A Detailed Guide To IoMT Implementation in 2019
Internet of Medical Things or IoMT is on the way of becoming the most sought after technology in the healthcare sector. According to a report, 87 percent of all healthcare organizations plan to implement IoMT related services by the end of 2019.
Connection of the medical devices and equipments to the Healthcare IT framework using networking technology is not only beneficial to the patients, it also helps in workflow optimization across the healthcare delivery systems and is instrumental in decreasing the healthcare costs. But before jumping into the applications of IoMT in healthcare and its advantages, let us first understand what exactly does Internet of things even mean.
What is Internet of Medical Things (IoMT)
IoMT comprises of a network of interconnected medical devices and other appliances that are capable of having machine to machine conversation over a network to form a connection of smart devices. The internet of medical things, also known as healthcare IoT basically the extension of the internet of things into the healthcare domain.
The computing devices embedded into the medical devices enables them to send and receive data over a shared network like a wi-fi. Equipped with state of the art sensors, these devices are able to capture and transmit vital healthcare data thus improving the efficiency of healthcare delivery and resulting in improved patient outcomes.
Classification of IoMT devices
The interconnected medical devices that constitute IoMT broadly fall under the following seven categories
- Fitness wearables
- Clinical grade wearables
- Remote patient monitoring devices
- Smart pills
- Point of care devices and kiosks
- Clinical monitors
- Hospital devices
1. Fitness Wearables
These are the consumer wearables which have in-built sensors to collect the physical activity related data of each individual and track the fitness regimen with the help of connected apps on the smartphones. These activity trackers are in the form of wristbands, smartwatches and smart apparel, each of which have advanced sensors attached to them to collect user’s vital stats.
The fitness wearables not only empower the users to keep track of their own health, the computation of the data collected using healthcare AI algorithms can facilitate advanced healthcare delivery based on precision medicine.
The examples of consumer wearable include wristbands and smartwatches like Fitbit and iWatch, Smart shoes like Under Armour, Mbody connected shorts from Myontec, UV sense – a wearable UV light tracker on the thumbnail for documenting exposure to UV light etc.
2. Clinical Grade Wearables
The clinical greade wearables are the iot devices which have been certified and approved for use by the regulatory authority and are generally used on the basis of a physician’s prescription. Unlike consumer wearables which are lifestyle devices, these are specifically aimed at clinical or at home use to improve chronic conditions and specific ailments. They require rigorous clinical trials to attain certification from FDA.
The example of clinical grade wearable devices include a smart belt from Active Protect that is meant for use in the elderly patients by detecting falls and giving hip protection for elderly wearers. Another example is QardioCore, a chest strap with embedded sensors to record ECG, heart rate, respiratory rate and temperature.
The device is yet to receive FDA approval but is being shipped outside of the US. Apple’s 4th generation iWatch is also a clinical grade wearable after it’s approval from the FDA. It is capable of generating ECG similar to a single lead electrocardiogram.
3. Remote Patient Monitoring Devices
Remote monitoring of the patient post hospitalization in case of management of both acute and chronic diseases is made simpler by use of at home health monitoring devices and sensors.
The continuous observation of discharged patients leads to better patient care,improves the patient outcomes, accelerates recovery time and prevents readmission into the hospital. The RPM devices allow for the medical practitioner to have virtual telemedicine visits and track the disease progression and recovery rate.
The IoMT devices are also helpful ensuring patient’s adherence to the medication plan by sending out reminders and alarms at regular intervals. Medication dosage tracking is made possible with any changes in the drug regimen if required which results in improved patient outcomes and lowering of treatment costs.
4. Smart pills
FDA recently approved smart pills with ingestible sensors that to keep track of patient’s compliance to medication. The pill, Abilify MyCite, contains the drug with a sensor that gets activated on coming in contact with the stomach fluids. Upon activation, the data about pill consumption is transmitted to the wearable patch on the patient’s arm that further transfers the information to the smartphone app. The medication compliance data can be accessed by the caregivers and physicians with the patient’s consent via a web portal.
This technology has widespread application in case of patient suffering from mental diseases like Alzheimer’s, when compliance can be hard to detect. What’s more, after the drug gets dissolved, the ultra-thin sensor gets discharged naturally via the patient’s GI tract.
5. Point of care devices
Point of care devices run on the premise of bringing healthcare closer to the consumer. They mark a shift of focus from the physician to the patients. POC devices aim at increased access to diagnostic and monitoring solutions for improving outcomes and reducing treatment costs.
Point of care devices and kiosks placed in remote locations can be a great tool for making diagnosis and treatment accessible to patients living in far off places.
Point of care testing devices can provide the preliminary screening procedures thus eliminating the need to visit laboratory setups to have the tests done. They are used to test glucose and cholesterol levels, for electrolyte and enzyme analysis, testing for drug abuse, infectious diseases, and pregnancy testing. The advantage of these devices are that they are portable,
Medical kiosks placed in the community centres can be used as an adjuvant to telemedicine and provide connectivity to healthcare providers. Self-serving kiosks placed within the hospital are a great tool for automating processes like registration a lot faster and result in optimization of workflow within the hospital.
6. Clinical monitors
The clinical devices that comprise IoMT consist of a wide range of smart devices used by the physician in the clinical setup. They can be used to digitally record and store the patient’s vitals directly in the EHRs. The electronic health records then can be stored on the cloud for later review or can be shared with the specialists for specific consultations.
The examples of clinical devices include digital stethoscopes which can relay the heart sounds on a mobile app and can save, store or relay the heart sounds as well. Another example is Rijuven’s Clinic in a Bag, a comprehensive cloud-based examination platform clinicians can wirelessly deploy to assess patients at any point of care. It is a one-stop destination for examination of heart, lungs, vitals, imaging, lab work and telemedicine.
7. Hospital devices
All the digital devices within the hospital premises, from the ECG to the MRI machine constitute IoMT. The premise of smart hospitals is on the rise with all the digital devices interconnected with each other for better patient monitoring and optimized workflow within the organization. Majority of healthcare providers have now shifted to electronic medical records, which ensures timely updates and remote accessibility of records.
IoMT is also important for asset and personnel management within the hospital. Implantation of RFID chips in the equipment can be done for tracking the high capital equipment in the hospital premises. The use of location based services on the healthcare provider’s smartphones can be used to track the live location and ensuring staff efficiency.
It also results in better inventory management and identification of crucial areas of patient flow within the hospital ensuring faster patient flow and greater patient satisfaction.
Challenges of IoMT implementation
- Data security threats
- Interoperability of data
- Regulatory challenges
- High infrastructure costs
- Standardization issues
1. Data security threats
Healthcare data is highly susceptible to breaches by cyber attacks and are constantly at a risk. According to a report, healthcare industry experiences 340% more security incidents than any other industry and is 200% more likely to encounter data theft.
Adding the IoMT data to the existing pool of clinically relevant medical data significantly increases the risk of exposure. As more devices become interconnected to one another and other systems, there is an increased risk of data breaches.
2. Interoperability of data
Data collected from the various IoMT devices is of no use if it cannot be collated and computed to give meaningful and clinically relevant results. In order to utilize the potential benefits of IoMT to the fullest, it is imperative that all IoMT devices are interoperable with one another and allow for relaying of the data to everyone using the technology including the providers and the payers.
3. Regulatory challenges
Clinical grade medical devices need approval and clearance from the FDA to be able to launch in the market. IomT devices present new challenges for the regulatory authorities and legislators as well. Currently, regulations like HIPAA govern the collection and storage of Patient health information but separate laws governing the medical devices and ensuring their regulation need to come out soon.
4. High infrastructure costs
While the long-term aim of IoMT is to reduce the overall healthcare costs, the costs associated with building the Healthcare IT infrastructure are enormous. The cost of the hardware, dedicated IoMT IT infrastructure, cloud computing and creating an app that’s consumer facing result in a high initial investment. While the eventual return on investments is a definitive, the high infrastructure costs act as a barrier to IoMT.
5. Standardization issues
With a number of vendors and manufacturers of medical devices, all looking to achieve scalability and reduce the time to market of their product, standardization of the IoMT devices becomes an issue. According to a 2017 study, only 51 percent of medical device manufacturers and 44 percent of healthcare organizations follow FDA guidelines. Lack of standardization affects interoperability of medical devices reducing the overall effectiveness of IoMT.
Future scope of IoMT
With the widespread proliferation of medical devices and greater research in development of IoMT devices focused on specific disease conditions, the future scope of IoMT is bright. It has to overcome the regulatory, legislative and judicial hurdle to ensure widespread applicability is backed by data security and compliance to norms. Read more about the future potential in our Healthcare Technology Trends report.
Ensuring that the medical devices manufactured and the healthcare apps are HIPAA compliant is essential for safety and security of medical data.
Legislative breakthroughs like Internet of Medical Things Resilience Partnership Act of 2017 and FDA regulations are paving the way for a future of IoMT that is widely accepted, and results in lowering of healthcare costs and increased effectiveness of healthcare delivery.
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