12 October 2017
The Internet of Things (IoT) has been defined in different ways. Some consider it to be purely machine-to-machine communication, others view it as the interaction of smart devices (an electronic device than can communicate with other devices) with the internet. Whatever the definition, the IoT vision is clear – an enhanced communication system that enables continuous real-time flow of information.
What is the internet of medical things? - view the infographic here
The continuing development of smart devices coupled with advanced telecommunication systems are enabling this vision and driving us towards the generation and exchange of ever increasing volumes of data. IoT could help underpin a ‘connected health system’ – one in which information can be accessed and transferred more easily and efficiently between different parts of the health system and in doing so improve and enhance how health is managed. Although progress is being made towards this vision, there are challenges to overcome before IOT become a commonplace in healthcare.
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The internet of things brings together a technologies such as wearables, data storage, analysis and telecommunication to allow greater networking between devices and information exchange. IoT applications are based on different combinations of these technologies resulting in different levels of applications. Simple applications for example can track an individual’s activity (e.g. Fitbit) but do not analyse the information or transmit it to other devices independently. Complex applications are those that monitor, analyse and prompt a response (e.g. a smart inhaler that records and transmits usage data to a digital platform allowing the user and clinicians to examine usage and adherence).
IoT devices and systems are being developed by a large number of companies, with healthcare applications being targeted for both health systems, as well as individual citizens. This is sometimes referred to as the internet of medical things (IoMT)
Two areas where IoMT are currently having an impact are assisted living and chronic disease monitoring. Devices that monitor activity around the home and transmit this to either a carer or health professional are enabling supervision of home environment and provision of care at home in vulnerable groups.
IoT-enabled devices such as wearables and ingestibles are available that allow greater physician-patients engagement to ensure compliance with treatment and medication and enable remote health monitoring. The main area being targeted is diabetes although devices are being developed for conditions such as asthma, and cystic fibrosis.
The value of IoT for healthcare has been recognised by the NHS and is being trialled in two NHS test bed projects. Technology integrated health management (TIHM) is aiming to identify technologies that can be placed in people’s homes to improve care for people with dementia and the Diabetes Digital Coach is examining the use of remote monitoring and coaching technology for better self-management of the condition.
Current IoMT uses tend towards the simpler rather applications i.e. we have a number of Smart devices but they are not connected to a wider ecosystem. Technical, ethical and legal challenges need to be addressed before the more sophisticated and potentially transformative applications of IoMT can emerge:
IoMT can create a paradigm shift in the interaction between different parts of the health system by allowing more remote monitoring, easier access to and quicker flow of larger volumes of information and greater citizen/patient involvement in health care. This may put greater responsibility on individual patients for monitoring their conditions and managing their care. It will also require secure and robust systems to manage and secure data, as this will be critical to safeguard data and build the patients and public’s trust to sharing their data. In addition systems will need to be created that enable assessment of this information, be it by an algorithm or health professional.
Although current technologies are limited in their connectivity both with external systems and in the range of current measurable characteristics, this is hardly likely to be the case for much longer. Investment in IoT is large and societies are becoming increasingly reliant on algorithms to provide them with efficient and effective solutions. Further developments in this field are going to be influenced by the degree to which individuals are willing to be monitored and share this information.