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In some ways, medicine represents one of the most obvious and exciting directions for IoT, and, yet, despite some promising starts, progress has been slow because of regulatory and compliance concerns as well as the siloed nature of the industry.
Medical devices cover many areas of health, including electromedical equipment, such as pacemakers; irradiation, such as MRI and X-ray machines; and surgical appliances, such as orthopedic limbs. A growing number of devices connect via a patchwork of Wi-Fi or machine-to-machine communications to healthcare IT systems.
How has medical IoT grown?
IoT in healthcare implementations have grown tremendously over the last five years, said Arti Bedi Pullins, the founder and CEO of Pundit Consultantz. This growth includes patient-level monitoring equipment, surgical equipment and pre- and post-operative procedures.
"We are seeing data measurement via sensory equipment that collects, tracks and quantifies patient-level data," she said. This is done through advancements in electrodes, patient beds and textiles, and remote patient monitoring equipment for dialysis. For example, Baxter Healthcare Corp. is developing devices to deliver medication using IoT innovations. Abbott Laboratories, a medical device company, is developing IoT medical devices to monitor cardiac health. And Apple and Google have specific partnerships with healthcare systems to supply IoT technology and IoT data storage.
Gregg PessinSenior research director, Gartner
One of the factors that can drive IoT adoption is the data devices can collect, said Brendon Buckley, healthcare technology director for Johnson Controls. For example, facilities can use real-time location data to track staff, equipment and assets to improve operational efficiency and limit the spread of infections from moving between environments.
"As healthcare executives look for opportunities to implement IoT, particularly those impacting the patient experience, existing data from facilities must be taken into consideration to best meet business outcomes," Buckley said.
The biggest challenge that lies ahead is how to consume, translate and make patient care decisions based on all the data the devices collect. Managing the data that devices collect and securely storing that data can also present a challenge for healthcare companies that must comply with patient privacy regulations, Pullins said. Manufacturers develop IoT medical devices faster than healthcare facilities know how to deploy and use them. With few, if any, standards for interconnecting different devices and sharing data, many big names like Mayo, Kaiser Permanente and United Health have chosen to partner with Amazon or Google to intake and then translate all this data in a concise and logical basis, she said. Still, no one player is using this data to make real-time unique or personalized patient-level treatments, she added.
Who develops IoT medical device standards?
Connectivity among and across devices is another important challenge. One of the efforts to address the problem of devices that don't work together is the Connected Care Testbed. This is a project of the Industrial Internet Consortium that is being led by Infosys and includes Real-Time Innovations (RTI), IoT software vendor PTC and the Massachusetts General Hospital Medical Devices Plug-n-Play Interoperability Program. A goal of the Testbed is to create an open IoT healthcare ecosystem that can support both remote monitoring and home care for patients and can help unify patient data into a single environment, including electronic medical records systems.
Brett Murphy, senior director of market development for industrial IoT at RTI and a leader in the Testbed said that a big challenge is that IoT medical devices "are generally little silos, and data integration is done by some human at the front end of that device." The process involves assessing values manually and integrating on the fly. It's full of the potential for error and misinformation. "There is also a lost opportunity because there are many ways to do sensor fusion coming from the control system and analysis world," all of which could potentially generate valuable insights, Murphy said.
Integration to date has largely been within the product lines of major medical device manufacturers, he said.
The Connected Healthcare Testbed is far from the only effort to boost connectivity. Even the effort to solve the issue of devices that don't work together has a similar problem of organizations all working separately to fix it.
For instance, the Center for Medical Interoperability (C4MI), a health system-led initiative, recently published specifications and launched a testing program to verify device compliance with various interoperability specifications. The organization's Patient Vitals Program will be the first verification segment with future initiatives focused on areas such as ventilators. According to the organization, the programs will help enable plug-and-play interoperability and build on recommendations made by the National Academy of Medicine.
The National Academy of Medicine recently published "Procuring Interoperability: Achieving High-Quality, Connected, and Person-Centered Care," a nearly 200-page report which details the state of data interchange. Among other things, the report noted, "Progress is particularly needed at the point-of-care level, where the lack of plug-and-play interoperability represents a fundamental impediment to patient safety, care coordination and cost reduction."
Another initiative affiliated with the IEEE in connection with the organization's ISO/IEEE 11073 Health informatics -- called the Wearables and Medical IoT Intelligence and Interoperability Initiative -- attempts to standardize medical and health device communication. In short, much is happening among vendors and the broader healthcare community.
What's still to come for IoT medical devices?
The net results of growth show a medical IoT market that is close to a tipping point but unlikely to hit its stride for a few more years, said Gregg Pessin, Gartner senior research director. A nexus of forces -- such as advances in technology, an appetite for a high-tech approach to medicine and the integration of data from products like Fitbit into the healthcare system -- will make further advances in medical IoT inevitable.
"The operational efficiency of old-school, predigital medicine is in place. Now, there is an opportunity to move it forward by collecting more data and more accurate data," he said.
For now, regulations such as Europe's GDPR will add a degree of complexity to medical IoT. However, in the U.S., the healthcare field has worked with HIPAA for many years, so mastering related new requirements on the privacy and security front will not be that great of a challenge, Pessin said.