When it comes to patient satisfaction, traditional health care is not making much progress. Patient waiting time is steadily increasing. For instance, between November 2016 and March 2017, more than 290,000 patients in the UK waited at least four hours to be admitted – an increase of almost 70,000 on 2015. Meanwhile, healthcare costs are getting sky high. The United States spends twice as much on healthcare as 10 other high-income nations. The U.S. government estimates that the health share of GDP will rise from 17.8 percent in 2015 to 19.9 percent by 2025.
At the same time, way too many medical resources are non-transparent and unevenly distributed, whereas legacy systems are halting every attempt at achieving connected healthcare. Suffice to say that, in spite of the reliable technologies available to measure patient vitals and feed the information seamlessly into hospital records, nurse rounds, temperature, blood pressure, etc. are still largely recorded by hand. And that leaves room for many errors.
More than ever, the world needs and wants connected healthcare. As reported by Ericsson:
- 39% of chronic patients prefer online consultations to face-to-face medical appointments;
- Almost 2 in 3 consumers say wearables that monitor and administer medication help them better manage chronic ailments, reducing the number of doctor’s visits;
- 35% of consumers believe having online access to a central repository of medical records will help them easily manage the quality and efficiency of their care;
- 52% of decision-makers in health care, insurance, regulatory bodies, app developers, telcos and medical-technology companies agree that automation and remote solutions will address resource scarcity in health care.
The good news is connected healthcare services are starting to emerge. In spite of the slow adoption rate, IoT already brought significant developments in healthcare. It follows to mention the growing number of connected wearable devices, 80% of them being used in clinical applications. Or the possibilities IoT creates for remote patient monitoring and diagnosis, treatment adherence, telesurgery and equipment monitoring.
But what shapes and forms does IoT take in healthcare? What do patients and healthcare professionals gain from an accelerated IoT adoption rate? Before we do an overview of the value that IoT creates, let’s take a quick look at the abundance of IoT scenarios in healthcare.
Major IoT breakthroughs in healthcare
IoT connects intelligent sensors, devices and software to computer networking systems using Bluetooth, Wi-Fi, radio-frequency identification (RFID) or machine-to-machine (M2M) wireless technology. This inter-functionality serves a greater purpose, i.e. provisioning cost-effective, information-driven and efficient patient care.
In the context of the Industrial Internet of Things phenomenon, healthcare providers are beginning to leverage IoT, in combination with applications and technologies in the field of robotics, Artificial Intelligence and Big Data.
According to a new Grand View Research report, the global healthcare sector is expected to invest approximately $410 billion in IoT devices, software and services by 2022, up from $58.9 billion in 2014. At the same time, 70% of people want doctors to monitor their health remotely. 81% of people under 45 are eager to learn about the IoT technology and share data with their doctors. This means that both healthcare providers and beneficiaries are becoming increasingly aware of how much there is to gain from building health care services using the IoT technology.
IoT already runs deep and wide, redefining the healthcare experience for both patients and healthcare professionals in so many ways:
Telehealth is not a specific service. It encompasses a broad variety of technologies and tactics used for delivering diagnosis and management, education and other related fields of health care.
In the beginning, telehealth was limited to the remote diagnosis and treatment of people from rural areas that lacked specialized medical professionals. Today, it connects patients, smart medical devices, tablets, phones and wireless sensors with healthcare professionals. Here are some practical telehealth applications:
- Live streaming (synchronous): Serves as a substitute for an in-person doctor’s appointment.
- Store-and-forward imaging (asynchronous): Refers to transmission of recorded health history, i.e. pre-recorded videos, x-rays and photos. Doctors can use such resources to assess cases and provide care without the need for a real-time or live interaction.
- Remote patient monitoring (RPM): Refers to personal health and medical data collected by wearable devices (like electronic blood pressure cuffs, blood sugar testing devices, insulin pumps) and connected sensors. The gathered data is sent via Wi-Fi to the patient’s Electronic Health Record (EHR) or to applications that healthcare providers can instantly access. Goldman-Sachs researchers David H. Roman and Kyle D. Conlee define remote patient monitoring as “devices and applications that allow care providers to keep tabs on chronically ill, recently released, and overall ‘high-risk’ patients.” In the US, the 2012 Affordable Care Act implemented a penalty for hospitals with a high readmission rate. RPM stands as an effective solution for hospitals to cut down on costs and avoid such penalties, without compromising patients’ access to healthcare services. Basically, connected monitoring devices allow doctors to gather and analyze their patients’ health without having to physically see them. Thus doctors have round-the-clock visibility into how their patients are doing and can catch early signs of problems and take preventive actions. Ultimately, RPM simplifies the treatment of the chronically ill and reduces the number of hospital readmissions as well as the lengths of stay in the hospital.
- Remote diagnostics: Data transmission via Electronic Health Records (EHR) allow for quicker and more accurate diagnosis and treatment of a large number of conditions.
- Mobile health (mHealth): IoT applications make it possible to collect community and clinical health data, deliver healthcare information to practitioners, researchers and patients, monitor patient vital signs and provide care in real-time using mobile devices.
The remote surgery (telesurgery) technology enables doctors to perform surgeries on patients even though they are not in the same location. The distance barrier between surgeons and patients is thus removed thanks to a system build on robotics, high-speed data connections and management information networks. The major benefit is that patients no longer need to leave their local hospital to benefit from the expertise of specialized surgeons from around the world.
For example, the da Vinci Si surgical robot provides surgeons with unparalleled precision and control, facilitating a minimally invasive approach to complex surgery procedures. The robot translates the surgeon’s hand movements into smaller, precise movements of tiny instruments inside the patient’s body.
The laparoscope is one such tiny instrument. The tiny camera embedded in the laparoscope sends images to a video monitor in the operating room to guide doctors during surgery. The robot offers enhanced 3D, high-definition vision of the operative field, visual clarity of tissue and anatomy, surgical dexterity and precision greater than the human hand.
3. Elderly monitoring
Advances in science and medicine translate into longer lives. The world population aged 60 and above is already estimated to reach 2 billion by 2050. Among them, 21% are likely to be aged 80 or above. These statistics are enough reason to build an unobtrusive way to take care of the aging population, and IoT already makes it less challenging for senior citizens to live independently.
With the help of technologically advanced gadgets, the elderly can live comfortably at home with minimal need of specialized care. IoT sensors and devices allow relatives and support systems to watch over them, monitoring their movements, body motility and vitals, analyzing their behavioral changes, enabling quick intervention in case of emergencies.
For example, people with mobility challenges or impaired memory are more prone to accidents. Smart home systems can monitor their movement and instantly inform caregivers and relatives on frailty signs or falls. At the same time, IoT enables senior citizens to handle household chores with minimum effort. The house temperature can be adjusted from a smartphone, food consumption can be tracked and groceries can be automatically ordered and delivered to them.
4. Treatment adherence
In developed countries, only 50% of patients who suffer from chronic diseases such as heart failure, diabetes, cancer or HIV follow their long-term medical treatment. In the US, medication non-adherence drives the largest avoidable cost as patients who do not follow prescriptions suffer from complications that incur approximately $105 billion annual expenses.
An IoT solution such as the wireless pill bottle helps people with medication-dependent conditions stick to their prescribed treatment. This internet-connected device works like an electronic nudge. The bottle can hold a long-term charge and can alert patients via call, text or by blinking whenever they need to take their medicine. The sensors in the bottle detect when the cap is twisted off and how much medication is removed.
The latest IoT solution for treatment adherence is the smart pill. In 2017, the US Food and Drug Administration approved the first drug in the US with a digital ingestion tracking system. Abilify MyCite has an ingestible sensor embedded that records when the medication was taken and sends a message to a wearable patch, which in turn transmits the information to a mobile application. The patient can track the ingestion of the medication on their smartphone and can allow access to their caregivers to access the information through a web-based portal.
5. Equipment monitoring
In the US, hospitals misplace or lose equipment making for 20% of their yearly budget. In case you’re wondering how it is possible for major hospitals to lose money by the millions, a 2015 investigation revealed that the University Medical Center (UMC) in New Orleans lost $15 million-plus worth of equipment. Why? Because the staff never tagged or recorded the assets.
Within hospitals, connected devices help staff keep track of resources and manage them more efficiently. For example, Intelligent Locations is an IoT solution that ensures precise tracking of medical assets and patients. The app, which is already used by several US hospitals, optimizes workflows and processes, cutting down on wasted time otherwise spent on searching for equipment or tracking down patients. The app’s analytics and automated reports on the utilization rate of medical assets help decision-makers better strategize their investment in new equipment. The other benefit of this application is that it enables staff to keep track of patients during admission and informs patients’ families whenever their loved ones change location.
Among other reasons, increased emergency room wait times are also due to the lack of visibility over the hospital occupancy. And that’s something IoT can also easily solve. For example, GE implemented a bed tracking system in a New York hospital that tells when and where beds are open. The bed sensors help the hospital staff reduce emergency room wait times by as much as four hours.
6. Hospital hygiene
Hygienic conditions play a major role in patient recovery. Especially since healthcare-associated infections affect 1 in 25 hospital patients every single day. However, monitoring hygienic conditions in big hospitals and ensuring that everything is as clean as it can be is not easy.
Interconnected monitoring devices can help hospital staff and infection control managers maintain a culture of safety and accountability. Hand hygiene IoT devices, for example, can set and detect a degree of cleanliness among healthcare and medical staff. Case in point – Versus is a hand hygiene device that tracks and reports on compliance, monitoring dispenser use and automatically reporting on trending in real-time. Other hand hygiene IoT devices can signal in real-time whenever medical staff comes in close proximity of a patient bed without washing their hands.
By integrating networks of connected devices, IoT achieves a paradigm shift: healthcare is no longer confined to hospital or hospice walls; healthcare is also available where the patient is most comfortable – at home. It follows to say that a sensitive scenario as this requires even more caution, as the IoT network integrates a system within a system/a system of systems, i.e. a variety of complex devices into the health communication space.
For example, when it comes to health wearables, new antennas and connectors in all kinds of form must be designed, eliminating all possible ergonomic/health risks. Furthermore, in the context of remote patient or elderly monitoring, such health patches will interfere with other existing smart home sensors tracking room temperature, humidity, heat leaks, etc. Hence, the IoT system will deal with massive flows of data generated by all the sensors integrated in the network. This is when modeling and simulating the IoT network becomes vital. Because they enable an early evaluation and optimization of IoT systems before going live.
Fortunately, we can count on technologies that allow us to determine the efficacy of an IoT system early in the lifecycle. For instance, Seebo is a cloud-based platform that visually turns an entire IoT system into a digital model. This platform combines tools for IoT modeling, simulation, execution and behavior analytics to enable the definition, validation and building of IoT systems.
What’s in it for patients
In any business, customer experience is the ultimate measure of success. The same goes for healthcare, only in this field there are two types of “customers”: the patient and the healthcare professional. Patients need and want better care. Healthcare professional need instruments and flows that can make them more efficient in their work.
With its unparalleled connectivity and capacity for generating big data, IoT radically changes the healthcare experience, creating value on numerous levels. One way to understand these levels would be to look at IoT applications from a consumer’s perspective. Case in point, the patient’s perspective.
A practical tool in analyzing how IoT benefits patients is the model for consumer value created by Eric Almquist, John Senior and Nicholas Bloch from Bain & Company. This value pyramid – a reinterpretation of Maslow’s hierarchy of needs – analyzes a product/service against 30 attributes ranged into 4 categories as illustrated below.
Healthcare IoT and the value pyramid
Incorporating all elements of value in a single service or product is quite unrealistic. Not even Apple, one of the subjects in the Bain & Company study, didn’t manage to score high on more than 11 elements. However, applying this heuristic model to IoT-enabled healthcare helps us measure the value IoT brings to the patient’s experience – how the above-mentioned IoT applications make it better, compared to the old traditional ways.
Health is a sensitive territory, where patients need a lot of things:
- Quality care services;
- Easy access to accurate medical information;
- Simple, effortless processes. Because of their emotional state and depleted energy, patients can’t afford dealing with unnecessary hassles and uncertainties;
- Be listened to and heard;
- Get immediate support;
- Feel safe and hopeful;
- Regain their quality time;
- Preserve their comfort zone as much as possible;
Quality is a mandatory element of value and no other element cannot make up for it when it’s missing; the rest of the elements are interdependent. Hence, if patients have easy access to accurate medical information, their anxiety decreases and they feel safer. It’s reassuring if they get help fast, so they have reasons to feel hopeful. If in treating their health problems, the steps are simple, they regain control of their time and focus on getting better. If they can get examined and treated without having to leave their homes, then they get to preserve more of their comfort zone.
At a quick glance, healthcare IoT applications create functional value, scoring high on 13 out of 14 elements (except sensory appeal). Furthermore, on an emotional level, they provide access, reduce anxiety, increase wellness, have a therapeutic value, adding 4 elements of value out of 10. Since it inherently provides hope, IoT-enabled healthcare also carries a life-changing dimension. Think tele-surgery, for instance.
To better illustrate the positive effects of IoT-enabled healthcare, we’ll just look at remote patient monitoring and see the value spikes for chronic patients and their caregivers.
- On a functional level: It saves time on both sides. Easily connects patients and doctors, simplifies the medical routine and keeps it organized. Reduces effort for patients, sparing them from unnecessary hassles like going to the hospital for check-ups. Reduces hospital costs by eliminating physical appointments. Provides accurate patient information to doctors, who follow up with treatment indications and decisions without having to meet in person. Doctors can intervene in real-time when vital signs are aggravating, advising patients to adjust medication to overcome crisis.
- On an emotional level: It reduces anxiety because it spares the patient from recurrent doctor’s visits. Provides patients with real-time access to information related to their health. At the same time it delivers accurate medical information that doctors can easily assess. Doctors provide patients with medical advice in real-time, thus increasing the therapeutic effect and the feeling of well-being.
The Internet of Things offers a multitude of opportunities for an integrated healthcare systems where patients are better cared for, treatment outcomes are improved, healthcare workflows are simplified and costs are significantly reduced.