Feature Story

The Doctor Is In: Internet of Things Becoming a Healthcare Game Changer

Dr. Keith W. Vrbicky

While the term has become ubiquitous, if not somewhat bandied about to death, the Internet of Things (IoT) is rapidly changing the way people, things and apps are connected and interact with each other.

The IoT is already resulting in significant changes in many areas of healthcare. To explore further, I reached out to a number of globally recognized IoT experts and posed a number of questions. Following are some capsule bios for this digital panel of sorts, and their excerpted responses:

The panelists: (listed alphabetically):

· Haluk Demirkan – Associate professor of service innovation and business analytics at the University of Washington-Tacoma. Haluk is also founder/executive director of the Center for Information Based Management, and co-founder of the International Society of Service Innovation Professionals.

· San Murugesan – Director of BRITE Professional Services, adjunct professor at the University of Western Sydney and editor-in-chief of IEEE IT Professional, San's areas of expertise comprise green IT/computing, sustainability, cloud computing, IT applications, social media, and Web 3.0.

· Daniel Obodovski – Author of 'The Silent Intelligence: the Internet of Things,' Daniel most recently served as Qualcomm's director of business development, where he led the commercial launch of multiple M2M products and businesses.

· Keith Robinson – Senior Strategist/Consultant, Head of M2M/IoT for market research firm Compass Intelligence.

· Mike Sapien – Mike's Principal Analyst-Enterprise for Ovum, a global market research company. He's the U.S. liaison for Ovum's telecom practice which includes coverage of enterprise mobility and M2M.

The questions – and their cogent remarks:

How important is the adoption of IoT to improving or generating healthcare solutions?

Haluk: IoT is becoming an emerging information communications technology (ICT) solution to improve healthcare outcomes and reduce healthcare costs by collecting, recording, analyzing and sharing lots of new data streams much faster and more accurately. Many of the inefficiencies in healthcare can be reduced as adoption of IoT grows. For example, many data collections, measurements, and tests that are currently administered and recorded manually can be performed by sensors embedded in medical devices, such as diagnostic equipment, drug dispensing systems, surgical robots, implantable devices, personal health and fitness sensors, and personal items.

San: IoT is poised to transform significantly healthcare – major transformation is already underway. Judicious use of IoT in healthcare can improve current healthcare practices and operations, drive new efficiencies, reduce healthcare costs and facilitate innovative new solutions, resulting in better healthcare services and improved patient experience. It will also improve the access to care for people in remote locations and at home as monitoring systems can provide a continuous stream of data for better decisions by healthcare providers. IoT is gaining lots of interest among healthcare providers and health tech industry and will emerge as a major enabler of improved healthcare.

Daniel: This is extremely important, for example, into gaining insights into patient's response to therapy or drugs. Traditionally healthcare providers had to look for samples of patients (usually small - thousands of people at most), pay them, monitor them over limited time and then analyze the results. Now for the first time in history it's possible to collect real-time data from hundreds of thousands or millions of patients over months from wearable devices.

Keith: IoT will be critical in taking healthcare to the next level. It's no secret that we have an aging baby boomer generation that is technologically advanced. IoT will help spur new innovative medical devices and solutions and it will give patients and doctors more access to data/information in real time. Furthermore, it will allow physicians to monitor patients when they are mobile.

Mike: Integrating communications including IoT will create new solutions in healthcare that will improve care and patient outcomes for chronic diseases and post-surgery care. Passive solutions that promote ease of use and provide population health information will make many of these solutions mandatory by major healthcare providers.

What are some of the key issues/challenges that IoT can address to improve healthcare systems in the US and abroad?

Haluk: Data and system integration are some of the major technology related costs. Each healthcare provider uses different IT solutions with different semantics. Also, this will be a cultural change for patients and healthcare service providers.

Daniel: One of the biggest challenges is getting insurance companies to pay and gaining FDA approvals for the new technologies. This risk-averse culture is one of the major challenges. The new technologies cannot guarantee miracles, but as long as they are not harmful, they should be given a chance to prove themselves.

Keith: IoT will allow physicians to collaborate with other doctors around the globe and share best practices. This will be a key enabler in allowing physicians that may have a specialty located in another city or country to provide assistance to healthcare providers. IoT will help increase the knowledge base of physicians around the world.

Mike: Getting chronic diseases, digesting proper medication and post-surgery care are the three main areas where I see improvement. The challenges that need to be addressed are the regulatory approval, patient and caregiver adoption and motivating providers to deploy new technology to address these major areas.

How will IoT resolve interoperability issues with healthcare systems?

Haluk: Interoperability has been (and will be) a major issue for these emerging solutions. IT solutions grow like ecosystems, living organisms, in different organizations. It will be almost impossible to use the same semantics in these ecosystems - that's why there will be many middleware technology solutions (and solution providers) to resolve this issue.

San: Interoperability is a key issue and a major barrier in adoption of IoT across many areas of healthcare system. To realize the full potential of IoT, the healthcare IT industry should collectively address interoperability issues and adopt open standards rather than proprietary protocols and interfaces. The good news is that professional societies and organizations in collaboration with businesses have begun to address this issue.

Daniel: By providing highly compelling patient data that healthcare providers and insurances would want to have access to. Once that happens, healthcare providers and insurances will become the driving force in resolving the interoperability issues instead of standing in the way.

Keith: This will be a major challenge. There will have to be standards in the healthcare market to overcome interoperability issues.

Mike: IoT will not resolve interoperability issues. It will push the healthcare industry to use new technologies to create new open integrated systems requiring existing and new vendors to resolve interoperability issues. New IoT technologies may create more agile, flexible techniques to break many of the interoperability within systems, process and people.

The chart provides an overview on the battleground for potential revenues in the IoT healthcare market. The motivated healthy sector is primarily served by wearable devices. The sweet spot for the IoT market is in the middle. This is where the bulk of the revenues can be made by focusing on products that target these areas.

How will IoT resolve information security issues with healthcare systems?

Haluk: Most IoT solutions are enabled by cloud solutions. Today, most cloud solutions are much more secure than internally hosted IT solutions. Some data will be hosted internally, and others will be hosted remotely. IoT solutions that are enabled by federated architectures and peer-to-peer communication solutions may reduce some of security related risks.

San: The widespread adoption of IoT in healthcare will increase security risks and appropriate measures have to taken to secure systems.

Daniel: Security and privacy need to be addressed upfront by technology providers. In addition, the industry needs to come up with a set of transparent privacy and security rules – and security is inseparable from privacy.

Keith: Healthcare has very stringent security requirements. Conquering the challenges in healthcare will allow IoT to improve security in other markets. Healthcare will play a critical role in shaping security in the overall IoT market.

Mike: Information security remains an issue with any and all healthcare IT including IoT. I see IoT as just another part of the system that will need to honor and provide security within the required technologies and platforms.

How can IoT improve healthcare data collection and exchange?

Haluk: Sensors that collect and stream data from various healthcare stakeholders such as patients, ambulances, hospitals, doctors, and nurses to be infused in operational processes for more effective and efficient healthcare services. And the dynamic collection of patient data over time to help enable preventive care, prompt diagnosis of acute complications, and promoting understanding of how a therapy is helping improve a patient's parameters.

Daniel: Remote wireless sensors will allow real-time data collection; cloud services will ensure accessibility of this data from any device, given the security and privacy in place.

Keith: Data collection can be provided when a pill box is opened - the information can be sent to a care provider to ensure that a patient is taking their medicine. Another example could be a glucose meter that sends results back to the care provider so they can chart the data in real time. IoT will also improve record management, inventory of assets, and real-time data on patients, and will also help reduce errors that can be caused by humans inputting incorrect data by accident since the process will be automated.

Mike: As more solutions are adopted and implementation, data collection of patients will be collected passively which will provide more actual information that will increase the accuracy and detail of population health data.

How about tracking and location-based services?

Daniel: RTLS (real-time location systems) are already being widely deployed across hospitals. These systems and constantly improving and soon hospitals will be able to accurately track patients, staff and equipment throughout the hospitals to optimize the flow and ensure better patient experience.

Keith: The tracking/location of narcotic drugs that require various sign-offs can be tracked in real-time and if an item is missing it can provide the timeframe in which it was moved. There is increasing need to track medical equipment assets similar to fleet tracking.

And analytics and intelligence?

Haluk: As a result of IoT implementations, more data will be generated, and will be enabled for a user's consumption for efficient and effective decision making. Predictive analytics will also be a part of traditional decision making processes.

Daniel: Once data is in the cloud a lot can be done to analyze it and mine it - that's one of the most rapidly growing areas of the IOT. Data visualization is another promising growth area.

Keith: IoT will provide a large amount of data that will allow for better predictability and improve decision making for patients.

Mike: Information and data will be available for population health that will increase the treatment and customization of care including predictive analytics and genetics.

What about mobile challenges?

Daniel: Wireless ensures mobility, at least in most cases. Today many solutions utilize hospital Wi-Fi systems, ZigBee, Bluetooth, low energy, ultra-wide-band to ensure that objects and sensors can easily be moved from spot to spot without losing connectivity.

Keith: IoT will eliminate current mobile challenges because cellular technology can be used.

How will IoT improve medical imaging?

Keith: It can provide first responders a device that can transmit images back to a hospital before a patient reaches the hospital. It will also allow any healthcare provider that is mobile with a mobile medical imaging device to capture images in the field/remotely.

Lastly, how about some sagely closing remarks?

Haluk: Today almost all healthcare service providers are looking for ways to offer more outcome-based effective healthcare services. For example, a hospital may provide a high quality service but a patient may not be cured. IoT might be able to provide the agility that healthcare providers are looking for. There also needs to be a balance between data-enabled decisions vs. instincts. Going extreme on one side may create new challenges and issues. Privacy issues may happen because of collecting too much data from people.

San: If ongoing developments and interest by businesses and investors is any indication of what is in the horizon, the technology for collecting, analyzing and transmitting data in the IoT will mature, and interoperability and security issues will get addressed. Several health tech startups as well as established IT companies are creating new IoT-compatible clinical sensors, tools and devices and innovative applications aimed at revolutionizing the healthcare industry.

Examples of new IoT-enabled devices are: infant monitors that send parents real-time data; smart diapers that analyze patients' urine to check hydration levels and identify signs of urinary tract infections (UTIs) and automatically sent to a caregiver's smart phone; and a smart insulin injection tracker to help diabetic patients manage their health. We'll see exciting new IoT-driven healthcare applications and systems.

However, as with any new technology, there is lot of hype about the promise of IoT in healthcare. IoT has to be embraced where it offers value addressing security, privacy, reliability and availability issues. To capitalize on the promise of IoT, healthcare providers must develop and implement a strategy that is suited to their needs and objectives while addressing the risks and concerns. This would also call for reengineering their current practices and procedures. One-size-fits-all strategy won't suit all of them.

Daniel: Healthcare technology changes will start with consumers. As large consumer electronics companies are entering the space - e.g. Samsung with their Simband announcement or Apple with their health platform and largely anticipated wearable device - they are establishing platforms and building consumers trust of measuring and sharing their health data. As more and more of this data will be collected, processed and analyzed in real-time it will bring healthcare providers and insurances on board to integrate it with their existing systems and processes. This will ensure better healthcare quality.

Keith: One of the biggest hurdles to adoption is who is going to pay for it. There is a clear benefit to IoT in the healthcare industry and it can help drive innovation and enable new processes. For IoT to take-off, it will require better education of healthcare providers, administrators, insurance companies and patients. Furthermore, it will require medical device companies to work closely with others that they are not used to working with. Once this technology is adopted, healthcare can improve by leaps and bounds.

Mike: There will more communication between patients and caregivers as well as improved treatment of chronic care with the increased use of IoT solutions. Patient information will become available and leveraged by patients for improved care.

And finally, here's my takeaway--today's evolving smart services and IoT have the promise of providing the desperately needed Connected Collaborative Care that delivers critical information where and when caregivers need it , resulting in improved care and increased efficiency. A "traffic cop" communications center for schedule coordination and assisting in data exchange is key to successful implementation

Questions? Comments? I welcome both – track me down at kwvrbicky@aetmedical.net.

Return to: 2014 Feature Stories