TToday’s pandemic shows us the promise of the Internet of Medical Everything

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The healthcare industry has long embraced new technologies, and new developments, from wearables to telemedicine, have become widespread as providers have striven to deliver quality care more efficiently. Providers on the front lines of the response to the COVID-19 pandemic are now leveraging transformative technologies in an effort to better understand and manage the current crisis. As the response has accelerated already in-progress efforts to transform workplaces and schools, innovators are exploring the future of healthcare ahead of schedule.

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We have been building an Internet of Things (IoT) over the past decade, a network of everyday objects so prevalent we now take it for granted. Virtually everywhere we go, devices can communicate with one another: at home, thermostats report conditions and receive their instructions via web services; wearables track our health stats and report to our smartphones; transponders on pallets let sensors in factories, warehouses, and stores keep track of goods as they make their way from manufacturing plant to retail shelves.

When we bring data, people and processes into the way we think about this digital ecosystem, we move towards an Internet of Everything. As next-generation cellular networks roll out — with their potential of higher speeds, lower latency, ability to support many more connections, and the capability to create virtual networks to serve specific groups of devices — this evolution of IoE will accelerate. The Internet of Things connects our stuff, but the Internet of Everything will bring together all of the data our stuff manages, and in turn will transform how we think, act and collaborate.

“Consumer wearables and apps that track and analyze data like heart rate, caloric intake and daily activity have made individuals more aware of their health habits. But it’s also showed the healthcare industry that technology can play a huge role in improving quality of life, both day-to-day and when medical assistance is needed and now, in this time of crisis.”

-Mike Katz, Executive Vice President, T-Mobile for Business

Managing data: Why the Internet of Medical Things must become the Internet of Medical Everything
The healthcare industry, already faced with delivering care to an aging population while controlling costs across a highly decentralized system, has shifted to emergency response. In order to do so efficiently in the face of resource shortages, innovative firms are looking to build on the kinds of transformative technologies the Internet of Everything can empower.

A robust Internet of Medical Things (IoMT) ecosystem is evolving, with some 60 percent of healthcare organizations having already incorporated IoMT devices into their practices, from wearable sensors that track vital signs to point-of-care testing tools. Some 88 percent of providers are currently either already using remote sensors to monitor patients or plan to in the future. And today’s patients are increasingly open to the practice, with some 53 percent of U.S. adults willing to wear devices that track vital statistics and fitness data. Tens of millions already wear consumer devices that perform such tasks, from fitness-specific trackers to watches that are capable of recording health data with an FDA-approved electrocardiogram (ECG) and can share that data with electronic health record (EHR) platforms.

These devices have become part of our social lives and are proving to be helpful in tracking how well social distancing — one of the most important tools in the public health effort against novel Coronavirus infections — is working.

As countries, states and municipalities become more serious about maintaining social distancing, mobile phones have become important tools. Unacast, an analytics company that works with cellphone location data, has created a tool it calls the Social Distancing Scoreboard; the service uses location data to estimate how many people are complying with stay-at-home, shelter-in-place, and similar social-distancing protocols.

Another firm, Kinsa, markets a connected thermometer alongside an app that provides personalized guidance on managing fevers based on temperature, age and other factors. It also leverages the data supplied by its nearly two million users to create a “Weather Map” of the U.S., highlighting regions experiencing an atypical number of elevated temperature readings or persistent fevers. Initially designed to track fevers during flu season, the map could help predict COVID-19 hotspots in the U.S.

Both efforts highlight how the data generated by everyday devices can potentially be far more valuable in the aggregate during a crisis situation than we might have expected.

“The prevalence of consumer wearables and apps to track and analyze data like heart rate, caloric intake and daily activity has made individuals more aware of their health habits,” says Mike Katz, executive vice president of T-Mobile for Business. “But it’s also showed the healthcare industry that technology can play a huge role in improving quality of life, both day-to-day and when medical assistance is needed.”

Bringing connected devices to the front lines
It is becoming clear that combining IoMT devices and healthcare IT — as well as capturing all that data and leveraging advanced AI to bear on that data and build an Internet of Medical Everything — is key to the future of healthcare delivery and innovation, potentially addressing costs, and with the possibility of achieving better outcomes.

While future 5G networks with the potential for higher speeds and capacities could unlock the potential of this Internet of Everything going forward, connected devices as well as telehealth and telemedicine platforms are already making a difference in the fight against COVID-19 — both on the diagnostic front lines and in the search for effective treatments.

A significant challenge in managing the spread of the outbreak early on, especially before regions moved to quarantine or distancing measures, had been keeping track of those who may be infected. In China, augmented reality glasses were employed by security staffers in order to detect fevers. The manufacturer of the system claimed that a staffer wearing AR goggles coupled to back-end AI could analyze and automatically log the body temperatures (and relevant data regarding the potentially infected) of several hundred people over a two-minute period.

As 5G eventually becomes pervasive, it promises to enable an even greater variety of sensors, with the potential to extend such techniques to more aspects of health and wellness. The future of 5G promises to enable real-time monitoring and remote control. Access to that stream of data can enable not just better diagnoses, but a host of new technological solutions — from smart pills and remote training to expanded telehealth and telemedicine via AR/VR, and even complex remote surgical procedures.

“Today, our healthcare system is facing a monumental challenge in COVID-19,” Katz says. “Patients are pouring into hospitals in need of fast triage, testing and care. At the same time, medical professionals need ways to minimize exposure to non-infected people, including themselves. But imagine a future where technologies like AR and VR can be used to speed or even automate diagnosis, and consult patients on next steps through telehealth platforms. The sooner we can integrate that into our healthcare system with reliable network access, the better off patients and medical professionals can be.”

A future networked world of devices has the potential to bring better engagement, improved preventative care and monitoring of chronic conditions without having to visit a clinic — all leading to possibly better outcomes, potentially lower costs and probability of more efficient management and distribution of healthcare resources, whether in times of crisis or once the situation has returned to normal.

“Imagine a future where technologies like AR and VR can be used to speed or even automate diagnosis, and consult patients on next steps through telehealth platforms. The sooner we can integrate that into our healthcare system with reliable network access, the better off patients and medical professionals can be.”

-Mike Katz, Executive Vice President, T-Mobile for Business

The Internet of Medical Everything: More connected, more efficient use of healthcare personnel and better outcomes
A key revelation of the COVID-19 response has been the need to better manage scarce hospital resources. With the expected influx of patients outstripping the numbers of critical hospital supplies, from beds and personal protective equipment to ventilators and other lifesaving equipment, the crisis has significantly taxed providers. And as social distancing becomes more common, frontline providers are seeking additional ways to serve patients outside of clinic settings wherever possible.

Significantly, in response to the pandemic, the U.S. government has changed Medicare rules to allow reimbursements for telehealth services. Many private insurance providers have followed suit. While in practice providers are still working out how to deliver increased telehealth care in the face of unprecedented patient needs — especially to rural and underserved urban populations — systems are quickly evolving. Usage of telehealth app platforms has grown by 50 percent or more nationwide during the pandemic, with some systems in hotspots like Washington state seeing usage grow by up to 650 percent. Whatever the difficulties of ramping up services in times of crisis, it is clear that telehealth solutions that can keep mildly symptomatic (but potentially contagious) patients at home can help manage the spread of COVID-19. Meanwhile, insurers, state and federal authorities, and providers continue to work toward solutions.

As they build capacity, these services may well build on the approach used by small businesses like Catalytic Health Partners. As Katz describes it, “Catalytic is able to give housebound patients monitoring equipment and a customized tablet so they can track their vitals from home, get reminders to take medication, speak face-to-face with healthcare professionals, and more. Connected care like this will only get better as we enhance our network, and it’s the broad adoption of this type of infrastructure that will play an important role in holding up a robust healthcare system in the face of crises like a pandemic.”

The U.S. Department of Veterans Affairs — the largest healthcare system in the country — is providing a model of what a very large scale Internet of Medical Everything might look like, unifying its digital platforms as it moves to incorporate IoMT devices, electronic health records, and remote care to better serve the more than nine million patients who interact with the agency each year. The VA is also in the midst of a $16 billion transition to electronic health records. An early innovator in telemedicine, the VA already operates the largest telemedicine program in the U.S. The VA has begun implementing IoMT products with an eye towards protecting patient data, working with the UL to develop a standard for medical device cybersecurity that conforms to both HIPAA and Department of Defense requirements.

In the future, we can expect to see further integration of monitoring like that deployed by Catalytic and the VA by building out high-speed, high-capacity 5G network coverage. This will support more sophisticated sensors and remote diagnostic and treatment devices like smart pills, implanted biosensors and defibrillators. Eventually this, integrated with all of the real-time data generated from patients’ EHRs, could give patients portable, persistent access to their own complete medical profiles as well as the tools to better communicate with providers while avoiding hospital stays. And in the event hospital treatment is necessary, clinicians could have immediate access to up-to-date data, giving them the opportunity for quicker diagnosis, which could lead to better treatment outcomes.

“Connected care like this will only get better,” Katz says. “As IoT, data analytics and other systems mature, we’re going to see technology and healthcare become interwoven in new, practical ways. Solutions that make receiving care easier for patients will also make providing care more efficient for providers. When I think of the possibilities that 5G and IoE will unlock for health care, I see a brighter, more promising future with the resiliency to help humanity overcome unprecedented challenges.”

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