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The Internet of Medical Things (IoMT)

The Internet of Medical Things (IoMT) has rapidly become an adopted technology in healthcare in the UAE. SME explores how and why 

As the Internet of Medical Things (IoMT) gains traction in the UAE, healthcare operators must recognise the need for high-level security for patient data records and connected devices. 

The Internet of Things (IoT) has truly revolutionised businesses across various sectors, including the healthcare industry that gave rise to the emergence of the Internet of Medical Things (IoMT). The benefits of interconnecting medical devices are easy to grasp; instead of test requisitions and reports sitting at the nurses’ station, physicians today conduct this entire transaction digitally, ensuring that patients receive a far better standard of care and are prioritised based on need rather than chronology.  

According to a report published by Deloitte, wider adoption of Technology Enabled Care (TEC) – where healthcare practitioners can undertake e-visits, write e-prescriptions, diagnose, and deliver treatment via remote digital monitoring – can result in direct cost savings and enhanced patient care. Hospitals have already started to increase use of connected devices, and operators feel that wider adoption in the healthcare sector can greatly reduce time spent on treatment and improve the doctor-patient relationship significantly. 

The time spent collecting patient data at regular intervals costs hospitals a significant amount of time and resources. Automating these processes by using technology such as wearable devices that can track a patient’s vital statistics results in not only cost savings for the medical services, but also benefits patients by offering a more efficient method of data collection and enabling doctors to make a well-informed diagnosis. This is just a small example of how connected devices can revolutionise medicine in ways that were unimaginable before. 

Protecting patient records 

The Dubai Health Authority (DHA) has announced pre-Covid, that 1.4 million patient records are now electronically available and a unified electronic medical system is live across a designated number of hospitals in Dubai under the ‘Salma’ initiative. Similarly, the government announced that it would launch the NABIDH program to digitise patient records.  Both of these initiatives are linked to the UAE’s wider vision of fostering innovative and integrated care models across the healthcare sector and using big data to develop evidence-based public health policies. 

This is a bold move, and the DHA recognises that technological advancements also bring with them risk: the risk of patient records and other sensitive data making its way into the wrong hands is a very real threat that hospital and healthcare operators run. According to the US Department of Health and Human Services’ Office for Civil Rights, one in two Americans were affected over this last year by a data breach in healthcare. Furthermore, cyber liability insurers raised their premiums threefold for healthcare providers as this has been the most attacked industry two years running, surpassing the financial sector. 

Last year, UK’s National Health Service’s Lincolnshire and Goole hospital cancelled all of its planned operations and diverted major trauma cases to neighbouring facilities following a targeted attack. Although the hospital didn’t divulge the kind of virus that infected its systems, it is likely an infestation of ransomware — a malware scourge whose purveyors have taken to targeting hospitals and healthcare facilities. Here in the UAE, a well-known private medical centre also faced a similar attack in 2016. 

If hackers manage to lock and/or encrypt the health record of a patient needing immediate healthcare attention, the patient’s life will be in danger. Securing the network and medical devices therefore has become top priority for the healthcare industry, and now more than ever the healthcare sector must ensure that they put patient data confidentiality on par with patient care. 

Operators therefore need to acknowledge that the data is as important as their patients. Given the reliance on connected healthcare devices and the data they provide, protecting this data and the devices that monitor and treat are in-line with protecting patient lives, hence the healthcare sector and medical device manufacturers need to understand that securing the Enterprise of Things is vital. The Enterprise of Things is a network of intelligent connections and end points within the enterprise – including a collection of devices that enable smart product development. For device manufacturers, the focus is still almost entirely on the function of the device rather than its capacity to be secured. 

Covid challenges 

The medical sphere has been rapidly modernising over the past few years, integrating technology to facilitate, accelerate and streamline processes with greater accuracy. Now, against the backdrop of the COVID-19 pandemic, the technology is becoming more connected to create a wider infrastructure that can cope with the increased burden on medical facilities. The IoMT system emphasises interoperability among the 50,000 medical technologies currently available, via either an internal or external network. 

As the World Economic Forum recently noted, “Our digital infrastructure needs strengthening to deal with the impact of COVID-19 and future public health crises. (…) A new age digital era has emerged.” Wearable devices, sensors, telemedicine solutions, machine-learning models, and computer-assisted services are increasing access to healthcare at a time when people need it most. In fact, big players like IBM, Siemens, and Johnson & Johnson have heavily committed to investing in IoMT during the crisis to provide a more holistic view of patients. 

Remote patient monitoring 

The pandemic has brought to light the need for systems that actively include and treat patients at a, particularly vulnerable time. Social distancing measures mean that many people cannot or are apprehensive about leaving their homes, putting their physical and mental health at greater risk, especially if they have pre-existing medical conditions. 

IoMT offers digital medical services to patients with chronic diseases who need continuous care while self-isolating. Devices like biosensors, worn on the body and measure vitals like blood-oxygen or glucose levels, can connect with patients’ cell phones, computers, or tablets. These electronics then transmit the data to medical professionals, who can remotely monitor the patients’ progress. Not only is this information easier to track because of the specific device identification number, but it can also be converted into visual data, displaying patterns and anomalies that represent the effectiveness of the course of treatment being undertaken. 

Biosensors additionally help ensure that patients comply with their medication guidelines. For instance, if the dosage and frequency deviate from the recommended amount, a biosensor will immediately alert medical professionals. Plus, because these sensors report in real-time, professionals can take action as soon as possible to prevent a deterioration in patients’ wellbeing. 

The University of San Diego has been quick to embrace biosensors as a solution to the pandemic. Researchers have asked discharged COVID-19 patients to use a biosensor to monitor vital signs like their heart rate, oxygen saturation levels, activity level, and quality of sleep. The data is then fed to a specially-designed app, where patients take a daily questionnaire to submit qualitative data about their recovery. This technology reassures patients that their care doesn’t end once they leave the hospital and gives them a direct channel to notify professionals if their status changes. 

Detecting & assessing the virus 

IoMT is proving to be very powerful as both a reactionary and preventative solution for the COVID-19 virus. Although there is no vaccine for the virus yet, interconnected technology raises awareness about the need to self isolate or see a medical professional, ultimately curbing the spread of infection. 

Experts from Fitbit have been using data from their wearable devices to uncover insights around people’s resting heart rates and daily activity patterns. An elevated resting heart rate has been associated with infection and has subsequently helped identify people with influenza-like illnesses that could be COVID-19. While the data cannot diagnose the virus, it can encourage susceptible persons to quarantine or take an official test. 

Elsewhere, Epicore Biosystems has been exploring a sweat-sensing microfluid patch that monitors patients’ sweat cytokine levels to predict which COVID-19 cases could become life-threatening. Cytokines are small proteins that help coordinate the body’s immune responses, and patients with the COVID-19 virus are likely to have a higher volume of them, which can trigger a fatal inflammation. 

Because cytokines can be measured through sweat, Epicore’s single-use patch is applied to a person’s skin and catches sweat through a series of chambers. The results are then analysed through a connected mobile app, and physicians can classify at-risk patients. Even more promising is the potential for the technology to be built into N95 respirator masks, where it could track the health and fatigue of frontline medical staff. 

Meanwhile, in Chicago, tests are continuing with a wireless sensor that sits on patients’ throats (the suprasternal notch, where airflow occurs closest to the skin) to document respiratory activity and coughing. The sensor transfers health data to a HIPAA-protected cloud, where a set of data algorithms specifically created to flag early symptoms associated with COVID-19 generate graphical summaries of the patient. The technology is so sophisticated that it may even recognise COVID-19 symptoms before individuals perceive them. 

Alleviating strain on hospitals 

Hospitals and medical organisations worldwide have had to cope with the pressure of increasing patient volumes, limited resources, and exhausted staff. IoMT is proving to be a much-needed logistical resource to alleviate the pandemic’s toll on institutional healthcare. For example, connected technology can track medicational inventory, confirm compliance with drug-storage conditions, boost energy-saving processes, and improve storage facilities. 

Smart vaccine fridges play a noticeable role, as an IoMT platform processes internal sensors. The real-time analysis helps to implement temperature controls that prevent vaccines from spoiling. It also documents when the fridge door is opened, reducing the risk of theft or exposure to undesirable conditions. As COVID-19 vaccines are expected to be globally distributed soon, having the correct equipment to store the medicine is of utmost priority for hospitals and clinics. 

In China, one smart hospital is completely operating with an IoMT model. Robots are carrying out all services, such as screening patients with 5G thermometers, using sensors to watch vital signs, and providing food, drinks, medicine, and entertainment. All actions and reactions are recorded on the cloud, allowing medical staff to treat patients at a safe distance. Simultaneously, disinfection robots routinely emit ultraviolet light throughout the hospital, decontaminating surfaces by tearing stands of the virus DNA apart. 

Technology itself can be monitored through IoMT capabilities. MRI machines, X-ray machines, CT scanners, and more can be remotely checked for performance issues. By integrating with hospital equipment, IoMT solutions can make remote diagnostic reports, predict maintenance issues, and even conduct upgrades. This connectivity reduces downtime for professionals who need to use the technology and reduces the need for physical contact with machines and contamination. 

Predictions state that the IoMT market size will be worth $142.45 billion by 2026 – a figure that may exponentially grow due to the COVID-19 crisis. As IoMT continues to demonstrate efficiency and effectiveness during the pandemic, more medical verticals are likely to adopt the tech on a long-term basis. 

The current conditions should be seized as an opportunity for healthcare institutions and patients to familiarise themselves with IoMT devices and services. As they do so, they not only contribute to data and systems that help in the fight against COVID-19, they can prevent it from occurring again. 

In conclusion, it can be said that enterprise technology gives healthcare providers a way to efficiently deliver the best quality medical services, but they need to develop a strong security framework to ensure the smooth functioning of their business without compromising on patient care. 

Nader Henein, Privacy Research Vice President, BlackBerry 

The Dubai Health Authority (DHA) has announced pre-Covid, that 1.4 million patient records are now electronically available and a unified electronic medical system is live across a designated number of hospitals in Dubai under the ‘Salma’ initiative. Similarly, the government announced that it would launch the NABIDH program to digitise patient records.  Both of these initiatives are linked to the UAE’s wider vision of fostering innovative and integrated care models across the healthcare sector and using big data to develop evidence-based public health policies. 

This is a bold move, and the DHA recognises that technological advancements also bring with them risk: the risk of patient records and other sensitive data making its way into the wrong hands is a very real threat that hospital and healthcare operators run. According to the US Department of Health and Human Services’ Office for Civil Rights, one in two Americans were affected over this last year by a data breach in healthcare. Furthermore, cyber liability insurers raised their premiums threefold for healthcare providers as this has been the most attacked industry two years running, surpassing the financial sector. 

Jamie McMillen, Managing Director Suprema Systems 

The COVID-19 pandemic has affected every aspect of life, and healthcare facilities especially the need to take heightened precautions to ensure employees, visitors and customers are secure and safe. In a hospital environment, where the spread of germs is a major concern, touch points are a hazardous breeding ground for germs and need to be well-managed. 

Thanks to the development of new technologies, hospitals can build access control systems that no longer require touch or contact. For example, access control devices that recognize and authenticate a credential from a distance remove the need to touch keys, ID cards or keypads.  

Among these technologies, facial recognition is one of the most preferred. The demand for facial recognition in all markets in the last 12 months has been significant, and Suprema has been involved in COVID testing and research applications that limit the number of touch points on site and potential for spread of germs and viruses. Facial recognition is preferred because of its convenience and speed. While other biometric systems that use hand geometry and iris scans are contactless as well, these systems require more effort on the part of users to correctly position themselves in front of devices for recognition and thus are slower.   

Advanced facial recognition devices also offer features such as remote user enrollment that minimize personal interactions and further help prevent the spread of viruses. Other helpful features include detecting and limiting access of people not wearing masks, recognizing users wearing masks and integration with thermal cameras to identify people with elevated skin temperature.  

 

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