Internet of Medical Things (IMoT)

imot

Many healthcare firms and consumers have latched onto the Internet of Medical Things (IMoT) by way of wearables, such as FitBits and Garmin watches, referred to as “FitTech.” With over 2/3 of medical devices estimated to be connected over the next 3 years, IMoT is going to have a significant impact in Healthcare operational and financial processes. Let us examine the impact of IMoT on healthcare payers, health providers, and consumers.

A) IMoT and Payers: 

i) Underwriting: The first process comes to mind is Underwriting. By equipping consumers with IoT-enabled medical devices underwriters can better understand what an individual’s health looks like daily, rather than at long historical intervals. With this wealth of information at the helm for an individual, underwriters gain access to health data from periods of time that used to be non-existent in health records and claims. IMoT can enable underwriting for

  • improved bottom-line of the payer by better understanding what each individual new member will cost them
  • increased wallet share by preventing lower-risk members from being improperly marked as high-risk based on one-off health encounters
  • Optimized underwriters’ time spent on due diligence, especially avoiding unnecessary full medical underwriting (FMU.)

ii) Preventive Care: Preventative care is a perfect application of IoMT. Biometric sensors and other devices can collect real-time data from health plan members, help point to higher-risk metrics or lifestyle choices, and notify payers to get the correct members enrolled in prevention programs. Oe successful use case is Beam Dental. The Beam Brush tracks an individual’s tooth brushing habits (such as the dental habits of employees under their employer’s insurance plan) and allows their good habits to drive down the cost of dental insurance for their group. By activating members to take control of their health before chronic or acute health issues arise, payers will see success in loss prevention as well as a happier (and healthier!) member base.

iii) Claims and billing efficiencies: IoT can aid in cumbersome tasks that waste administrative hours by leveraging AI led solutions, such as determining whether a claim should be accepted or rejected for minor claims or processing payments. By freeing up administrative time from these tasks that can be automated, payers can invest more in programming for their members to drive focus towards prevention leading to savings in administrative costs and savings in claims payments from healthier members.

B) IMoT and Providers:

IMoT has the potential to facilitate remote patient care to optimizing hospital operations to streamlining data management, healthcare providers can leverage the lucrative potential of IoT. These use cases are elaborated below.

i) Improved hospital operations: IMoT can be introduced and ramped up to optimize a hospital’s daily functions and cut unnecessary costs. Tracking medical assets within a facility is a good use case. Every year, millions of dollars bleed from hospitals from lost or stolen equipment. By attaching sensors (e.g., RFID or Bluetooth) to equipment, hospital staff can track the exact locations at any point in time, allowing for better oversight. This can solve the problem of lost equipment, reduce theft, and even track overall use of equipment. The life of medical equipment varies greatly based on the frequency of use. By tracking movement over the life of a piece of equipment, hospital administration can get a better idea of when to replace or schedule maintenance to avoid periods of time where equipment is unusable.

A second IMoT use case is in intake or discharge processes. With IoT, unobtrusive sensors can be placed in patient wristbands and staff badges better to track how quickly patients flow through different areas of the hospital (such as pre-op rooms to the operating room) or how efficiently staff attends to a given patient. This can remove backup from current bottlenecks in flow at the hospital, including but not limited to Emergency Department wait times, intake, discharge, and shift changes.

ii) Interoperability and Data Monetization: IMoT at a basic level improves existing systems for providers. For example, biometric devices and sensors are often system-agnostic and can connect through APIs to multitudes of EHR systems. If a patient has doctors in multiple health systems, their disparate EHRs (and therefore doctors and care plans) can be updated accordingly. The IMoT combined with AI/ML and NLP can nurture the massive loads of HC data. By relying on IoT-enabled technologies, providers will no longer deal with unusable, unstructured data but rather well-organized and insightful data systems. The world of well-managed data in hospitals and health systems opens up with the adoption of forward-thinking technology. Doctors can better tailor care plans to patients’ specific needs based on historical data of like patients and avoid oversight of potential complications such as contraindications.

iii) Expanding remote care revenue streams: IoMT eases the implementation of remote patient care. With IMoT doctors can help patients purchase and set up remote equipment to measure biometrics, provide care, and talk face-to-face over the internet i.e. telemedicine. Doctors then are able to receive the data they need to adequately modify care plans without requiring a patient to walk into the office as well as have more frequent communication and therefore a better understanding of a patient’s day-to-day health status. IoMT not only allows for better continuous care but also boosts patient satisfaction and engagement. Patients that spend more face time with their providers tend to have better relationships and therefore better patient satisfaction—a critical component of healthcare with more and more models shifting to value-based reimbursement from health payers.

IMoT implementation roadmap:

While the Internet of Medical Things has the potential to fuel HC growth, IMoT implementation sought to be a rocky path. But approaching IMOT implementations with a pragmatic approach leads to a better navigation path. Let us evaluate some basics steps of IMoT roadmap.

  • Identifying Healthcare organization business goals to build IMoR ecosystem
  • Develop a viable and convincing business case to roll-out IMoT
  • Next coming up with a clear vision and goals to realize with connecting medical devices
  • Big-Bang approach may lead to burn-out, and hence identify pilots or PoCs od IMoT success areas
  • Take an iterative approach to reiterate the ideation process and move forward with an implementation initiative

Sounds generic! That is the stepping stone for IMoT implementation. Imagine that healthcare companies manufacture more than half a million different types of medical devices, including wearable external medical devices like insulin pumps, blood glucose monitors, etc, implanted medical devices – implantable cardioverter defibrillator devices, and stationary medical devices – scanning machines, etc. to name a few. Most patient interactions with the HC system involve the use of medical equipment and devices. IMoT brings these interactions to life. Hence taking an incremental approach is the only way forward.

The true implementation of IMoT involves, “developing an in-depth understanding of end users”, “defining funding, business and operating models”, “clearly understand device interoperability requirements”, “embed security at the core”, “ensuring regulatory compliance”, “more importantly attract talent and build digital capabilities”, “improve the adoption of medical technology at scale and with trust”, and finally “create an ecosystem of seamless partnerships”.

IMoT Solution Providers:

Colleagues on this forum have highlighted many advantages of IMoT like cutting emergency room wait times, remote health monitoring, ensuring critical equipment availability, improved drug management, optimized staffing and workflow, better diagnoses, better outcomes with fewer false alarms, etc. As IMoT value proposition is gaining more traction, many solution providers are offering products and solution to tap this value.

With an estimated market value for IMoT technologies >$150 billion in over next 3 to 4 years, Philips, Siemens, GE Healthcare and Medtronic are currently leading IoMT technology investments, with Philips primarily dealing with cardiac monitoring, remote patient communication devices and sensor-related products, and GE and Medtronic instead focusing on cloud-based technologies in existing monitoring devices, implants, and cardiac pacemakers.. Listing below few examples.

  • IMoT and Telehealth: Health Net Connect offers various remote patient monitoring packages that monitor conditions like CHF, COPD, diabetes, and hypertension with devices like BP/BG monitors, Handheld ECGs, pulse oximeters and spirometers. Not only is this technology leading to reduced costs as patients handle everything in-house, but by eliminating the need to visit health professionals and vice versa, it’s also improving their overall patient experience.
  • IMoT and Drug Management: Proteus Discover is a health company that measures medication treatment effectiveness and helps physicians improve clinical outcomes and patients reach health goals through sensor-embedded pills like the one mentioned above. Once the ingestible sensor-containing pill reaches the stomach, it sends a signal to patch the patient is wearing, which monitors each time a pill is taken, as well as their general rest and activity patterns. another example is, Abilify MyCite approved by the U.S. by the Food and Drug Administration
  • IMoT and Medical Device Monitoring: e-Alert from Philips are also ensuring that critical hardware is always accessible, and if something like a breakdown does happen, staff members will be immediately alerted.
  • Siemens IoT solutions for the medical device industry are powered by combining big data with digital twins, a virtual representation of actual devices, moving in tandem across the lifecycle and connected by digital threads. By connecting virtual development and production planning environments with real support and lifecycle production data, Siemens equipping med-tech organizations with the transparency and advanced analytic tools required to gain a competitive edge using big data.
  • eVisit is a telemedicine platform that enables doctors to conduct examinations and prescribe remedies for their patients by remote.
  • Amiko.IO focuses on providing products for respiratory disease management, complete with an AI-powered platform.
  • InfoBionic’s MoMe Kardia provides remote monitoring of cardiac arrhythmia.
Challenges implementing Healthcare IoT / IMoT:

HC firms have to overcome a few key challenges ranging from data security to legacy infrastructure that may hinder health care IoT initiatives. Alongside these evident challenges, IMoT should address the following areas for widespread adoption.

  1. Health data explosion and sensitivities: HC is one the largest sector contributing to massive data creation. HC organizations to use IMoT technology effectively have to address growing data storage needs. As well HC has to be exceptionally careful to treat patient data from IoT devices according to federal and state regulations. The flood of data created by the IoT gadgets and devices used in the HC industry could also cause unforeseen problems if organizations are not equipped to handle it properly and verify its quality.
  2. Lack of EHR system integration. While the data that is collected from IMoT devices can include a patient’s vital signs, physical activity that information does not typically travel to an EHR system and, in most cases, is not centralized or made easily available to providers. This limits the information’s value since it is not always presented to the provider in a clinical context.
  3. An increase of available attack surfaces with IoT devices: IMoT devices explosion in health care present concerning vulnerabilities as device use rises, so does the number of ways hackers could infiltrate the system and mine for the most valuable data. Hackers could potentially learn about how a connected medical device operates by getting into the system and reading its error logs. The knowledge the hackers gain could facilitate breaking into a hospital network or making devices publish incorrect readings that influence patient care. It is high time for vendors, providers, and manufacturers’ to collaborate to reduce patient risks by closing the gaps that can form between the layers of an IMoT system by reinforcing standards and normalizing secure protocols. It’s not possible to know all the cybersecurity risks health organizations may face. Nonetheless, facilities planning to implement IoT technology must take care to increase awareness of existing threats and understand how to protect networks and gadgets from hackers’ efforts.
  4. IMoT data in silos due to interoperability challenges: Patients are likely to collect different sets of data when using different medical devices depending on each device’s purpose and, in some cases, the ordering physician. IMoT data alone may not be as meaningful if it is not within the context of a full health record. With the lack of wider adoption of adequate interoperability, data from different IMoT devices may remain locked in each individual system and lose its potential value to the rest of a patient’s care team.
  5. Data security causes concerns in the IMoT implementations: From the time that the data is collected at the device level to the point that it is transmitted over to its final destination, securing that information is critical and is required under HIPAA. But with the lack of common security standards and practices, many health IT professionals have concerns about the risks associated with IMoT device tampering and data breaches.
  6. Plan for ecosystem needs to be successful: According to a recent Cisco survey, ~60% of projects encounter trouble at the PoC stage or shortly thereafter. The study suggested that utilizing external partnerships (e.g. platforms) was a crucial factor for those organizations that achieved successful implementations. When it comes to the starting small and prioritizing projects that align with their most prominent business objectives or patient needs is key to the success.
  7. Overcoming legacy infrastructure challenges: Outdated infrastructure is a known fact in HC. Even though retrofitting can breathe new life into aging infrastructure, truly taking advantage of IoT is tricky if a facility’s infrastructure is outdated. Hence using IMoT in ways that make sense for the needs, budgets, and infrastructures of HC organization and having robust plan to ramping up resources to fill the gaps is the key to the success of IMoT implementations.
  8. Stringent high availability and near-zero tolerance for failure: One of the common use of IMoT technology in HC is to apply it to patient monitoring systems. While it is handy to take that approach, unlike other IT systems (ex: websites), these devices typically cannot go through planned periods of downtime. Hence, updates have to occur seamlessly as people use the monitoring devices. For the hospitals to depend on IMoT-enabled supply cabinets to track resources reducing inventory management issues, IMoT devices devices are to be audited correctly eliminating human errors.
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