A new paradigm, known as the Internet of Things (IoT), has an extensive applicability in numerous areas, including healthcare. The advancements of electronics has enabled miniaturized sensors, processors and communications functionalities to be integrated into everyday objects, making them ‘‘smart’’, such as smart watches, fitness monitoring products, food items, home appliances, plant control systems, equipment monitoring and maintenance sensors and industrial robots.
By means of wireless and wired connections, they are able to interact and cooperate with each other to create new applications/services in order to reach common goals. IoT in healthcare has unparalleled benefits which could improve the quality and efficiency of treatments and accordingly improve the health of the patients. IoT has now formed its subset called Internet of Medical Things (IoMT), that is used for remote monitoring of the patient’s or the client’s health through wearables (including ECG and EKG monitors), smart sensors, and mobile apps.
The Internet of Medical Things (IoMT) brings together smart connected medical devices, advanced analytics and people (healthcare professionals, caregivers and patients). It’s the network of a multitude of medical devices connected by communications technologies. IoMT results in systems that can monitor, collect, exchange, synthesize and deliver valuable new insights like never before. Healthcare is transforming through Internet of Medical Things (IoMT) technology advances and as smart connected products are deployed into the hands of doctors, nurses, field technicians, caregivers and patients. By 2020, it is expected that up to 30 billion IoMT devices will be deployed worldwide.
IoMT applications include health and wellness applications, remote patient monitoring, telemedicine interfaces, diagnostics tools, robotics, diabetes care, drug delivery, and many other emerging medical technologies. IoMT transformation highway, will accelerate the pace, quality, and efficiency of healthcare both in hospital environments and through telemedicine.
IoMT holds numerous benefits for both patients and healthcare providers.
Personalized, precision diagnoses and therapeutics — Many IoMT devices are designed to track a patient’s vital signs in detail and depth, to a degree that wouldn’t be possible during a brief office visit. For example, with a month’s worth of blood pressure or pulse rate readings, a doctor can more accurately diagnose a condition and create a more personalized and effective treatment plan.
Remote medical treatment and advice — The very nature of IoMT devices means they can capture data from anywhere — such as a patient’s home — then transmit that information securely to the physician, all without requiring a visit to the office. IoMT tools help clinicians to monitor patients at home or on the go from any corner of the world. Connected devices are leveraged to monitor at-risk patients to ensure they take medication, measure glucose level and blood pressure, set reminders and alerts.
Several breakthrough technologies have taken place in 2019, with the World Economic Forum (WEF) identifying the prominent role IoMT has played in the healthcare industry. It gives an example of a pill with a tiny sensor, that transmits information to a patch on the patients arm when taken, with the resulting information then relayed to a mobile phone which is monitored by a doctor to ensure medication is taken at the correct frequency and time.
Patient empowerment — IoMT devices such as wearables and smart scales let patients take control of their vitals, giving them information they would otherwise have to visit a doctor to get. Rather than waiting for an annual checkup, patients can now keep tabs on their health in real-time.
Healthcare providers benefits: With the cost of medical care ballooning in recent years, providers are embracing cost-effective healthcare technologies. In 2015, Goldman Sachs predicted the savings from IoMT technologies, namely remote patient monitoring, would total about $305 billion. Chronically and seriously ill patients need more intensive monitoring, sometimes requiring around-the-clock care. IoMT devices allow physicians to monitor patients from afar without having to rely on human caregivers, alerting them instantly if something goes awry.
IoMT improves hospitals’ operations by giving providers and administrators easier, centralized control over their facilities. IoMT devices can provide them with more visibility into their environment, and provide physicians with new technologies like robotic surgical aids and high-resolution digital imaging systems.
Telehealth and telemedicine are now booming, in part because the COVID-19 pandemic has accelerated trends that were already taking the industry in that direction. A recent McKinsey & Co. report estimated that physicians are seeing up to 175 times more patients via remote telehealth systems than they were prior to the COVID-19 pandemic: In a single year, consumer usage of telehealth shifted dramatically from 11% adoption in 2019 to 76% in 2020. Before COVID-19, the telehealth industry was estimated to be a $3 billion market. Looking ahead, that market could soon grow to consume $250 billion of healthcare spending.
Recently, the United States Army Research Lab awarded $25 million to the Alliance for Internet of Battlefield Things Research on Evolving Intelligent Goal-driven Networks (IoBT REIGN) to develop new predictive battlefield analytics. Researchers say one key element of healthy IoBT/IoMT is a strong edge architecture that uses biometrics, environmental sensors, and other connected devices to send and receive data quickly, allowing military personnel to respond to potentially dangerous situations on the battlefield.
In the Internet of Military Things (IoMT) or Internet of Battlefield Things (IoBT), the sensing and computing devices worn by soldiers and embedded in their combat suits, helmets, weapons systems, and other equipment are capable of acquiring a variety of static and dynamic biometrics such as their face, iris, periocular space, fingerprints, heart rate, gait, gestures, and facial expressions.
“Such devices may also be capable of collecting operational context data. These data collectively can be used to perform context-adaptive authentication in-the-wild and continuous monitoring of soldier’s psychophysical condition in a dedicated edge computing architecture,” write researchers Aniello Castiglione and Michele Nappi of the University of Salerno, Kim-Kwan Raymond Choo of the University of Texas San Antonio, and Stefano Ricciardi of the University of Molise.
Military IoT Network for Maximizing soldier performance
There is great potential for IoT technologies to revolutionize modern warfare through data and automation to deliver greater lethality and survivability to the warfighter while reducing cost and increasing efficiency.
Soldier Body Area network for Real time decision making & health Monitoring
The vision of a connected battlefield is becoming reality today. It starts with the connected warfighter in the field, who becomes a communications node that is capable of gathering and transmitting data from many sources back to analytics and command centers. Connected warfighters become a network extension. Soldiers are equipped with sensors, communications systems, navigation systems, battle management systems, head-borne systems, weapons, and power sources. These devices allow collecting, record and analyzing data faster resulting in improved near- real time battlefield communication, control, planning and decision making. They help maintain situational awareness with an accurate knowledge of the environment and real-time access to video and data.
Soldiers operating in battlefield are affected by injuries, extreme weather conditions like avalanches, desert storms, landslides etc. Soldier wearable’s like band wrists containing vital sign monitors (temperature, blood pressure, heart rate, cholesterol levels and blood glucose) and heat, radiation, and helmet impact sensors will allow the health of the soldier to be monitored in real time.
Soldiers can be alerted of abnormal states such as dehydration, sleep deprivation, elevated heart rate or low blood sugar and, if necessary, warn a medical response team in a base hospital. This can keep troops safe and reduce response times for lifesaving aid when needed.
Cognitive stress and overload monitoring
Mental overload may compromise soldiers’ performance and sometimes safety, by increasing error rates and engendering fatigue, decline in motivation, higher reaction time. Using Electroencephalography to monitor electrical activity of the brain, functional near-infrared spectroscopy that can directly display areas of the brain that are active, and blink monitoring could reveal excessive levels of stress or fatigue in individuals / teams. These measures could provide more efficient and effective teams and deliver better operational effect.
Army Outfits Paratroopers with Wearables to Gauge Stress
Alaska-based, U.S. Army paratroopers are sporting biometric data-collecting wearables nonstop for half a year as part of ongoing research to inform how military members operate—and deal with strains—in arctic and other extreme environments. The project is unfolding in collaboration with the University of Queensland, according to a press release published Wednesday, and human performance company WHOOP is behind the devices.
“What makes this research unique is it is the first study to capture 24/7 biometric data, subjective measures, and performance data over a six-month period. This will provide reliable insights into what is really happening with wearers throughout their daily lives, and also provide an accurate non-invasive measure of stress during high octane activities like those conducted in the military,” WHOOP’s Vice President of Performance Science Kristen Holmes, told Nextgov Tuesday. “The collective goal is to provide Army Alaska with a physiological blueprint to make a more resilient soldier.”
Holmes, who helped design the study, explained that part of the intent behind it is to “gain a better understanding of the individual soldier, by utilizing wearable technology.” The fitness-monitoring devices have sensors that sit against users’ skin and can be worn continuously anywhere on their wrists or arms. Specifically, the rugged accessories track metrics like heart rate variability, ambient temperature, resting heart rate, respiratory rate, and sleep staging. On an app that accompanies the wearable, those involved can also track more than 50 different behaviors and lifestyle choices, which can subsequently be factored alongside physiological data. “We utilize [artificial intelligence] in our algorithms which learn from the rich datasets we have collected over time to continue to refine our product,” Holmes said.
The research project is set to analyze personalized data around wearers’ daily strains, recovery and breathing rates, sleep—and more. It’ll produce “a biometric baseline for the Spartan Brigade grounded in overall resilience, stress, and sleep quality,” Holmes noted. Participating paratroopers can directly access their own data, and those in charge will be able to assess and act on their own teams’ information, as well. “Imagine as a squad leader that you have a paratrooper that has had an abnormally low recovery for several days. Maybe your platoon has been in the field for weeks, or the paratrooper just returned from an Army school,” Spartan Command Sgt. Maj. Alex Kupratty said in a statement. “Now, you have the data to better help them recover, or to adjust your training to match the team’s needs.”
While the Pentagon encountered previous challenges posed by wearable technology, Holmes said WHOOP’s “unique security functions” were a factor that contributed to the Army’s use of it. The device “does not have Wi-Fi, GPS, and utilizes a unique Bluetooth function that makes it user-friendly in most military spaces,” she noted, adding that the data and insights captured via the wearables and app are “securely stored by WHOOP.” It’s all to be shared in a de-identified form with the university researchers, who will keep the data on password-protected computers prior to data analysis. “By providing the U.S. Army with more insight about individual physiology and the impacts of training in an extreme environment, soldiers will be better equipped to manage stress and ultimately, have higher readiness,” Holmes said.
Airmen mental health monitoring
The last few years have seen a dramatic increase in mental health conditions for Americans in general, and for military service members, in particular. An annual report from Veterans Affairs found that the suicide rate for Veterans was about 50 percent higher than for non-veterans. In fact, the Air Force loses more Airmen to suicide than any other cause.
Talk therapy, resilience training, and stress management skills can all help Airmen avoid mental health crises. Unfortunately, seeing a therapist often disrupts daily operational activities and the referral process can take more than five weeks, on average. While a number of programs and organizations are devoted to helping Airmen exist, identifying the right resource for an individual is difficult and time consuming. A clear gap exists when it comes to delivering personalized, relevant resources to help our Airmen develop skills to manage stress and build resiliency in the field and back at home.
Fortunately, there is good news. In recent years, the Air Force has taken deliberate steps to encourage mental wellness and provide support for Airmen through innovative digital solutions. Air Force leaders have partnered with NeuroFlow, a Veteran-founded technology company. NeuroFlow connects Airmen and Guardians with on-post and community resources, such as Veteran Service Organizations tailored to meet their individual needs. NeuroFlow tracks health factors like fitness, sleep, loneliness, depression, and alcohol use. It also offers exercises and tools such as guided meditation, journaling, and evidence-based cognitive behavioral therapy (CBT) resources. The NeuroFlow platform encrypts individual health data and activity to ensure it is not publicly shared or integrated into official records. Additionally, Airmen can use NeuroFlow confidentially, which is crucial for combating the potential stigma of receiving mental health support.
“From a military perspective, we fly the plane for two hours, and then we spend 12 hours maintaining it. And we should be able to do at least that much for our human weapons systems, in terms of helping them and giving them the tools that they need to maintain their peak performance,” says clinical psychologist John F. Drozd, PhD, ABMP, who uses NeuroFlow with his military and veteran clients.
NeuroFlow aggregates user data and feeds it into a clinical dashboard that unit leaders can review to better understand the behavioral health trends of Airmen over time. The platform’s artificial intelligence algorithm can also flag individuals with declining mental health conditions or those at risk for self harm. To date, NeuroFlow has been supporting thousands of Airmen and has proactively identified over 150 individual users requiring additional support, connecting them to relevant support and crisis resources. Moreover, seventy-five percent of those with mental health conditions who completed a follow up 4-8 months after starting with NeuroFlow achieved a clinically significant improvement based on validated measurements.
IOMT Security and other Challenges
Implementing IoMT is not without its share of challenges, the biggest being security and privacy. Medical data is highly regulated — most notably by the Health Insurance Portability and Accountability Act (HIPAA) — and providers have a heavy burden to prevent its compromise. Introducing IoMT devices into the environment invites some level of risk, largely due to the copious amount of additional data that flows between patients and providers.
As the physicians are increasingly adopting telemedicine, and telehealth services which rely on the transfer of data from one location to another, whether it’s through interactive video consultations, store and forward technology or remote patient monitoring. Unfortunately, this data can be stolen or even manipulated during transmissions by cyber criminals looking to harm patient outcomes. To protect consumers and their own businesses, telemedicine providers should provide services via applications that use end-to-end encryption and other security technologies to prevent information theft or tampering.
These cyber threats don’t just mean financial losses for the patients. They could mean the loss of a human life. Hackers may use malware for device reprogramming which alters device function. Malware attacks can shutdown healthcare devices and equipment, including pacemakers, insulin pumps, and light scopes, and even add tumors to MRI scans.
At another hospital, hackers find a way to connect to the software that controls IV pumps, changing their settings so they no longer deliver the correct doses of medication. “There were several reports of UK hospitals unable to administer X-rays. The computer equipment attached to the X-ray machines was compromised and attacked by ransomware and rendered inoperable for some period of time.” Patients could be harmed or even die. Many people — both patients and health-care workers — could be inconvenienced by systems going down.
Interoperability and standards are other hurdles that IoMT vendors face. In an ideal world, healthcare IoT equipment from one vendor would work seamlessly with another vendor’s infrastructure, but that hasn’t been the case, and uniform standards have been elusive. While some certification processes have emerged, the industry is still a long way from having universal interoperability.
Another ongoing issue — and perhaps the most difficult to resolve — is the inability to update IoMT devices. While IoMT devices are state of the art when they’re released, once a device is in the field, it can be difficult to upgrade or update with new features. Consumers are unlikely to upgrade their wearable devices or connected devices every year, and hospitals are generally slow to roll out expensive new equipment, resulting in a patchwork of products with different capabilities across the market. Upgrades become even more of a challenge with implantable devices, such as pacemakers, that are surgically embedded.
Internet of Medical Things (IoMT) Market
Market for Internet of Medical Things (IoMT) is expected to grow at a CAGR of around 27.2% from 2020 to 2027 and reach the market value of over US$ 155.8 Bn by 2027 largely due to the integration of sensors into more medical technologies and the full implementation of 5G technology.
The global Internet of Medical Things (IoMT) market is segmented on the basis of product type, services, application, end-user, and geography. Based on product type, the market is divided into smart wearable devices, home-use medical devices, and point-of-care kits. On the basis of services, the market is bifurcated into on-premise based services and cloud-based services. The Internet of Medical Things (IoMT) market offerings have application across real-time monitoring, end-to-end connectivity, data assortment & analysis, tracking & alerts, and remote medical assistance.
Additionally, the end-user of the Internet of Medical Things (IoMT) market include hospitals & clinics, research institutes & academics, and homecare. By geography, the market is divided across North America, Europe, Latin America, Asia Pacific, and Middle East & Africa. Additionally, the above mentioned prominent regions are further bifurcated into major countries.
In 2019, North America held the major share in terms of revenue of the Internet of Medical Things (IoMT) market, and the region is also projected to maintain its dominance over the forecast period from 2020 to 2027. The presence of major players in the region and the early adoption of new and advanced technologies by them are supporting the regional market value. For instance, Proteus Digital Health has announced the launch of digital oncology medicines for cancer patients in January 2019, which is significantly helping in improving the outcomes of treatment. The launch of the new development was announced in partnership with the Fairview Health Services and the University of Minnesota Health.
Furthermore, Asia Pacific is anticipated to experience the fastest growth during the forecast period from 2020 to 2027. The developing economies of the region including China and India are majorly contributing to the regional market value. The increasing funding in the healthcare sector of the region in order to provide effective treatment to the increasing population base coupled with the increasing number of chronic disease patients.
Some of the leading competitors are Boston Scientic Corporation (US), Cisco Systems Inc. (US), General Electric Company (GE Healthcare) (US), Honeywell Care Solutions, IBM Corporation (US), Johnson & Johnson Services, Inc., Koninklijke Philips N.V. (Netherlands), Medtronic Inc. (Ireland), Microsoft Corporation (US), NeuroMetrix, Inc. (US), and Siemens Healthcare GmbH (Germany) among others. Internet of Medical Things (IoMT) companies’ have announced mergers and acquisitions, partnerships & collaborations, and new product development to expand their position in the Internet of Medical Things (IoMT) industry. Major players are also moving into new regions along with their advanced technologies for gaining the competitive advantage.
Some of the key observations regarding Internet of Medical Things (IoMT) industry include:
- Qualcomm Life, Inc., a US-based company and a subsidiary of Qualcomm Incorporated have announced several new offerings in November 2018 on its smart platform that make data more visible and actionable. Additionally, the smart digital platform helps clinicians and caregivers to make better decisions for their patients based on insight. The newly launched platform connects medical devices with the clinical systems, subsequently collects and examines all available data, and securely integrates the data into other applications and systems.
- Sensimed S.A. has announced the approval of the Sensimed Triggersh in Japan in September 2018. The approved Sensimed Triggersh is a non-invasive soft contact lens-based solution that provides an automated recording of continuous ocular dimensional change over 24 hours.
- Otsuka and Proteus have announced the approval of their digital medicine system, Abilify MyCite (an antipsychotic medication) in November 2017 by the U.S. Food and Drug Administration (FDA).
- F. Homann-La Roche Ltd. has announced the launch of the CoaguChek INRange system in June 2016. The launched system allows patients to monitor the quickness of the formation of their blood clots.
- General Electric Company has acquired Monica Healthcare in March 2017. The strategic acquisition is expanding its Maternal-Infant Care business division and is intended to help in innovations and enhanced product offerings for expecting mothers and babies worldwide.
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