IoT in Healthcare:
Too Fast, Too Furious?

IoT in Healthcare:
Too Fast, Too Furious?

May 2020:

IoT in Healthcare: Too Fast, Too Furious?

When Silicon Valley’s ‘fail fast and break things’ mentality doesn’t work,
and when it does.

The IoT (Internet of Things) leads to automation, convenience, and efficiency. In healthcare, the IoT is creating opportunities to optimize every aspect of care, transforming the way it is managed across the healthcare continuum. IoT technologies are also helping to shift the entire healthcare paradigm from a reactive to a proactive model.

In the past year, the market has shown both growth and change. According to CB Insights, 2019 was a notable year for healthcare in terms of VC (venture capital) funding, M&A (merger and acquisition) deals, and partnerships. The research firm reports more than 4,900 rounds closed in 2019, and overall startups raised $54 billion in equity funding.

Innovation is happening quickly, as is the norm in tech, but is it happening too quickly for healthcare, where “quick” is not the norm? Rob Havasy, managing director of the Personal Connected Health Alliance, says he used to begin his industry presentations with the following joke: “What is the phrase ‘fail fast and break things’ called in Silicon Valley? Innovation. You know what it’s called in medicine? Malpractice.” It’s a joke, but one that rings with an alarming amount of truth.

And then there’s the big COVID-19 question mark, which hangs over so many industries right now. In the past few months, healthcare (and all industries, really) have been turned on their heads thanks to the COVID-19 pandemic across the globe. Will this pandemic change the status quo in healthcare? Will it change how innovation happens?

The Speed of Innovation

The IoT is having a transformative effect on healthcare. It’s giving the world a view of a sustainable future where data is available to decisionmakers without special infrastructure and efforts. “For routine healthcare, many doctors and patients operate with very limited data about their patients’ health,” Havasy says. “A few questions or a few tests a year are all we have to work with today. But an IoT world promises to fill in many of those gaps between doctor visits with at least some indicators of a patient’s health.”

Havasy believes the speed or pace of innovation isn’t really the problem, and, sometimes, the risks of rapid innovation are justified—just consider the current situation with COVID-19. “But the pace (of innovation) needs to match the risk environment, and the current pace might feel too fast were things back to normal,” he explains. “Rapid advancement often leads to something programmers call ‘technical debt,’ or, simply, the cost of shortcuts in design to meet a deadline that cause pain and headaches when the shortcuts make it into production. A sprint of rapid innovation is fine, as long as time and money is allocated to pay back the technical debt at some point. Unfortunately, it’s this routine maintenance and periodic rebuilding of technology to pay off the technical debt that often gets neglected in investment plans.”

Kimon Angelides, founder and CEO at Vivante Health, says one of the key ways the IoT is impacting healthcare today is by offering the ability to remotely monitor aging adults and people with chronic conditions. This in itself is a huge contribution to patients’ quality of life and families’ peace of mind. As to the speed of innovation, Angelides says: “I think the technologies that are being developed and can be applied to healthcare are indeed innovating quickly. However, the challenge as I see it is selecting those technologies that address real clinical or costs-structure problems. So they have to be vetted with respect to solving a problem. The problem is that there are dozens of technologies that are cool but really don’t address a painpoint in the healthcare system.”

  • 5 IoT-in-Healthcare

    1. The IoT is having a transformative effect on healthcare.
    2. The pace of innovation needs to match the risk environment.
    3. Rapid innovation in healthcare should never put patient safety on the backburner.
    4. More attention should be given to security by design and privacy by design in developing IoT products, especially in healthcare.
    5. COVID-19 will leave a lasting mark on the healthcare system; in fact, it won’t ever be the same again.

Global AI healthcare market is expected to reach
31.3 billion by 2025, growing at a CAGR of 41.5%.

Source: Grand View Research

For Paul Sonnier, innovation leader at PA Consulting, one of the most exciting ways the IoT is intersecting with healthcare and addressing real needs—like the need to involve willing participants in medical research—is the continued integration of Apple Watch into healthcare. “There are now tens of millions of the watches in use, which can be leveraged in healthcare for a variety of purposes,” Sonnier says. “For example, tracking and recording biometric information related to health, fitness, and medical conditions can be shared with healthcare providers to better inform care, manage chronic diseases, and foster disease prevention. Significantly, (Apple Watch) is also being used as an enabler and means of enrolling participants into medical research and clinical trials, paving the way for what are called ‘virtual trials’, where patient visits do not have to happen in a clinic, hospital, or other site.”

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On Privacy and Security

Michael Swartz, president of MediXall, points out that while the IoT brings numerous benefits to the healthcare industry, it also creates vulnerabilities. “Healthcare industry constituents need to realize that security of their connected devices and systems is integral to the health of the organization,” Swartz says. “Although not everyone in a healthcare organization will be technical professionals, they must be trained in security awareness. They must understand that those devices can be used against them or their patients. Blindly relying on machines connected to the internet or trusting the data from them without verifying is a recipe for disaster.”

Despite all the evident benefits that the use of IoT technologies is creating for the industry, the IoT is also challenging data security—an integral part of the healthcare infrastructure. “I believe the best measure we can take is to drive industry-wide standards around IoT ecosystems,” Swartz concludes.

Additionally, more attention should be given to security by design and privacy by design.

Source: Technavio

There are many levels of security to be considered when applying the IoT to healthcare, says Eric Van Der Hulst, innovation manager of health at imec. These levels of security include the on-device algorithms and primary data measurements; the communication of data from the device to the data storage; and the protection of the data platforms (in the cloud) where data is stored and analyzed.

“Every level of security and privacy should be considered a major concern from the conception of the product,” Van Der Hulst says. “There are definitely companies that will intentionally hack the connected health devices and systems—and consider this scenario: What if you could kill a president with his pacemaker? Ethical hackers can be used as a measure to detect holes in the security. Still many companies will undoubtedly try to make maximum use of the data they have collected, even if that use is purely commercial, never explained to the customers, or even unethical. Accidents will happen; it will be a constant struggle and continuous improvements will be needed to ensure IoT devices can safely be used in the future.”

As to the unexplained and potentially even unethical use of patient data, the industry was recently challenged on this point over the Google/Ascension collaboration dubbed “Project Nightingale.” After the Wall Street Journal reported on the initiative in November of last year, many have wondered how data-sharing partnerships like this one violate HIPAA, and, if not, whether they should.

Other poignant questions about the use of IoT technologies in healthcare have to do with AI (artificial intelligence). AI can play an important role in collecting health data, establishing trends, bringing attention to abnormal conditions, and suggesting when intervention is needed. It can analyze continuous data streams and help make IoT data more meaningful and actionable in the medical field. AI can also potentially automate defined and repeatable tasks, reducing the potential for human error and freeing up medical professionals’ time to focus on other aspects of patient care.

  • Top 10 Tips for Cybersecurity in Healthcare

    1. Establish a Security Culture
    2. Protect Mobile Devices
    3.  Maintain Good Computer Habits
    4.  Use a Firewall
    5. Install and Maintain Anti-Virus Software
    6. Plan for the Unexpected
    7. Control Access to Protected Health Information
    8.  Use Strong Passwords and Change Them Regularly
    9. Limit Network Access
    10. Control Physical Access
    Source: Dept of Health and Human Services

Some are skeptical, though, about the hype and the legitimacy of AI products in the medical field. The “fail fast and break things” mentality of Silicon Valley can be downright dangerous when patients’ lives are at risk. AI devices are also often outside the scope of the FDA (Food and Drug Admin.), and bias in AI is a real concern. But are there ever moments in time when the need for innovation vastly outweighs the (albeit legitimate) concerns?

COVID-19 and the Way Forward

The answer appears to be yes, and the U.S. is in one such period right now. Laura Mitchell, CEO of GrandCare Systems, says remote patient monitoring and virtual visits are allowing more individuals to remain at home than would otherwise be possible. She says HIPAA-compliant video chat functionality can connect patients with providers virtually, and this is especially helpful right now, when entire communities are being locked down due to COVID-19 concerns.

“In our current Internet-of-Things world, we are uniquely suited to physically isolate ourselves while connecting socially, professionally, and medically in a more profound way than ever before,” Mitchell says. “A pandemic, while potentially devastating, is also mitigated by today’s technology.”

Going forward, imec’s Van Der Hulst said a future world enabled by digital health would absolutely have a leg up on today’s capacity to handle COVID-19. “The coronavirus has disrupted the slow entrance of medical IoT devices into the European healthcare systems. Slow innovation accelerated and budget constraints were adapted/breached because of the sense of urgency,” he explains. “This crisis pushes and allows the use and experimentation of a lot of IoT technology that is already on the private market but not validated nor considered financially viable in the regulated modern health systems (through refunds or reimbursements).”

Source: CB Insights

It’s possible that the current pandemic will open doors for various digital health tools to find their place in the regular care system, which could help in the event of another, future pandemic. Of course, Van Der Hulst points out there are no guarantees of success or quality improvements from using these tools and applications; they will have to be implemented wisely in a modified care model.

MediXall’s Swartz similarly says the COVID-19 pandemic has certainly made a case for more virtual tools, highlighting the power of technology to improve health outcomes at scale. “These solutions now should show value like never before,” Swartz says. “Innovation in digital health such as telehealth, virtual visits, context-aware clinical communications, automated scheduling, patient engagement, and clinical surveillance and reporting solutions can play an important role in helping address the evolving COVID-19 outbreak.”

Waqaas Al-Siddiq, founder and CEO of Biotricity, says in his opinion, a future enabled by digital health solutions would significantly reduce the burden on the healthcare system, if a similar situation were to take place again. This is because digital health and virtual visits can act as boosters to social distancing without sacrificing quality of care.

What’s more, Al-Siddiq suggests the current pandemic will leave a lasting mark on the healthcare system; in fact, it won’t ever be the same again. “I believe that COVID-19 will create ripples in the healthcare system, forever changing it,” he says.

“Remote patient monitoring and telemedicine will become more important than ever. The barriers around adoption have been bulldozed, creating an openness to experiment and try such solutions.”

Perhaps, then, while Silicon Valley’s “fail fast and break things” mentality doesn’t usually work well within the confines of the U.S. healthcare system, there may be times when it does. Time will tell whether this is such a time.

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