IoT is coming, but is healthcare ready?

Imagine an implanted pacemaker detecting an abnormality, making an automated phone call to the nearest ambulance station, and activating an autonomously driven unit carrying the paramedics to the patient’s location.

Imagine a deteriorating patient’s status recognised by wearable devices, which then activate emergency alarms and communicate to the hospital’s intensive care unit autonomously.

Or imagine an intelligent mechanical ventilator communicating with the blood pressure monitor and the dialysis machine and suggesting alteration of parameters to the intensivist.

These things are not science fiction any longer but an immediately foreseeable reality. Welcome to the Internet of Things, affectionately called the IoT. Emerging rapidly on the horizon, this disruptive technology may have a meteoric impact on the way we deliver healthcare.

While the definition of ‘things’ is as yet unclear in this context, it refers to objects that can communicate with each other without the involvement of humans in a grand network. These ‘things’ can also recognise a human presence in the network and can communicate with them.

However, their communication and responses are for most part autonomous. This has led to some people predicting the end of the information age and the beginning of the artificial intelligence age.

The increased availability of energy for human utility, the ever diminishing size of powerful processors, technologies such as radio frequency identification (RFID), mass production of mobile computer systems in the form of smartphones, tablets and wearable devices and the development of wireless communication infrastructure have made the conditions favourable for IoT to take on a life of its own.

The development of a new addressing system called IPv6, which has literally exploded the bottleneck of conventional IP addresses with its ability to assign unique identifiers to objects to the tune of billions and billions, will be a boon to the development of IoT. In addition, futuristic technologies such as Witricity (or wireless electricity) could expand IoT’s capabilities to beyond human imagination.

IoT smart hospitals

In the healthcare setting, IoT systems could continuously and autonomously stream data from various devices and patients and respond autonomously. This may lead to a radical modification of hospital operations.

There are already moves to create IoT smart offices, the design principles of which could also be used in the design of IoT smart hospitals. In such hospital systems, the identification of personnel and patients, the logistics of patient and resource transport and the monitoring of patient’s vital parameters to activate emergency response could all be made autonomous.

Existing electronic medical record systems are for most part passive repositories of information. With IoT, the situation will radically change: not only will the data acquisition become autonomous but it will be much more intense, continuous and autonomously actionable.

This could translate to better patient outcomes, efficient care and overall cost savings. There could also be a significant reduction in the man hours spent on mundane data acquisition, which could be directed to actual patient care.

IoT healthcare device design

With such a rapid advancement, IoT could influence the design of healthcare devices in a significant manner. What were thought of as discrete devices now become a part of a very large network.

It is likely that the integrated nature of IoT will aid in the development of devices that interact with devices, which were previously not considered related. For instance, it may be necessary for vital organ support systems to communicate with building automation systems to plan ahead for emergencies like fire, power outages and maintenance routines.

Importantly, in advanced areas such as intensive care where very sophisticated systems are used to deliver complex care, the communication between various devices could help in adjusting support and detection of deterioration more efficiently.

There is the potential for various healthcare devices to reduce their physical and carbon footprint while at the same time becoming more efficient. This may lead to a significant degree of reduction in clutter and, potentially, human error.

Challenges

Contrary to the wild imaginings in some movies, it is impossible for IoT to gain self-actualisation and become an automaton, but it does appear IoT will have a significant effect on the way we will be providing healthcare in the near future. The obvious benefits of IoT in healthcare set aside, the speed of adoption will depend on the technology’s ability to satisfy the complex legal and ethical questions that may arise.

A significant question will be one of privacy – both that of the patients and of the care providers. The other challenges will pertain to its perceived effect on the workforce. There may be ethical questions that could arise out of automated systems being involved in healthcare decision making, especially in specialties such as intensive care.

While such questions and more will arise, it is important that patients, clinicians, healthcare planners and administrators start the discussion on integrating this new technology to everyone’s benefit.

Dr Balaji Bikshandi FCICM is an intensive care specialist from Canberra.

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