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Enabling a healthy relationship with IoT in healthcare

IoT in healthcare represents an exciting new frontier for the wider tech community; it’s a landscape that is packed with opportunity and potential. But it’s also a sector which is strewn with challenges and requires more sensitivity, commitment and innovation than most. Lead strategist at Future Platforms, Olivier Legris, shares his insight on how innovators can conquer the IoT complexities of this frontier.

An aging demographic, shrinking budgets and increased demands are driving the urgent need for solutions across the healthcare sector. While running headfirst into innovation may be tempting, the healthcare sector presents a series of challenges, meaning that IoT developers need to take a slow-and-steady-wins-the-race approach if they are to achieve results that are as futureproofed as possible; their solutions could become a matter of life and death.

An obligation to change

While it’s difficult to say if IoT will guarantee a marked improvement in service, there is at least an obligation to change because of the potential benefits it could bring to hospitals, with optimization topping the chart. With the right tech, shift-work can be optimized, for example, thus determining a more efficient way of working, pushing costs down and returning the focus to the provision of quality patient care.

There are savings to be made too, and according to analysts at Goldman Sachs, a major spending reduction is not far away, thanks to IoT. In a recent report, they predicted that there is “opportunity for $305 billion in savings from [U.S.] digital healthcare, with as much as $200 billion coming from chronic disease management [CDM] [such as heart disease, asthma and diabetes],” which currently accounts for a third of U.S. healthcare spending. Enabling remote patient monitoring for CDM through IoT and its connected devices could therefore be integral to cost savings in this sector. Although, according to the report, “seismic shifts like this will take time to materialize.”

As with budget pressures, an aging demographic presents a challenge too — but one that can be overcome. Japan provides a good example: in spite of an aging population and reduced investment into healthcare, this technologically advanced country has embraced innovations in the fields of automation and robotics to answer its healthcare problems — with Toyota’s Human Support Robot being a flagship development. And with a notion that there will come a point when robots will be able to undertake 90% of human tasks, these solutions are real stepping stones towards achieving this future vision.

If countries like Japan can get it right, why are others falling down on the road towards a fully-fledged IoT experience? There are multiple reasons, including regulation constraints and social adoption, but largely it hinges on cost.

Many devices being used are not in mainstream production yet, and so costs — taking sensors as an example — are still high. In relation to sensors specifically, IBM urges that “to truly achieve cost-effectiveness, the whole system cost has to be optimized — focusing on cost optimization of a single component may not result in the lowest overall system cost over the product’s intended lifespan.”

The shift from mainstream is set to change, however, as there has been an explosion of smart, connected sensors across the board. And healthcare is one industry that is poised to lead this charge. shared its projections that the healthcare IoT market segment is set to hit $117 billion by 2020, and so it’s unsurprising that a number of initiatives are being rolled out with the aim of making it easier to connect devices to the internet. Companies leading this revolution, such as Temboo — which provides the software stack for developing IoT applications — will be first to capture a piece of this $117 billion pie.

There are a number of good examples of IoT in healthcare that are engendering this revolution, and across a variety of device types too, including connected inhalers, activity trackers for use during cancer treatment, ingestible sensors and even connected contact lenses.

Both heavy investment and time is needed before new innovations such as these will fill the IoT space in healthcare; you cannot simply throw a prototype into the space as there are many constraints surrounding regulations, the ecosystem and social adoption. It will take five to 10 years before devices in healthcare are in a good enough position to become mainstream.

Scale up with caution

Innovation and investment aside, data and its role in healthcare will be critical in the IoT game plan. The amount of data being processed in this sector is almost unparalleled, and it is likely to continue climbing. Therefore, the efficient and sensitive handling of this data — a massive task in itself — will need addressing in a new way.

IoT’s capacity to leverage a series of connected devices to deliver data more efficiently makes investment in this arena a must — a conclusion that is further strengthened by recent reports from Gartner that the total number of connected devices is forecast to reach 20.4 billion worldwide by 2020, with healthcare and retail leading the charge. However, while the collection of data is important, the analysis of it is even more crucial.

In terms of research, a major shift is starting to occur whereby studies that have been traditionally small scale and consisting of a minimal sample of patients are now growing. Google’s health spin-off, Verily, recently launched Project Baseline in an ambitious attempt to gather health data from 10,000 U.S.-based volunteers. Having scaled-up results will have an important impact on the future of healthcare as it will help professionals gain a deeper understanding of health and the transition to disease.

There’s more hesitancy surrounding the data debate in healthcare than in other industries due to its personal nature. Because of this tension, anything related to health needs to be scaled up cautiously as any backlash could be potentially devastating; the misuse of data in this sector could trigger fatal consequences.

As hackers take advantage of poor security on embedded devices, the call to protect data and patients is urgent; imagine the impact of a hacked insulin pump that can administer a fatal dose — there’s potentially a life-or-death scenario, as noted by Ed Cabrera, chief cybersecurity office at threat research company, Trend Micro.

Looking at the solutions emerging in this space, ownership and responsibility of data are therefore important issues.

A recent report by Berkley Research Group underscored the significance of data and its impact on healthcare’s IoT landscape, indicating that ultimately it’s all about information management. The report urged businesses to:

  • Know your data
  • Map your data
  • Classify your data
  • Protect your data
  • Enforce regulatory controls

To stimulate greater acceptance or readiness to share information, solution providers must keep security as a top priority, because if it goes wrong, it’s going to happen on a massive scale.

According to May Wang, chief technology officer at ZingBox, “Over the last three years, the healthcare sector has been hacked more than the financial sector. And more hacking incidents are targeting medical devices.”

At last year’s IoT hacking contest, hackers found 47 new vulnerabilities in 23 IoT devices at the DEF CON security conference. From thermostats to wheelchairs, the hackers flagged vulnerabilities which included poor design decisions and coding flaws. In spite of efforts to draft security guides and standards for IoT vendors, it seems the rush to bring new devices to the IoT marketplace means some security best practices are being ignored by device manufacturers.

To ensure best security practices are being met, Berkley Research Group’s report highlighted a number of recommendations, including:

  • Take a risk-based approach
  • Incorporate security language into procurement contracts
  • Engage stakeholders
  • Follow the data flow
  • Conduct security testing
  • Go for the low hanging fruit

The invisible touch

The decentralization of hospitals will also be paramount when evolving IoT in healthcare. At a base level, patients are admitted to hospitals so they can be assessed, monitored and treated.

The growing cost of running these facilities is exponential. To be able to have more people treated in their own homes will not only encourage a more comfortable recuperation for them within a familiar environment, but will also spur massive savings as the cost of treatment falls.

There is also the notion of accessibility and technology can work to improve the lives of those with disabilities. But it’s more than just designing user-friendly interfaces, it’s about social acceptance. For this to be achieved, developers need to consider how to create solutions which are, effectively, invisible. From pacemakers to hearing aids and mobile ECGs, there is a growing need for connected health and medical devices to become less conspicuous.

Healthcare deals with private issues that relate to personal feelings. Technological developments need to factor in this human element and the notion of acceptance of these tools at a human level. The more we succeed in making these tech tools invisible then the more successful the initiative will be.

A matter of priority

When considering the digital transformation of a sector such as healthcare, it’s important to remember that we are at the beginning of the process. There’s a lot of expectation around how and when IoT can make a positive impact, yet it’s still very early days. While we start to lay down the building blocks that will form a foundation for the future of the industry, there are a few key points that developers and innovators need to keep close to mind:

  1. Be responsible: If you don’t run a project with empathy or human care, you will fail.
  2. Think long term: Most innovators develop projects with longevity in mind, but it’s wise to remember that healthcare requires more commitment than most.
  3. Be safe: Cybersecurity is already a massive threat to healthcare, and with the rollout of new connected devices, it is only going to increase. The good news is that many IoT vendors are already investing in keeping their systems up to date and IoT management platforms are working hard to ensure threats are kept to a minimum.

While we focus on the potential downsides, we should not forget the upside, which is that this is an exciting time for tech in healthcare — think of how artificial intelligence (AI) will identify tumors more precisely than its human specialist counterparts; think of the remote surgery concept and its impressive arrangement; think of how virtual reality (VR) can be used to reduce pain levels, aid mental health issues such as claustrophobia, or entertain patients to provide them have better experiences.

While AI, machine learning and VR will potentially drive exciting and positive changes to the industry, mobile will still play an integral role, becoming the real brain behind the IoT operation.

To yield optimum results from the full implementation of IoT, the healthcare sector and its tech leaders need to be bold in their pursuit of technological innovation and adoption. It will not happen overnight, but early adopters will reap the benefits of getting a head start.

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