IoT - a prom­ise for bet­ter to­mor­row

The In­ter­net of things (IoT) con­nected med­i­cal de­vices is poised to rev­o­lu­tion­ize the func­tion­ing of the health­care in­dus­try. While there are many ben­e­fits of the IoT con­nected med­i­cal de­vices, it comes with its own chal­lenges.

BioSpectrum (Asia) - - Bio Content - Aishwarya Venkatesh aishwarya.venkatesh@mmac­

2018 is here and it is no doubt go­ing to be the year of in­no­va­tions and tech­nol­ogy. The US FDA closed 2017 on a pos­i­tive note by grant­ing ap­proval for Alive Cor’s Kar­dia band, a real-time elec­tro­car­dio­gram (ECG/EKG) housed in a watch strap. Yes, you heard it right! ECG in a watch strap! AliveCor al­ready sells an FDA-ap­proved de­vice called Kar­dia Mo­bile, a strip at­tached to the back of a smart­phone. The de­vice re­quires the user to place two fin­gers of each hand on the strip for a 30-sec­ond read­ing. How­ever, this newly ap­proved Kar­dia band de­vice is more dis­creet and ex­tends the tech­nol­ogy into con­tin­u­ous rather than on-de­mand mon­i­tor­ing. It de­tects nor­mal si­nus heart rhythms and atrial fib­ril­la­tion (AF), the most com­mon heart ar­rhyth­mia.

“Sev­eral times when I was in atrial fib­ril­la­tion, I was able to talk with my doc­tor by phone and ad­just med­i­ca­tion and avoid a trip to the ER. As they say, knowl­edge is power; in my case, knowl­edge leads to peace of

mind,” reads a tes­ti­mony in Alive Cor web­site.

The first ECG’s, when in­vented 100 years back, they were huge ma­chines, took up con­sid­er­able space and of­ten re­quired pa­tients to sub­merge their limbs in jars of salt solution. A cen­tury later, ECG equip­ment has ad­vanced to the point that it can be in­te­grated

into a smart­watch that’s ca­pa­ble of far more. AliveCor, the watch band’s cre­ator, is alive to the health­care op­por­tu­ni­ties that come with tech­no­log­i­cal ad­vance­ments in med­i­cal de­vices space.

Atrial fib­ril­la­tion (AF) is the most com­mon heart ar­rhyth­mia and a lead­ing cause of strokes, af­fect­ing over 30 mil­lion peo­ple world­wide. Many peo­ple are un­know­ingly liv­ing with AF, yet two out of three strokes are pre­ventable when AF is de­tected and treated. There is there­fore huge scope for ac­ces­si­ble real-time mon­i­tor­ing so­lu­tions to help pre­vent ma­jor heart-re­lated health is­sues. With an ECG de­vice on the wrist, AF can be de­tected wher­ever the pa­tient is, 24 hours a day.

Thus, pre­ven­ta­tive mea­sures that uti­lize IoT in health­care not only stand to ben­e­fit the pa­tient, they also go a long way to low­er­ing costs for health­care ser­vices and ex­pen­sive treat­ments. Now next gen­er­a­tion med­i­cal de­vices are the in-thing. By har­ness­ing the power of tech­nol­ogy, de­vice manufacturers are con­nect­ing de­vices to the IoT, us­ing ad­di­tive man­u­fac­tur­ing (3D print­ing), pro­duc­ing wear­able elec­tron­ics (“smart” cloth­ing, skin-ad­hered sen­sors) mak­ing re­mote and con­tin­u­ous mon­i­tor­ing of a pa­tient’s health pos­si­ble.

IoT en­abled med­i­cal de­vices is the way for­ward

It was only 25 years ago that the web re­ally started to take off. Now ev­ery­one is con­nected and soon “every­thing” will also be con­nected through in­ter­net of things (IoT). Imag­ine a sce­nario sit­ting at the com­forts of your home and get­ting a dial­y­sis done! No has­sles, no vis­it­ing doc­tor fa­cil­i­ties, pa­tient can get his dial­y­sis done with the help of a por­ta­ble/home ma­chine de­signed for the pur­pose. Data gath­ered from this de­vice is an­a­lyzed and stored, and helps make in­formed de­ci­sions in a timely man­ner. Care­givers can mon­i­tor the pa­tient from any lo­ca­tion and re­spond ap­pro­pri­ately, based on the alert re­ceived. Ad­vanced treat­ment of this na­ture har­ness­ing IoT can dras­ti­cally im­prove a pa­tient’s qual­ity of life.

The IoT has myr­iad ap­pli­ca­tions in health­care that ben­e­fit pa­tients, fam­i­lies and physi­cians alike. Around 20 bil­lion de­vices are ex­pected to be con­nected to the in­ter­net in the next few years, ex­perts say. The global In­ter­net of Things (IoT) in health­care mar­ket is fore­casted to reach $410 bil­lion by 2022, ac­cord­ing to a Grand View Re­search re­port. Health and well­ness is one of the most promis­ing ap­pli­ca­tion ar­eas of IoT tech­nol­ogy. Re­mote health man­age­ment, manag­ing lifestyle-re­lated dis­eases and con­di­tions, fit­ness pro­grams, care at home, chronic dis­eases and care for the el­derly are some of the im­por­tant use cases. Med­i­cal de­vices such as per­sonal home-use di­ag­nos­tic de­vices or low-end di­ag­nos­tic and imag­ing de­vices that are used by mo­bile health work­ers are one of the key tech­nol­ogy com­po­nents.

Hence, for de­vice com­pa­nies to suc­ceed, in this highly com­pet­i­tive mar­ket, it is im­por­tant that they think be­yond tra­di­tional prac­tices and in­te­grate tech­nol­ogy into their prod­ucts. The de­mand for de­vices with in­te­grated sen­sors, con­trollers, wire­less con­nec­tiv­ity, firmware and re­mote mon­i­tor­ing is be­ing fu­eled by sev­eral health­care trends. These

in­clude tran­si­tion­ing of care de­liv­ery from acute set­tings to the com­mu­nity; in­creased pa­tient in­ter­est in track­ing their own health; rise in eco­nomic sta­tus and dis­pos­able in­come; an ag­ing pop­u­la­tion with chronic con­di­tions with greater fo­cus on pre­ven­tive health­care to drive down costs. A con­nected health­care en­vi­ron­ment pro­motes quick flow of in­for­ma­tion and en­ables easy ac­cess to it, improves home care fa­cil­i­ties and pro­vides reg­u­lar health up­dates to clin­i­cians. Con­nected health so­lu­tions can also be used to track lifestyle dis­eases such as hy­per­ten­sion, di­a­bet­ics and asthma which need con­tin­u­ous mon­i­tor­ing. All these fac­tors have cre­ated strong in­cen­tives for de­sign­ing de­vices built on the lat­est tech­nol­ogy and get­ting them to mar­ket faster than the com­pe­ti­tion.

But health­care IoT isn’t with­out its ob­sta­cles

Re­cently hacked med­i­cal de­vices are mak­ing scary head­lines! The number of con­nected de­vices and the tremen­dous amount of data they col­lect can be a chal­lenge for cy­ber­se­cu­rity. Last year, the FDA took the un­prece­dented step of re­call­ing 4,50,000 pace­mak­ers be­cause it was found to be vul­ner­a­ble to cy­ber threats. John­son & John­son, last year, had warned cus­tomers about a se­cu­rity bug in one of its in­sulin pumps. It is im­por­tant to ex­cise se­cu­rity and pro­tect pa­tients, so that at­tack­ers don’t hack an in­sulin pump and ad­min­is­ter a fa­tal dose. Med­i­cal de­vices also con­nect to a huge ar­ray of sen­sors and mon­i­tors, mak­ing them po­ten­tial en­try points to larger hos­pi­tal net­works.

Im­planted de­vices are so per­sonal and no­body will want some­thing in your body to be re­mote con­trolled by a hacker. A re­cent study by Synop­sys high­lights that only 51 per cent of de­vice mak­ers and 44 per cent of health­care or­ga­ni­za­tions fol­low cur­rent FDA guid­ance to mit­i­gate or re­duce in­her­ent se­cu­rity risks in med­i­cal de­vices. For­tu­nately, med­i­cal de­vice vul­ner­a­bil­i­ties have been on the FDA’s radar for some time. In July 2015, the FDA is­sued an Alert high­light­ing cy­ber risks re­lated to in­fu­sion pumps. Then, at the end of 2016, it is­sued what it called “guid­ance” on the post-mar­ket man­age­ment of cy­ber­se­cu­rity for med­i­cal de­vices.

FDA in its web­site, says, “All med­i­cal de­vices carry a cer­tain amount of risk. The FDA al­lows de­vices to be mar­keted when there is a rea­son­able as­sur­ance that the ben­e­fits to pa­tients out­weigh the risks. While the in­creased use of wire­less tech­nol­ogy and soft­ware in med­i­cal de­vices also in­creases the risks of po­ten­tial cy­ber­se­cu­rity threats, these same fea­tures also im­prove health care and in­crease the abil­ity of health care providers to treat pa­tients.”

Thus, IoT con­nected med­i­cal de­vices is dras­ti­cally change the face of health­care mon­i­tor­ing, treat­ment out­comes thus pro­mot­ing a bet­ter stan­dard of liv­ing. Na­tions across the world are strug­gling to im­prove pa­tient care and these con­nected de­vices pro­vides a timely and cost-ef­fec­tive re­sponse to this crit­i­cal im­per­a­tive. More­over, re­cent de­vel­op­ments in sen­sor, in­ter­net, cloud, mo­bil­ity and big data tech­nolo­gies have led to af­ford­able med­i­cal de­vices and con­nected health pro­grams, vastly in­creas­ing the po­ten­tial of IoT en­abled med­i­cal de­vices to in­flu­ence fur­ther changes. How­ever, con­nected de­vices are vul­ner­a­ble to se­cu­rity breaches and statis­tics re­veal that that manufacturers are not build­ing these de­vices with se­cu­rity as a pri­or­ity. As IoT de­vices grow in pop­u­lar­ity, seem­ingly end­less se­cu­rity- and pri­vacy-re­lated con­cerns are sur­fac­ing and need to be ad­dressed.

Source: Vari­ant Mar­ket Re­search

Source: Vari­ant Mar­ket Re­search

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