In part two of a two-part Q&A, Frank Palermo, senior vice president, digital, for IT consulting firm Virtusa Corporation, talks about using Internet of Things (IoT) to improve patient satisfaction in the "hospital of the future." Palermo also discusses security vulnerabilities of healthcare IoT, as well as the healthcare benefits and privacy and security hazards of the Apple Watch.
So before we talk about the hospital of the future, how is the Internet of Things changing healthcare?
Frank Palermo: We've talked a little about the monitoring of health, whether it's [Apple] Watch or Jawbone or Fitbit, that whole idea that I can now collect your individual biometric data, that's kind of the first wave.
Now, taking regulatory and compliance stuff out of the way, you're beginning to share that data. Then, whether you're a payer or provider, you're basically sending that information on a real-time basis. Can it start to move care to more preventative care, so people are now looking at your health metrics on a periodic, real-time basis? Can the watch at some point be doing real-time EKGs and look at heart patterns and be able to predict a stroke or a heart attack before it happens and basically send you alerts, saying basically, 'I'd like you to step into the clinic?'
But there's an ugly side of that, too, which comes down to security and would people use that as a way to categorize you and decide how much they charge you and assign you to a higher risk pool and begin to base premiums on this? All this stuff has to be balanced.
How do you address security-related vulnerabilities in IoT healthcare applications? Also, how do you deal with the lack of a single IoT standard in healthcare?
Palermo: Security is obviously the big topic. Hardware devices, whether it's [Apple] Watch or something else, have to have security protocols built in, just as there's firewall and virus protections built around computers and networks. This same kind of diligence has to be done at the wearable device layer. How do you make ... a thermostat, a watch or a wearable have some kind of physical protection and isolation capabilities?
Security and protocols have to get standardized and evolved, whether that's encryption or other mechanisms for the transmission of data. Ultimately, this comes down to policy and governance and education, making sure people understand how their data is being used, when it's being used, and being able to have fine-grain access to data. How do you turn off data sharing, and ultimately, what is the chain of custody of that data? Who owns that data?
Will the hospital of the future be built from the ground up, with smart beds, smart doors, smart rooms, smart everything?
Palermo: Like anything, if you're building the store of the future or the bank branch of the future, if you're building it from ground up you have a lot more flexibility, but at the end of the day, what's paramount is the patient experience side of it.
Even though a lot of progress has been made with devices in healthcare, I still think the whole front end of that process is still pretty elongated around the administration side. How do you get registered when you walk into a hospital? That should be a lot more streamlined. Today, most of the experience in a hospital is still around the administrative side and not so much around the patient side. It's all about waiting and going through registration. If you were to measure the cycle time, even for an ER visit, the least amount of time is probably spent seeing a doctor. There's a tremendous opportunity to just redesign that whole process flow and take advantage of connected information and make it more about the patient.
Are you thinking healthcare IoT applications like RFID [radio frequency identification] tagging of patients and family members to improve information about wait times, for registration, for surgery start and exit times?
Palermo: Those are some of the things I'm alluding to, but even more interesting is if I were to come in and be presented with a 'care kiosk' where I start to enter my symptoms. They already have access to my patient record. So I click the hospital app on my mobile phone when I'm on my way to the emergency room, [and the hospital app] knows who I am and what I'm coming in for.
Now you walk up to the kiosk and there's a QR [quick response] code on your mobile device. The kiosk is not asking you who your insurance is. It's there to help the care process. It's saying: 'Describe to me a little more about the symptoms that led up to this episode,' to help diagnose. 'How long has it happened? Have you tried this remedy? How'd that work?' It involves all the stuff that might happen during the first five minutes of the doctor actually coming to see you, and uses analytics to start to diagnose a range of options -- all before you even see the doctor or a nurse.
The minute I walk in the door of the hospital, it should be about me, even if it's e-care. It's about improving the depth and quality of care, and maybe this is where [Apple] Watch or the wearables come in. You're able to put together a more customized experience.
Kind of like in the retail business, using technology to improve customer experience?
Palermo: Yes. Organizations that take care of patients can learn a lot from retailers, that's for sure.
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