patients most appropriate for them. Apple watches and Fitbit wrist bands to home glucometers and blood pressure cuffs give consumers instant access to personal measures of well-being. Wearable devices will become a $6 billion market by 2016, with 171 million devices sold, up from $2 billion in 2011 and just 14 million devices sold.
Smart pills
These are ingestible medical devices consisting of sensors, cameras, patches and trackers that help to measure various physiological measures such as weight, sleep patterns, temperature, pH levels etc. They can also be used to monitor the patient’s adherence to medication. They enable doctors to remotely observe a patient’s internal conditions and diagnose problems without exploratory surgery. These pills will soon replace conventional diagnostic techniques of colonoscopy and endoscopy. Home medical dispensers will automatically upload data on to the cloud indicating when the medication is taken and when it is not or for any conditions that needs immediate attention. Proteus Digital Health has made substantial contribution in this area by developing a system consisting of a smartphone, a sensor patch and a pill. These pills consist of sensors which get activated by the electrolytes in body when they are consumed. The pill then sends a signal to a battery-powered patch worn by the user and also informs the caregiver about the same on his smartphone. The global smart pills market is expected to reach $965 million by the year 2017.
Smart beds
Smart beds are able to monitor patients’ vital signs and mobility without using electrodes. They can interface with information systems to transfer information collected and alert healthcare providers when a patient is getting out of bed unattended. It can also adjust itself to ensure appropriate pressure and support is applied to the patient without manual interaction of nurses. Smart beds prevent bed sores and free nurses from turning and moving patients from side to side every few hours. In an IoT-enabled world, nurses will be able to spend more time taking care of patients. The BAM Labs Smart Bed Technology solution helps to achieve these functionalities. A ReST Bed collects and reports ones sleep behaviour and automatically adjusts itself to help one sleep better.
Smart lens
Patients suffering from diabetes need to prick themselves many times a day in order to measure their body’s production of glucose. Continuous monitoring of the blood glucose level is difficult and incorrect monitoring could lead to serious repercussions. Smart lens is a non-invasive means of continuously monitoring the blood glucose levels by analysing the tears. They can be used for other ophthalmic ailments such as vision correction, which have been difficult to cure via traditional methods. Smart lens can be used to capture images with the help of micro camera embedded in them, process data related to them and take appropriate actions.
Smart hospitals
Smart hospitals in the near future will provide various smart devices to communicate with each other enhancing patient’s experience. The smart rooms will be mounted with devices, which will not only provide entertainment but will also enable doctors, nurses to provide instant help or interact with the patient at regular intervals. On the other hand, video conferencing technology can be used to educate medical interns while the doctor performs his rounds to see a patient and the same can be streamed live in a classroom fostering experiential learning. Smart hospitals will be an amalgamation of kiosks to register the non-resident patients who have come for consultation, location tracking devices to track the in-ward patient’s movement through the healthcare facility, a mobile app which not only makes it easy to register a patient at the hospital eliminating the wait in long lines and the manual registration process, GPS-enabled app that provides directions to a particular department in the hospital optimising navigation. This app also makes room for consultation with specialists; helps schedule future appointments, make payments and view reports.
Hospitals will use the IoT to identify inventory levels that are running low and machines will play a vital role in replenishing the same. Hospitals will use IoT to keep a tab on the location of medical devices, personnel and patients. IoT can be used to collect and share patients’ biometric data and monitor them after they’ve been discharged from a hospital. Internet-connected devices have been introduced to patients in various forms. The plethora of medical devices that relay information about a patient’s condition such as heart monitors, IVs, respirators and blood pumps will now automatically transmit patient data to Electronic Health Records (EHR) increasing accuracy. All the scattered data will now be automatically available at one location.
Challenges of connected health
While IoT brings a plethora of opportunities, it brings with it new challenges. Managing different devices and their interoperability, integrating data from different sources, processing volumes of data in real-time accurately and the need for medical expertise are some of the challenges to address. Some of the other restraints of IoT implementation are technology adoption by hospitals and the elderly people. Most of the IoT implementations take place on the cloud and thus are vulnerable to attacks by hackers. A major question that IoT must address in future is to ensure how to secure patient sensitive data and prevent it from being used against the individual. According to Gartner, the worldwide spending on Internet of Things (IoT) security will reach $348 million in 2016, a 23.7 per cent increase from 2015 spending of $281.5 million. The government must make sure that there are systems and standards in place to enable IoT deployment to maintain a balance between the boons and the banes.
Keeping in mind the complexity of the implementation of these technologies, leading IoT solution providers encompass various monetisation strategies from one-time payment to subscription – based services. With the patient data available on the cloud, doctors will be able to respond more efficiently in case of emergencies. Just as each coin has two sides on one hand privacy and security are the main concerns for IoT implementations, while on the other IoT will integrate the healthcare ecosystem thus providing improved health outcomes.