Evolving Use Cases Within Health IoT Applications
In 1982, computer science students at Carnegie Mellon University got their Coke machine online. If you’re wondering why — other than the obligatory because they could — open-source pioneer, Tom Lane, explains:
“In the mid-seventies expansion of the department caused people’s offices to be located ever further away from the main terminal room where the Coke machine stood. It got rather annoying to traipse down to the third floor only to find the machine empty — or worse, to shell out hard-earned cash to receive a recently loaded, still-warm Coke. One day a couple of people got together to devise a solution.”
This clever hack is often touted as the origin of the Internet of Things; and it certainly embodies some of IoT’s hallmarks — remote monitoring, responsive technology, optimized customer experience, and so on.
IoT is more about data, less about things
But for Kevin Ashton — who coined the term, Internet of Things, in 1999 — an online Coke machine is not the real thing. More than simply connecting everyday “things” to the Internet, IoT is really about automating data capture — enabled by a combination of networked computers, sensing systems, and machine-to-machine (M2M) communication:
“The ‘Internet of Things’ means sensors connected to the Internet and behaving in an Internet-like way by making open, ad hoc connections, sharing data freely and allowing unexpected applications, so computers can understand the world around them and become humanity’s nervous system.”
Humanity’s nervous system.
It’s an evocative analogy that reveals the crux of IoT.
Your nervous system coordinates all your body’s activities — both its routine operations and its response to unexpected or emergency situations — like touching something hot.
Ashton believes the Internet of Things will eventually coordinate all of humanity’s activity — at least its economic activity — by performing the same core functions as the human nervous system; sensing, processing, and responding to stimuli. Intelligently, automatically, and all in real time.
But to be sure, many core human activities — like maintaining the health of people and their communities — transcend mere economic activity, and cross over every market segmentation.
“Healthy Communities” intersects the traditional IoT segmentation
Most analysts divide the Internet of Things into two large segments — industrial and consumer.
Industrial Internet of Things (IIoT)
Traditional industries currently spend the most on IoT, with Manufacturing ($178B), Transportation ($78B), and Utilities ($69B)leading the way, according to IDC. Industrial IoT is all about making factories, offices, farms and other workplaces “smart.” Machines, devices, vehicles, cameras, and other “things” are equipped with sensors that monitor temperature, motion, pressure, and other parameters. The data generated by the “thing” can trigger an automatic response — say, shutting down a machine. Or, the data can be collected, collated, and analyzed to optimize equipment, maximize uptime, and ultimately increase revenue.
Consumer Internet of Things (CIoT)
Think smart homes and domestic devices, like smart thermostats. Fitness trackers, smart watches, and other “wearables.” Tracking devices for your stuff, your pets, and your kids. Connected cars and smartphones.
Smartphones are bristling with connectivity, apps, and sensors (the “neurons” of humanity’s nervous system). The average smartphone sports over a dozen sensors — everything from a gyroscope and GPS to a fingerprint sensor. As smartphone manufacturers and software developers create new sensors and apps for a variety of health, entertainment, and other purposes, your smartphone will become your gateway to the Internet of Things. A thing itself, yet so much more. That said, the real world doesn’t cleave quite so neatly. Industrial and consumer IoT applications co-mingle, overlap, and cross-pollinate. And there’s probably no better example of the convergent, multivalent world of IoT than healthcare.
Rapid advances underway: Health IoT as a constant
The most common uses of Health IoT are tracking and monitoring applications. What is changing today is how core these are to the healthcare mission, and how constant and prevalent their presence.
Hospitals use real-time location systems (RTLS) and other RFID technologies to track equipment, medications, and even people. “Lost equipment is a chronic and under-appreciated challenge in today’s hospitals,” says Andy Holman, Applications Director for connected business solutions provider, Mojix. “Especially where different units share in-demand equipment. Any technology that helps staff find the equipment quickly and efficiently is a valuable time-saver — sometimes even a life-saver.”
RFID technologies are also being deployed to help prevent medication errors — one of the most common inpatient errors and a huge patient safety concern.
“Healthcare providers need better, more intelligent systems for managing their pharmaceutical inventory, “says Gary Burns, CEO and Co-founder of IoT and smart packaging innovator, eAgile. “Drug manufacturers are always looking for ways to combat diversion, counterfeiting, and product tampering. Our eSeal solutions solve both these problems.”
Closer to the patient: body of data
Cloud-based electronic medical records — increasingly accessible on tablets and smartphones — provide immediate access to complete health records from anywhere, allowing clinicians to deliver better, more informed care, faster.
But health IoT opens up tremendous opportunities for data that comes direct from the human body — for example, via remote patient monitoring. Beyond telemedicine and video consultations, innovators like Dr. Joseph Kvedar and his Center for Connected Health have developed smartphone apps and wearable, real-time monitors to help patients manage obesity, diabetes, heart disease, and cancer. They are collaborating with Partners Healthcare to automate the capture of vital signs from patients at home and transmit them directly into electronic medical records. Others are developing “smart toilets” and “smart clothing” that will also automatically capture and relay biomedical information directly to caregivers.
This is a whole new diagnosis paradigm — diagnosis as a constant in peoples’ daily lives, rather than episodic events that require in-person visits to the doctor or hospital, perhaps when it’s already too late.
Many connected medical/monitoring devices can already ‘talk to’ each other, monitoring patients more closely (including at home), and leveraging predictive analytics to support clinical decision making and vastly improve outcomes.
Healthcare technology companies are already reaping benefits by using sensors to monitor and maintain medical devices. Smart devices can even “self-diagnose,” mitigating the risk of operational malfunction.
For now, device interoperability remains a challenge — and not merely a technological challenge, since many companies view their device data (if not patient data) as proprietary. “But the arc of technology bends toward open source,” says James Turner, Chief Technologist for Health IT Now, a broad-based coalition of patient groups, provider organizations, and payers, lobbying for broad deployment of health information technologies. “Likewise, Health IoT will most likely follow suit.”
How can Healthcare manage the data flood?
There are some 7 billion devices connected to the Internet today — 2 billion of which are smartphones. Futurists predict the number of connected “things” to hit 200 billion by 2020 and 1 trillion within a decade. If over a third of those of connected things are in healthcare — as we expect — the industry has a lot of work to do to prepare for that tsunami of data.
It’s not just the sheer volume of IoT data that concerns Health IT professionals. They also worry about balancing storage, security, and analytics requirements.
“Obviously, information accuracy and security are especially important in healthcare,” says John Grieco, Chief Technology Officer for The University of Vermont Health Network. “There is so much more at stake than operational disruption or loss of revenue if a hospital IT system falters. Medical information is perhaps the most sensitive personal information.”
Healthcare organizations design and build their IT systems with flexibility and scalability in mind. But with IoT, we’re adding more and more connected devices and we’re creating constant streams of big, complex, often unstructured data. Patient medical records contain charts, (huge) images, and physician’s notes — different kinds of data that might require different kinds of storage.
Meanwhile, we want to store and manage clinical data in ways that are HIPAA-compliant with no compromise on user access.
Cloud storage makes a lot of sense for analytics-heavy applications and many popular analytics platforms run in cloud environments. Additionally, cloud storage can scale affordably, reduce maintenance costs and facilitate HIPAA compliance.
Figure out what data should be captured, saved, and actioned
“It’s worth remembering that the use cases for Health IoT data are still evolving, says John Schneider, Chief Technology Officer for Bay Area healthcare data science firm, Apixio. “Healthcare as a system is still figuring out what data should be captured, how much of it should be saved, what should be done with it, and so on. In the future, presumably storage will be so affordable that you might just hang onto everything, just in case. But we’re not there yet.”
Big data analytics and Health IoT can equip caregivers with better, timelier information to make smarter decisions and accomplish better outcomes. It’s already happening, incrementally, in places like Joseph Kvedar’s Center for Connected Health, where they are making the vision of Health IoT real.
But to scale those incremental innovations to the entire healthcare system, we first have to solve a couple of non-trivial problems, endemic to the entire Internet of Things.
We have to figure out how to process, analyze, and leverage the explosion of life-critical, real-time data. We have to solve data security, once and for all. And we must determine how to prioritize the data we save, because we can’t afford to save it all.
But with so many smart, creative people working on all these challenges, we are bullish on the future of Health IoT.