Every component of the healthcare ecosystem runs on information. Big data capabilities present an opportunity for IoT applications to rocket healthcare into a new era of accessibility and efficiency. However, health care is, undeniably, a high-stakes arena. The sensitivity around physical circumstances breed warranted concerns around personal health information — its accuracy, privacy, and utility.
Despite the perception that we are already swimming in more data than we can handle, more information presents the real solution to perceived risk. Once patients (and providers) have more clarity and justification around healthcare IoT, the long-term benefits will become more tangible.
Connected/smart technology promotes greater personal safety, better medical outcomes, and more control over patient interactions with providers. Also, guidelines about information ownership and handling is positioned to evolve alongside big data and connected implementations.
The Real-Time Health System (RTHS) Context
RTHS refers to collection of real-time information from patients, devices, and electronic records, for the purpose of immediate provider decision-making (e.g. diagnoses). It’s the vehicle driving the vision – still being developed – of a universe with zero delays in conveying and acting upon medical discovery. Gartner calls RTHS a “management and operating paradigm…for the next-generation healthcare provider.”
It is important to view IoT in healthcare in the context of this real-time vision because the potential benefits of this future are universal for healthcare stakeholders and patients alike. It’s equally important to note that hospitals present the most complex, high-stakes IoT environments. Decisions have consequences.
Humans: Wired to Doubt
While people acknowledge connected health benefits, it is in our DNA to ask questions and have doubts–especially when health is on the line. There are legitimate concerns that need, and deserve, to be addressed. Appropriate guidelines around privacy and ownership of health information are paramount. From a patient’s point of view, risks span from security and costs to bedside manner and accessibility.
Insurance companies have come a long way since they led with the “do you smoke” applicant question. Many insurers now have access to a growing cache of direct, detailed information. Reaping benefits from good health habits is great. On the flip-side, however, people don’t generally want specific conditions, that may or may not be within their control, to dictate their insurance premiums. Ultimately, many people fear what self-serving measures insurance companies could take with more information.
Cloud-connected pacemakers also include location trackers. In fact, pacemaker information was actually admitted as evidence in a criminal arson trial. There is even conversation about the direct physical danger of such implanted devices being vulnerable to hackers.
Decreased Human Touch
Patients value their relationships with doctors, and some worry that automated systems may make healthcare feel (even more) cold and robotic. There is tremendous convenience in remote care access, however. Not having to physically travel to a doctor’s office can provide tremendous peace of mind. Furthermore, the anxiety around remote health care tends to be generational.
A [survey](https://giving.jefferson.edu/content/dam/oia/ambassadors/April2018/Jeff Ambassadors – April Mailing – Op Ed (18-0934-SC).pdf) at Thomas Jefferson University found that,
“92% of patients under 40 expect to have two-way electronic communication with their providers, and 83% expect to be able to access all their patient information online, as they do their bank accounts.”
Providers: Diagnosing Data Hazards
Healthcare professionals are well-positioned to identify IoT benefits via connected systems. Although not as pronounced as patient anxieties, providers certainly recognize some potential hazards–namely data security.
Data security protocols and compliance requirements continue to evolve, as does cybercriminals’ creativity. Impersonating legitimate patients in order to buy drugs or collect insurance settlements is a real problem. And the information-sharing protocols between legitimate devices are not yet standardized, creating still another potential opening for identity fraud and larger data breaches. This incompatibility also has a negative impact on the ability to scale.
Powering Hospitals with Data
Hospitals are equipped to handle large amounts of data, so IoT integration is a natural evolution. More than half of U.S. hospitals currently use at least three connected IoT systems, centered on the following functions:
- Facilities management: Hospitals depend on smart facilities for HVAC systems, lighting, waste disposal, water and plumbing, building security, and more. Automated backup power systems support patient safety in case of local power outages.
- Inventory management: Similar to retailers, hospitals deploy enterprise resource planning solutions to manage medical supplies, pharmaceuticals, and overall inventory in their warehouses.
- Workflow optimization: As RFID technology becomes cheaper and more reliable, data analysis from employee badges and wristbands promotes efficient staffing. Visitors can also be tracked via badges, protecting additional security and health protections for patients.
- Patient experience: Mt Sinai Medical Center in New York City, for example, correlates bed availability with 15 other metrics including staffing, patient need, etc. As a result, the center has reduced wait times by 50% for ER patients who need to be admitted.
Similarly, patient safety increases with biometric identification. Tracking a patient from admission through all procedures eliminates the risk of “wrong patient” or “wrong condition” human error. It also decreases record-keeping mistakes, billing confusion, and insurance reimbursement delays.
Feedback from Personal Wearables & Sensors
A range of medical and fitness devices embody the RTHS vision. Delivering patient information immediately to the care team as well as to electronic health records saves time and can pave a smoother path to treatment. These devices include both internal and external biological sensors, as well as smart environmental instruments. Bioelectronic medicine constructs methods of using connected devices for actual treatment.
Smart watches, like the Apple Watch Series 4, that offer exciting capabilities around heart monitoring and other health and wellness information are familiar to consumers. But these sleek, user-friendly options represent only a fraction of wearable sensor utility. The excitement around future sensor features within these wearables is just getting started.
When it comes to personal, often non-invasive, wearables making a difference in daily life, the momentum continues to build:
- Continuous temperature monitoring sensors for vulnerable populations, from premature babies to cancer patients to the elderly.
- Headbands and earbuds record electroencephalograms, measuring brain waves to detect pain.
- Smart watches help diagnose sleep apnea.
- Non-invasive finger clips and skin patches monitor blood glucose levels without the need for needles.
- Head-mounted wearables use low-intensity electrical brain stimulation to aid those suffering from mood disorders.
Sometimes the best work sensors do is invisible–gathering information and providing bio-feedback from the inside. Every pacemaker in the U.S. is cloud-connected, automatically transmitting patient data to providers and health records. Ingestible sensors can be swallowed by patients, providing crucial information from inside the body without the trauma of surgery. Makers of the dementia medicine Abilify, uses “smart pills” that transmit information about whether the medication has been taken.
Bioelectronic medicine promise quantum leaps in diagnosis and treatment, decoding signals from the brain for both diagnosis and treatment. Research and development continue on a treatment for paralysis that bypasses an injury to the spine. It brings impulses straight from the motor cortex of the brain to an external computer and then to a second implant beyond the injury site.
Entering the New Healthcare Landscape
Full awareness of the perceived and real risks that come along with opening up this new terrain will help smooth the path to a safer future. The rich potential for better outcomes, lower cost, and improved patient experience have already launched an imperative for real-time smart health care.
Connected medicine fuels a revolution in how people perceive and interact with the healthcare industry, providers, and, most importantly, their own bodies.