The ‘Internet of Things’ (IoT) refers to the interconnection of uniquely identifiable devices containing sensors that share data over connected computer networks. Within healthcare, these devices range from sensors on smartwatches to more complex devices like Florence, the Robotic Nurse Assistant currently on trial in Singapore. Regardless of their level of complexity and sophistication, they all share one common characteristic – they collect data about their environment or user activities and send that data over the network to other entities for analysis, and to direct activity.
The Types of IoT in the Healthcare Sector
In a healthcare context, IoT promises better patient outcomes and operational efficiencies from Personalised Medicine (PM), as well as a reduction in overall resources required. While far from a formal demarcation, there are essentially two fields of IoT devices within the healthcare field; consumer-based devices that help provide monitoring and insights, and secondly, IoT equipment deployed inside healthcare facilities (or used remotely for in-home care) to streamline operations and improve patient care. While the latter may include wearables, the purpose is different. For example, a smartwatch equipped with an electrocardiograph (ECG or EKG) function to provide data to a user to monitor their own health and fitness has a very different use case and connotations to an ECG found and deployed in a medical facility.
IoT Inside Hospitals
In recent years, there have been significant advancements in medical science and technological innovation which have led to improved patient outcomes. However, despite these advances, it remains difficult for clinicians to capture and access all relevant information about their patients at any given time. This problem of timely healthcare is compounded by the fact that most clinical decisions are made based on limited evidence and expert opinion rather than hard patient data. As such, there exists a need for new methods to integrate real-time patient data into routine practice. One way to address this issue is through the use of wearable sensors. Wearable sensors enable healthcare providers to track vital signs continuously throughout the day, providing valuable insights into the condition of their patients. These insights allow physicians to make informed treatment plans and avoid unnecessary interventions. Furthermore, they also help reduce costs associated with treating chronic conditions as well as reducing readmission rates.
The benefits of IoT for patient outcomes are self-evidently positive. There are, however, pronounced patient benefits that stem from operational efficiencies of healthcare facilities that have a knock-on effect too. Digital pharmacies are now being used to dispense medications and monitor patient reaction to medications. Through the use of RFID tags, for instance, hospitals are reducing the occurrence of drug misadministration, and even surgical mishaps through better patient-tracking.
There are several autonomous vehicle programs for ambulances & paramedic deployment meaning earlier on-site medical assistance. The incidence of ambulance traffic collisions is understandably high, and the benefits of AVs in this application are even more pronounced than for the general populace. What’s more, there are often shortages of paramedics, and as each ambulance driver also tends to be a paramedic (though not always) we can essentially double the count of available ambulances on the road without the commensurate number of paramedics being required. This alone would save lives, but the improved efficiency of such a service would potentially drive down the cost of ambulance trips for regions where cost is a decision-making factor in whether to use such services.
Personal Medical Devices
Ultimately, healthcare is about the individual. Consumer-grade devices tend toward monitoring at a non-critical level, but there are personal use IoT devices that go far beyond the likes of the heart rate monitors and O2 levels from pulse oximeter functions. Pacemakers, glucose monitoring, ingestible sensors, embedded medication delivery – these are specialist devices that require interaction and deployment by medical professionals. And IoT can absolutely help here too.
A huge issue that leads to 125,000 deaths and some 10% of hospitalisations is non-adherence to prescribed medications. With IoT, patients needn’t rely on alarms or pillboxes – unreliable, particularly in aged care situations – but can instead have delivery systems embedded subcutaneously that adjust dosage according to biofeedback metrics.
We are now seeing brain implants, as well as non-invasive Brain-Computer Interface (BCI) devices that are being used to treat chronic pain, epilepsy, PTSD, anxiety, depression, and even through to some forms of more complex afflictions like schizophrenia. IoT can more effectively control the variables in such treatments through personalisation based on collected data.
While many of these devices have been around in some form for some time, the additional layer of IoT means that data can be uploaded and in near real-time to facilitate earlier – and better – interventions, as well as no longer requiring frequent trips to the hospital for interfacing with the device. Recalibrations, firmware updates, and changes in operational parameters can all be done remotely.
Looking at consumer-grade IoT devices, the current state of wearables is still relatively nascent. However, solutions are coming to the market that offer help to people to manage their own health to a degree that would have historically required specialist equipment and medical professionals.
In addition to improving care delivery, wearable sensor technology has the potential to improve health outcomes by enabling early detection of disease or injury before symptoms become apparent. For example, wearable devices can be used to monitor heart rate variability during exercise, allowing doctors to identify a person’s risk of sudden cardiac death. Similarly, monitoring may provide insight into whether someone is experiencing high blood pressure due to stress, and if they should seek further evaluation from a physician. Simply, the ability to detect subtle changes in physiological parameters could lead to earlier intervention and better overall patient outcomes.
IoT Security Challenges in Healthcare
Important security issues must be addressed before IoT in healthcare can be fully utilised. At the extreme end, we’ve seen the possibility of a heart attack being induced by hackers. IoT device developers, managers, and healthcare providers must protect data produced by IoT devices too. Medical device data is usually considered protected health information under HIPAA and other regulations. If not adequately protected, IoT devices might be exploited to steal critical data, and indeed, 82% of healthcare firms report assaults on IoT equipment.
Developing secure IoT hardware and software is the first phase. Managing IoT devices in healthcare is also critical to preventing unmonitored data from slipping into the wrong hands. A patient monitoring device with outdated software or firmware, or one that is not properly decommissioned after use, might allow attackers to access a network or steal protected health information. Identifying and classifying all IoT devices on a healthcare provider’s network mitigates this risk. Then, managers may watch device activity to spot abnormalities, assess risk, and segregate susceptible from mission-critical devices. CyAmast helps providers maintain every facet of their IoT management and security in a non-invasive manner, running in parallel with existing infrastructure.
So while each type of deployment has its own use cases and benefits, the real value of IoT within healthcare is about where these two facets meet. Consumer IoT healthcare equipment can provide insights to promote better lifestyle choices, and potentially critical data, to allow for early intervention. On-premises (or remote deployments for in-home care) IoT enabled medical devices, however, are by necessity much more accurate and with deeper functionality as their use is inherently in more critical environments. In both deployment types, security and reliability are of paramount importance – literally a matter of life and death. The promise of IoT in healthcare is to encourage healthier behaviours, offer earlier identification and interventions, and ultimately better in patient care and outcomes in more critical situations, and CyAmast are proud to assist in bringing the future of healthcare to reality.