Smart healthcare: IoT redefining the way healthcare is delivered

As the world is embracing the new wave of digitalization triggered by the pandemic and the arrival of 5G, the adoption of IoT devices will further boom. With adoption set to soar, IoT security issues and other challenges can't be ignored anymore.

The Internet of Things (IoT) technology, an ecosystem of internet-connected physical devices that generate and exchange a huge amount of information in real-time, is transforming the nature of connectivity and service delivery around the world. From transportation and agriculture to hospitality and healthcare, all major industries are embracing this technological innovation in multiple ways.

The COVID-19 pandemic has further accelerated the boom in the adoption of IoT technology, especially in the healthcare sector. As the health applications of IoT are surging, the technology is picking up momentum.

When it comes to the healthcare industry, IoT has opened a myriad of possibilities to improve accessibility, safety and affordability of services through better analytics and techniques. The emerging technology holds the power to address various challenges the healthcare industry is facing today- from rising healthcare costs and increasingly aging population to care management- and redefine the way healthcare is delivered.

Healthcare IoT in action: Use cases and applications

There are numerous use cases and applications of IoT in the healthcare industry, from remote health monitoring to personalized care and health management. Let's explore a few of them:

Telemedicine and remote health monitoring

IoT technologies have extended patient care beyond the four walls of a hospital. Using IoT-powered remote care solutions that generate and transmit patient data in real-time, medical professionals can remotely monitor patients and keep track of their vital signs and respond quickly in event of an emergency, subsequently improving health outcomes and reducing the number of hospital visits of patients.

For instance, QuiO, a cloud platform that wirelessly connects various therapeutic devices related to medications, activity, and health for patients with chronic conditions, delivers virtual and proactive care. Tools for mobile and web allow healthcare providers and caregivers to see trends and more effectively respond to data. Users can also get personalized tips on dealing with conditions and have opportunities to anonymously participate in research studies.

Real-time monitoring can be a boon for rural regions, for patients with acute and chronic conditions such as heart attack, respirators attacks, and diabetes that require continuous intervention, and also for post-hospitalization care of patients.

Babylon Health is a subscription health service that enables subscribers to contact doctors and other medical professionals via video messaging and text for virtual consultations on all medical concerns. This service is bringing high-ranking specialists to those who would otherwise have no access to medical care at all. Patients rate each interaction and the feedback helps the company in consistently improving the quality of service high. The service is currently available in the United Kingdom and Rwanda only, but it plans to rapidly expand coverage to the entire world.

Another example is Spry's wearable Loop device that delivers the “monitoring power of a hospital bed in the form factor of a fitness tracker." Among its capabilities are the facilitating of continuous vital sign data monitoring as well as the ability to monitor patient status via the cloud and glean actionable insights that spur better care.

The COVID-19 pandemic has dramatically increased the use of telemedicine which involves the use of digital channels to provide care, and it is likely to become the new normal.

Doctor on demand, one of the leading virtual care providers in the US, is making telemedicine mainstream. Using video conferencing, the company's wide range of specialists are diagnosing and treating both urgent medical conditions such as urinary tract infections, conjunctivitis or respiratory infections, and chronic conditions like diabetes, obesity, and thyroid issues. All at a fraction of the cost of in-person care.

The virtual care provider of choice for several Fortune 100 companies, Doctor On Demand recently launched Synapse, a virtual primary care platform designed to integrate with US health plans and employers' existing networks. Synapse will enable the company's customers to import health data from connected devices such as blood pressure monitors or fitness trackers and easily share it with their Doctor on Demand's care team either via electronic records or even fax.

Personalized care

Based on an individual's unique health needs, IoT based health systems can help deliver personalized healthcare. IoT empowered devices such as smartwatches, smart bands use sensors to get detailed and real-time insights on patients' health, and the information can be passed on to medical professionals for further analysis, subsequently enhancing the quality of healthcare. IoT devices can be a savior for at-risk elderly individuals and the disabled who need full-time care.

For instance, DxtER, a mobile diagnostic device inspired by the medical Tricorder of Star Trek fame, uses non-invasive sensors to continuously measure vital signs, body chemistry, and biological functions to accurately diagnose 34 health conditions such as diabetes, atrial fibrillation, tuberculosis, and pneumonia independent of a healthcare professional or facility. Developed by Basil Leaf Technologies, DxtER was the winner of the 2017 Qualcomm Tricorder XPrize.

Another example is HealthCrowd, the first end-to-end engagement platform for healthcare that provides support for healthcare organizations interested in unifying, automating, and optimizing multiple forms of communication in order to deliver individualized patient-oriented care. HealthCrowd provides a solution combining healthcare expertise and ad analytics. Its main focus is to engage patients, ensuring improved quality, clinical, and financial better care outcomes. HealthCrowd's Unified Communications Platform employs different technologies and channels text, voice, email, and nanosites – working in concert to drive members to action.

Higi, a health engagement platform that builds innovative solutions to empower consumers to measure, track, and act on their health data through easily accessible smart health stations. Through its network of over 10,000 FDA-cleared smart health stations, Higi solutions engage and connect the consumer and their data in real-time with their trusted healthcare organizations to improve satisfaction, increase quality, and reduce cost.

Tobacco kills more than 8 million people each year. According to the World Health Organisation (WHO), more than 80% of the 1.3 billion tobacco users worldwide live in low- and middle-income countries, where the burden of tobacco-related illness and death is heaviest. However, professional support and proven cessation medications can more than double a tobacco user's chance of successful quitting.

Digital health company Nicotrax has developed an intelligent solution that uses a smart cigarette case that attaches to a cell phone combined with a well-designed app, to create personalized plans that help people stop smoking. The program monitors all aspects of smoking behaviors, including where you smoke, times of day, and food intake, among other factors. A dashboard reveals individual patterns of smoking behavior in relation to those of other users. This information is combined to provide methods to decrease and eventually eliminate smoking habits. Anyone who seriously wants to quit smoking can use this technology to powerfully support their efforts.

Improving medication adherence

Medication adherence is vital to improving health outcomes and reducing health care costs. However, according to a 2003 report by the World Health Organisation, approximately 50% of patients do not take their medications as prescribed, leading to increased morbidity and death.

Insights derived from connected devices can help promote medication adherence. According to a study, adopters of digital health activity trackers tend to be more adherent to hypertension, diabetes, and dyslipidemia medications, and adherence increases with tracking frequency.

Proteus Digital Health has developed a digital system comprising an ingestible sensor, a small wearable sensor patch, a smartphone application, and a provider portal to get insight into patient health patterns and medication treatment effectiveness. When the ingestible sensor reaches the stomach, it produces a small signal that is picked up by a sensor worn on the body. The data is then relayed to a smartphone app, confirming that the patient has taken their medication as directed. With patients' permission, the digital record can be shared with healthcare providers and caregivers.

For medication management, a Canadian healthcare technology company has developed AceAge Karie, an automatic medication dispenser that organizes, schedules, and delivers your medication with the touch of a button. The device automatically syncs with patients' prescription schedule, lights up, and produces a calming chime when it's time to take medication. With the push of a button, the medication dose is delivered, in a pre-opened pouch.

Similarly, there are multiple smart devices and smartphone applications in the developing IoT marketplace that can simplify medication routines.

Health management

Healthcare providers can leverage the data collected by IoT devices and sensors to identify gaps in service delivery and prevent patients' readmission to hospitals, thereby reducing the burden of readmissions on the already overwhelmed health systems.

Kensci, an AI-powered risk prediction platform for healthcare enables health systems to easily manage their data and gain predictive insights, which in turn increases the quality of care and lowers costs. By aggregating data from electronic health records, wearables, and other sources, the platform predicts patient risks of developing chronic and critical illnesses including heart disease. KenSci also provides estimates of expected costs for future years, helping hospitals to better plan their annual budgets.

Spry's FDA-cleared Loop System is another such example that manages care for high-risk and immunocompromised patients by identifying early physiological deterioration and helps avoid hospital admissions or readmissions. In situations like the COVID-19 pandemic that require at-risk patients like older adults and those with chronic health conditions, suspected and confirmed patients to regularly check for the symptoms, solutions like Spry's Loop System can be really helpful. It can track multiple vitals that are critical to assess the risk and progression of COVID-19 and intervene ahead of an emergency.

Less explored use cases

While the above-discussed IoT healthcare applications and use cases promise a transformative change in the healthcare space, there are also several other areas where the potential of IoT technologies hasn’t been tapped at a wide scale. In this article, we are highlighting some of the less explored but promising use cases of IoT in healthcare:

Large-scale health data collection and analysis: The purpose may be to find out the prevalence of the disease, general health and nutrition status or may even help in identifying the cause for a disease that is afflicting a large number of individuals or can even help avoid large scale public health emergency like the ongoing pandemic.

Data collected through these sources can even help in monitoring of public health programs and gauging their success in real-time through multiple means with the ability to discover intended interconnections through analytics.

Use of Mobile sensing solutions to deliver a preliminary diagnosis: Lack of availability of services is not the only barrier to healthcare access. Even if the services are available, there are still barriers like the high cost of healthcare, overwhelmed public hospitals, lack of public transportation, social barriers that prevent people from gaining access to even primary healthcare services. In these cases, mobile sensing health and fitness devices like wearable and implantable sensors as well as carry-able devices that utilize sensors and wireless technologies have great potential to improve primary healthcare by introducing new delivery channels.

Minimize drug resistance: Drug resistance is one of the biggest challenges for modern medical science. IoT can be used for closely monitoring a patient's response to a particular treatment and identify signs indicating the presence of drug resistance. Technologies like ingestible sensors can be used to combat the problem as they facilitate the collection of real-time data on individual patients.

Addressing vaccine hesitancy: According to the WHO, vaccine hesitancy, the delay in acceptance or refusal of vaccines despite its availability is one of the top 10 threats to global health. Community engagement and trust-building are key to improving and maintaining vaccination uptake and reducing the burden of preventable infectious diseases on healthcare systems. IoT devices can be leveraged for real-time and effective public health information dissemination to increase knowledge and awareness surrounding vaccination and promote its uptake and acceptance among under-vaccinated communities.

Challenges

As with other evolving digital technologies, there are some technical, financial, and regulatory challenges that are holding back the full adoption and acceptance of IoT, not only in the healthcare sector but in other industries as well. One of the most significant challenges for IoT today is data security. With a huge amount of personal data being stored and transmitted in real-time, IoT devices are extremely lucrative for hackers to exploit. Moreover, these devices have poor built-in security features due to a lack of regulations. Lack of awareness among customers is another reason that these devices are often targeted by hackers.

According to a recent report from Nokia, 2020 has witnessed a massive surge in IoT-related infections with IoT devices now making up roughly 33 percent of infected devices, up from about 16 percent in 2019. The COVID-19 pandemic and subsequent restrictive measures like lockdowns and social distancing dramatically accelerated the adoption of internet-connected devices whilst opening ample opportunities for cybercriminals to take undue advantage of the vulnerabilities in IoT devices.

Apart from data security and privacy concerns, high up-front investment is another major barrier to IoT adoption in healthcare. Hospitals, other healthcare organizations, and individual providers are required to make high initial investments to upgrade their existing infrastructure to integrate IoT devices, manage the constant influx of data, and derive actionable insights from them. The initial cost of availing IoT-powered healthcare services is often high for patients as they may need to purchase smart medical devices to connect with providers. Further, IoT devices also need maintenance and regular updates. Therefore, the high cost of IoT device deployment and maintenance is an obstacle for a majority of the healthcare providers seeking to transform and modernize services.

Large-scale adoption of IoT could also increase power leakage and energy consumption due to an increase in the number of sensors and the devices that require higher energy to process.

Yet another major challenge hindering the implementation of IoT in the healthcare sector is the lack of integration and interoperability among the large range of devices and services available in the market. This challenge is posed by inadequate regulations and a lack of commonly accepted standards that can enable these devices to seamlessly work and exchange data. This non-uniformity limits the scope of scalability of IoT in healthcare and makes it difficult to aggregate data for vital insights and analysis.

Other major barriers include a lack of technical skills and familiarity with the new technologies, the digital divide, and a lack of user trust and awareness.

Way Forward

As the world is embracing the new wave of digitalization triggered by the pandemic and the arrival of 5G, the adoption of IoT devices will further boom. With adoption set to soar, IoT security issues and other challenges can't be ignored anymore. It's high time for the IoT device makers to take responsibility and make security a top priority. Further, consumers need to take equal responsibility for protecting their IoT systems.

A coordinated response to tackle hindrances and kickstart mass adoption is required to ensure system-wide interoperability to minimize future problems and maintenance costs.

To conclude, IoT technology is undoubtedly a transformative approach for the healthcare industry but there are still challenges and concerns that need to be resolved to further drive its mass adoption and reap its maximum benefits.

VisionRI's Centre of Excellence on Emerging Development Perspectives (COE-EDP) aims to keep track of the transition trajectory of global development and works towards conceptualization, development, and mainstreaming of innovative developmental approaches, frameworks, and practices.