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.

AI in Healthcare

AI
Healthcare fueled by AI/ML/DL:
AI Use Cases in Healthcare:
Roadmap to Implement AI in HC
Commoditizing AI/ML in Healthcare:
AI/ML Impacts on HC. AI and machine learning are already delivering value in HC. The following are high impact areas.

The Changing Role of Retail Workforce

I was visiting Lush – a fresh handmade cosmetics store along with Lush_app.jpgmy daughter and felt that the shopping experience compared with the past is changing in a noticeable way, in particular when it comes to interactions with the store workforce. I came to know that Lush employees typically go through extensive training to ensure they have the tools and knowledge to deliver this kind of service. At Lush the digital technology offers a replacement to the information usually found on packaging – the Lush Lens app uses machine learning to recognize products, meaning customers can simply scan ‘naked’ products to discover key information about them. Hence the retail workforce is upskilling to add value beyond the digital offerings.

This blog post is a result of the experience above. Global Retail and e-commerce leaders reimagining their business models in digital evolution and which is further changing workplace practices. I can say from my vantage point that digital, social and environmental developments are shifting the needs of the retail workforce. It is evident that device and sensor proliferation is aiding retailers to experiment intelligent and connected methods to innovate new business models to try new markets, offer new services and create rich & compelling customer experiences. The new-age developments listed below reflects the continuous transformation of the retail workforce

  1. Knowledgeable workforce offering personalized shopping experience: In a world where just about any product or service is instantly available online, shoppers visit a physical location is driven by specific needs. It means recognizing that shoppers would make the trip because they need something more than what they find in the digital world: face-to-face contact, empathy, and deep expertise. Whether they want to figure out how to hook up a smart home, what dress to wear to a formal dinner, or what to pack for that dream wilderness vacation, they want to talk to someone who can offer them more knowledge and personal understanding that they can find with a quick online search.
  2. Fitment of the retail workforce in experience economy: Stores just can’t be product-fulfillment centers. In both the physical and virtual worlds, product fulfillment is fast becoming the domain of AI and robotics, with retailers, consumer products companies and e-commerce platforms racing to develop the best systems to anticipate consumer needs and deliver products to meet them. What technology cannot fulfill, however, are human needs that remain unmet today and will continue to evolve in the future. One thing I’ve learned through my work is that as technological connections grow, so does the human need for meaningful connections. This need is what’s driving the experience economy. Whether in restaurants, travel groups, shared workspaces, yoga studios or spin classes, people are actively seeking intimate connection with other people and finding it in spaces and communities like these.
  3. Uplifting workforce skills is the need of the day: Process improvement, speed, and efficiency are at the core of successful online businesses. With online infiltrating over to brick-and-mortar sales it’s a mismatch in areas such as supply chain, inventory management, trend identification, competitive pricing analysis, etc.; for example, the ability to automate 99% of pricing decisions, not only offers a real-time advantage, but it also eliminates hours and hours of manual work per week. Hence the use and mastery of algorithms is a key tool of the buyer in successful online companies, a skill that is not as prevalent in brick and mortar;

With the advent of modern technologies bringing e-commerce intelligent systems that make running a retail store more efficient, my experiences with retailers progressed on leveraging in-store data. Having the right retail workforce management solution can take care of tedious administrative tasks across the board, while simultaneously collecting data to instantly improve in-store operations. With this schedule, store managers can be confident knowing that the most knowledgeable and high performing sales assistants are on the shop floor during times of high customer traffic, enhancing the shopping experience and resulting in more sales.

As retailers continue to evolve in experience economy continuum, it’s the value that a capable retail associate can add – the expertise, social sensitivity, and problem-solving skills – that will differentiate the good stores from the bad, the stores that will endure from those destined to fade from the scene.

Facebook Coin – A closer look

fbThis is the second initiative from Facebook after they tried to introduce Facebook Credits* (see below for the details) during 2011 and was not successful. This time it may translate into a success due to the following reasons. I am keeping the arguments on the centralization, stable coin and comparison with Bitcoin to a later post.

  1. Feasibility of massive adoption: Facebook, WhatsApp, and Telegram combined user base of over 2.7 billion. WhatsApp alone has more than 1 billion daily active users and crypto transfer can be a click of a button and trust is pre-established. Telegram biggest messaging applications in South Korea and Japan, Kakao & Line.
  2. Similar successful products in the market: Venmo has taken off in the United States by making it easier to send payments by phone. And in China, many consumers use the payment system that operates inside the hugely popular WeChat messaging system.
  3. Ease of opening a Facebook account compared to a bank account. Regulation and compliance is the next big puzzle to solve for Facebook.
  4. Coin backing with fiats making it more versatile: Unlike JPM Coin backed by USD alone, Facebook could guarantee the value of the coin by backing every coin with a set number of dollars, euros, and other national currencies held in Facebook bank accounts.
  5. Coin launch followed by Blockchain adoption making it a robust approach: As Facebook recently revealed their plans to integrate blockchain technology into Facebook Login and betting on blockchain technology by bringing data security aspects, it seems like the next level details on FC will be very interesting.

The big question facing Facebook is how much control it would retain over the digital coin. If Facebook is responsible for approving every transaction and keeping track of every user, it is not clear why it would need a blockchain system, rather than a traditional, centralized system like PayPal. Let us follow another interesting development.


* Facebook Credits was a virtual currency that enabled people to purchase items in games and non-gaming applications on the Facebook Platform. One USD was the equivalent of 10 Facebook Credits. Facebook Credits were available in 15 currencies including U.S. dollars, Pound, Euros, and Danish Kroner.  It was expected that Facebook would eventually expand Credits into a micropayments system open to any Facebook application, whether a game or a media company application. While the Facebook Credits website is still active, Facebook has announced that it is doing away with Facebook Credits in favor of local currency

Crypto adoption is next on the radar

Image result for bitcoin adoptionAs progress is made in solving bitcoin trilemma, Decentralization – Security – Scalability, the next focus area is increasing the adoption rate. With a lot of lull in the crypto market until recently, the subject of crypto adoption is being echoed by adversaries and supporters to prove their point of views. In this blog post, I will be taking a closer look at drivers of crypto adoption.

  • Samsung Galaxy S10 is unveiling the mass adoption of cryptocurrencies with future built-in and secure mobile technologies. Galaxy S10 is built with defense-grade Samsung Knox, as well as secure storage backed by hardware, which houses your private keys for blockchain-enabled mobile services. Would this take the crypto to the hands of mass? Here are the details.

    https://news.samsung.com/us/samsung-galaxy-s10-more-screen-cameras-unpacked-2019/

  • tippin.me get tips lightning fast. Twitter with 270million+ users has integrated tipping service on lightening network. Lightning Network is a technology built on top of Bitcoin that provides instant micro-payments almost for free. Tippin.me makes Lightning Network easier, by giving you a simple web custodial wallet to receive and manage Bitcoins through Lightning Network. Join now to start receiving tips and micro-payments right away, just sharing a link. There are a lot of features in the roadmap if this gets traction: integration with merchants, better wallet functionality, etc.
  • Lightning Network, beyond the above use case, is enabling Scalable, instant blockchain transactions for the future. The drawbacks to bitcoin’s decentralized design are that the transactions confirmed on the bitcoin blockchain take up to one hour before they are irreversible. Micropayments, or payments less than a few cents, are inconsistently confirmed, and fees render such transactions unviable on the network today. The Lightning Network solves these problems. Crypto users are soon experiencing scalable ad low-cost instant payments with an ability of cross-chain atomic swaps.
  • Making buying easy: As the avenues to buy Bitcoin gets easy and so the adoption. Since Virwox shut down its PayPal deposits in January 2019 it got really hard to obtain Bitcoins through a PayPal account. The two main methods that still allow you to buy Bitcoins with PayPal are, eToro – for those who only speculate on price and don’t need access to the actual coins and LocalBitcoins – for those who want to actually withdraw their Bitcoin to their own wallet
  • Spontaneous liquidity is becoming reality with Coinbase cash withdrawals to Paypal. Starting in December 2018, U.S. customers can instantly withdraw Coinbase balances to PayPal, providing even faster access to their funds through one of the world’s easiest and most widely-used payment platforms. These withdrawals are not only fast; they’re free and incur no fees.
  • Troubled Economies. One of the Satoshi Nakamoto’s vision for inventing Bitcoin was helping the troubled developing nations to get out of their misery brought upon them by their flawed centralized banking systems. Venezuela is one such country which has seen its financial economy go down the drains, the inflation has made their fiat not even worth the paper they are printed on. When all doors seem closed for Venezuela including petro coin (due to technical weakness), Bitcoin came in as the savior they were looking for. The government legalize the use of Bitcoin in the country and are looking to incorporate it in their financial system so that citizens can use Bitcoin in their day-to-day life.

Alongside all the above parameters, crypto wallets, transaction volumes, computing power, ETFs and Futures, games, arts, web searches for bitcoin terms, and industry hirings, shows bitcoin and crypto adoption is on an upward trajectory.

AI in Operations (“AIOps”)

AIOps

Recently I was searching for verbatim “AIOps” on Google and got 624K results. Without many surprises noticed that there have been over 100 times rise in search trends since July 2017. That signifies the momentum for AI led Operations.

As my curiosity on AIOps increased, I looked at market opportunity for AIOps. From MARKETSandMARKETS analyst data, the global AIOps platform market size is expected to grow from USD 2.55 billion in 2018 to USD 11.02 billion by 2023, at a Compound Annual Growth Rate (CAGR) of 34.0% during the forecast period (2018–2023).

In this blog post, I am attempting to capture some highlights gathered from my learning curve over a past year or so. Refer to the schematic above that provides a high-level “AIOps Framework”. The following are key elements of the framework.

“AIOps” Verbatim Defined: Simply stating AIOps stands for Artificial Intelligence for IT Operations. Extending AIOps to business operations is inevitable in near future. Adding further, AIOps automates various aspects of IT and utilizes the power of artificial intelligence to create self-learning programs that help revolutionize IT services

AIOps Context: There is a significant opportunity to leverage AI for analyzing enormous data being created by IT and business operations tools, to increase the efficiency of operations, speed up services delivery and ultimately create superior user experiences. The resulting power of AIOps is enabling the progress from siloed to integrated operations backed by intelligent insights.

Signals: In today’s business and IT operations environment, the user is adapting multiple channels of communication for ease and enriched experience. So the backend operations teams as well should expand their ability to sense, analyze and respond to such structured, unstructured and semi-structured data signals. With this in mind, the AIOps platforms are being developed with built-in capabilities to receive and response signals that can encompass any events, alerts, service requests, IoT sensor data, Email, Video, Text, Voice support, UX, Social channels and many other forms.

Interfaces: The way enterprise operations backbone interfacing with signals and external queries also is shaping up in this transformation.

  • The first layer is Machine-First: Giving software/machine/bot the first act on sensing and responding to operations requisitions not only improves the automation of repetitive tasks but also augments cognitive intelligence in complementing human intelligence.
  • Human-Next Touchpoints: Human-next layers take up the operations requisitions that are not solvable by machines. These are the requests which involve human interventions.
  • Ensuring Reliability of Services: Alongside the above two layers, taking an engineering approach to services reliability for constant monitoring, triaging and incorporating insights from advanced analytics of enterprise data brings the culture of continuous improvements and stability to operations.

AIOps Platform: The entire AIOps ecosystem is based on the underlying Platform and Enterprise Core that ties all the components together. As Gartner defined, “Artificial Intelligence for IT operations (AIOps) platforms are software systems that combine big data and AI or machine learning  functionality to enhance and partially replace a broad range of IT operations processes and tasks, including availability and performance monitoring, event correlation and analysis, IT service management, and automation.”

As businesses are increasingly software-driven, operations downtime is becoming more costly and slow is the new down. This is leading businesses to proactively manage and improve experiences of services, applications, cloud, and networks. Along with this business 4.0 is digitally shifting the businesses offering the technologies that increase the volume, velocity, and variety of data. As traditional systems and manual efforts are facing challenges in correlating and analyzing the data or alerts, AIOps is stepping up to augment the enterprise intelligence in operations.

To conclude, the future is bright for IT and business operations with AIOps. The increasing shift of organizations core business toward the cloud, raising investments in the AIOps technology ecosystems, exponentially growing data volumes and increasing end-to-end business application assurance and uptime are driving the growth of AIOps market demand.