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The world’s older population is growing dramatically; 8.5% of people worldwide (617 million) are aged 65 and over, and this number is projected to jump to nearly 17% of the world’s population by 2050 (1.6 billion). In addition, global life expectancy at birth is projected to increase by almost eight years, climbing from 68.6 years in 2015 to 76.2 years in 20501. Chronic diseases and conditions are on the rise, which will push the current healthcare systems beyond its current limits and capabilities. Societies have rising expectations for robust health care services; and healthcare facilities are facing many new and serious challenges balancing the expectations against the available resources. Luckily, continuous technological developments are helping to improve some medical processes, ease the workflow of healthcare practitioners, and ultimately, to improve the situation in an overloaded hospital. 

 

Digital transformation of healthcare
Internet of Things (IoT), or to be more specific, Internet of Medical Things (IoMT), is revolutionizing the healthcare industry. The number of connected medical devices is expected to increase from 10 billion to 50 billion over the next decade2. Cisco estimates that by 2021, the total amount of data created by any IoT device will reach 847 Zettabytes (ZB) per year3. At some point, IoT will become the biggest source of data on Earth. Imagine the possibilities if human-oriented data, like medical history, allergies to medication, laboratory test results, personal statistics, amongst many other things, were to be digitized as part of the electronic health initiatives. Healthcare practitioners will be able to interpret and leverage the plethora of big data from connected systems to make informed patient care decisions as well as understand and predict current and future health trends. The answer? Machine Learning (ML).

 

Machine learning helping to propel healthcare IoT
ML is an approach to achieve artificial intelligence (AI); algorithms are utilized to analyze data, learn from it, and identify patterns, then makes decisions with minimal human intervention. Healthcare providers and device makers are integrating AI and IoT to create advanced medical applications and devices that can provide person-centric care for individuals, from initial diagnosis to ongoing treatment options, while solving a variety of problems for patients, hospitals and the healthcare industry. At the same time, these AI-enabled medical IoT devices will make healthcare treatments more proactive rather than preventive.

 

An autonomous “nurse” is an example of AI-enabled medical IoT application. It will be able to answer patients’ questions since it is connected via the internet to a large range of data from previous health records. By integrating facial recognition, the robotic ‘nurse’ will be able to recognize the patient’s mood and will adapt its behavior and reaction accordingly. It will also be able to remind its patients to take medication, as well as reminding them of their doctor’s appointments. Now, imagine if a hospital were to “hire” robotic “nurses” that can reason, make choices, learn, communicate, move and are connected to the hospital’s network and connected to each other, they would be able to help the nurses with tasks like administering medication, maintaining records and communicating with doctors and educate patients and on disease management, just to name a few. This will be a good solution to the situation where the nurses sometimes are pushed to handle more than they are capable of.

 

Soon, ML will bring a set of bots to the healthcare industry, with billions of “dumb” machines transformed into smart machines.  This change is going to transform the way patients are assessed and treated; and healthcare professionals can provide a better quality of care that is tailored to each patient.

 

A bright future for telehealth
Another new development the healthcare industry is experiencing today is a general shift of in-office visits to remote health monitoring or telehealth. Many patients have agreed that home is the best place for healthcare, with patients being in their “normal everyday environment”.  A survey conducted in 2016 concluded that 94-99 percent of 3,000 patients were very satisfied with telehealth, while one-third of the respondents preferred the telehealth experience to an in-office doctor visit4.

 

With IoT, remote health monitoring, or telehealth is feasible, especially for patients living in remote areas. Another reason why remote health monitoring is getting popular is because of the vast varieties of biosensors and medical wearables that are available readily in the market today. So, what’s in it for the healthcare practitioners? All data coming from their remote patients will be able to help them detect patterns and gain new insights into health trends. That’s what IoT, big data and analytics software can help to achieve. 

 

Conclusion

The healthcare landscape has changed and is still changing.  Patients are starting to embrace the change, using medical IoT devices to manage their health requirements. Healthcare providers are starting to incorporate connected healthcare to drive excellence, be competitive and improve treatment outcomes to give patients better healthcare experience, while medical device makers are developing solutions that are more accurate, intelligent, and personalized. Ultimately, leveraging technologies in an effort to improve treatment outcomes, the management of drugs and diseases, and the patient experience, will lead to a more efficient hospital.

 

References:

1. https://www.census.gov/content/dam/Census/library/publications/2016/demo/p95-16-1.pdf 

2. https://www.medicaldesignandoutsourcing.com/connected-medical-devices-5-things-need-know/

3. https://www.cisco.com/c/en/us/solutions/collateral/service-provider/global-cloud-index-gci/white-paper-c11-738085.html

4. https://www.fshealth.com/blog/29-statistics-about-telemedicine-healthcare

 

The use of connected medical devices or medical equipment in hospitals has increased with the expansion of wireless technologies and advancement in medical device designs. As a result, the number of connected devices in a large hospital or a healthcare facility reaches 85,000 at any given time1. As the density of the connected devices increase, so does the density of the electromagnetic environment; and there are concerns about the impact from sources producing radio frequency interference (RFI). Advances of technology in medical devices and many general consumer products are significantly affecting the efforts aimed at maintaining the required operations and interoperability between the products in a hospital or healthcare facility.

 

Some of the RFI sources in a hospital environment are, natural or ambient electromagnetic energy like lightning, television transmission or AM, FM or satellite radio. Other sources are from medical equipment and consumer products like ventilators, cardiac defibrillators, infusion pumps, motorized wheelchair, MRI systems, cellphone, tablet or laptops. RFI can cause many serious problems, some of which can lead to a patient’s death. There have been many reported cases; sleep-apnea monitors failed to sound an alarm when babies stopped breathing, power wheelchairs started rolling after their brakes released because of certain field strengths, and anesthetic gas monitors stopped working when influenced by interference from electrosurgery units2.

 

Hospital administrative staff, product makers, patients and the public has a huge responsibility and challenge to keep pace with efforts needed to maintain the required level of electromagnetic compatibility (EMC) in a hospital environment. Here are some examples of how everyone can play their part.

 

Hospital administrative control:

1. RF shielding

There are two reasons why certain medical equipment needs to be shielded. As an example, let’s take an MRI machine. The MRI machine is usually placed in a shielded room to prevent extraneous electromagnetic radiation from distorting the MR signal, and secondly, to prevent electromagnetic radiation generated by the MR scanner from causing interference to nearby medical devices. RF shielding must encircle the entire room; walls, ceiling and floor. The management of hospital could also consider less expensive materials that can increase shielding capacity, such as electricity-conductive paint, electricity-conductive wallpaper, and electricity-conductive cloth for less critical areas in the hospital.                

 

2. Restrict RF sources from certain areas in the hospital

Controlling the number of devices that could potentially contribute to the radio frequency interference (RFI) in a specific area will help to lower the risk of interfering operations of clinical and other electronic equipment. The management of hospitals should take measures to control the electromagnetic environment in the hospital by restricting cell phones and other potential RF sources from sensitive areas in the hospital; such as the intensive care unit, the neonatal intensive care unit and the operating theater, where critical care medical equipment is in use.

 

Public and patients:

3. Implementation of control techniques

There has been an increase in the use of electronically controlled medical devices outside the clinical environment, and they are often used at home, attached or implanted into a patient. RFI problems will also affect these patients, especially patients with cardiac pacemaker implants. Though the chances of an EMI from a cellphone could produce a life-threatening situation, certain steps are advisable to minimize any risks. Government bodies has issued caution and recommendations to the wearer3.

  • Using a cellphone very close to the pacemaker may cause the pacemaker to malfunction.
  • It is advisable to avoid carrying a cellphone in the breast pocket directly over the pacemaker because an incoming call will switch the phone to its transmission mode and may cause interference.
  • When using a cellphone, it is advisable to hold it to the ear farthest from the pacemaker.

 

Medical device makers/developers:

4. RF immunity of medical devices

For many years now, military, aircraft and automotive electronic systems have been required to meet strict RFI immunity requirements. The technology has been developed and can be easily deployed for medical devices. Most techniques are not costly if they are incorporated into the electronics system design in the early stage. The international standard for RF immunity of medical devices is the IEC standard 60601-1-2, requires a minimum immunity level of 3 V/m in the 26-1000 MHz frequency range4. Medical device developers and makers need to consider incorporating RF immunity techniques like shielding, grounding and filtering to ensure the medical devices are in conformance with the standard and is robust against RFI.

 

5. Incorporate RFI immunity into product design

Modern medical devices are getting smaller in size; combining low power integrated circuitry which is more sensitive and susceptible to RFI. A medical device maker could incorporate RFI immunity into the product design, making sure the medical device is robust and able to work well above the defined minimum immunity level.  One way this could be done is by testing the product in a real-world setting to ensure the medical device is able to withstand high RF field strength.

 

As you can see, there are many ways to deal with electromagnetic interference in a healthcare facility. However, the field strength to which the medical device may be exposed to depends on many conditions, and is beyond what the medical device makers or developers can do. It is up to the hospital administrative staff to impose and regulate a certain guideline to maintain safe environment for the hospital patients.

 

Here is a related webinar that talks about RF Coexistence challenges, what is RF coexistence testing and how it is performed. And if you are looking for solutions to combat your design challenges, please go to www.keysight.com/find/IoT for more information.  

 

 

References:

  1.       https://hitinfrastructure.com/news/edge-computing-uses-iot-devices-for-fast-health-it-analytics
  2.       http://www.nlc-bnc.ca/eppp-archive/100/201/300/cdn_medical_association/cmaj/vol-154/0373e.htm
  3.       https://www.fda.gov/Radiation-EmittingProducts/RadiationEmittingProductsandProcedures/HomeBusinessandEntertainment/CellPhones/ucm116311.htm
  4.       https://www.ncbi.nlm.nih.gov/pubmed/9604711

Here’s a question for you. Is your connected home safe? I’m not talking about whether you remembered to lock your doors and turn on your security system. What I’m more interested in is if the wireless data being transmitted from one connected home device to another, and to the internet, is secure. It’s a potentially scary proposition and one you will likely have to confront in the very near future, if not already.

 

Gartner estimates that the number of connected things will increase multiple folds yearly—the latest forecast is up 31 percent from the year prior. By 2020, the number of connected things will top 21 billion. What that means is that sooner or later, you will have a growing number of consumer products and smart home devices connected  in your home. From televisions, refrigerators, audio speakers, and home alarm systems, to door locks, these devices will soon be able to talk to one another. Your home alarm system will be activated as soon as your door lock is turned on. And, when the room temperature in your living room reaches a certain limit, it will automatically turn on the air conditioning. One day soon, this type of activity will become the norm in every household.

 

And that brings me back to my original point. Have you ever wondered how well these devices are talking to one another, or how safe your home will be when these devices start to send information wirelessly? These devices may not necessarily be designed to perform across a wide range of real-world conditions, and if so, their performance can fall off. That performance might be affected by the device’s distance from the nearest wireless access point, density of wireless signals in the same area, interference from other radio-frequency noise sources, and of course, data interoperability. To make matters worse, the task of securing these smart devices is like trying to protect endangered wild species in a sub-Saharan desert or the Amazon forest.

 

Making sure new devices establish robust, reliable, and secure connections across the intended range of environments cannot be left to chance; it must be guaranteed. To do that, product makers, consumers, operators and cloud providers alike will need to implement different strategies, coupled with the right test tools, to ensure connected homes stay both connected and safe. 

 

Product Makers

With many connected things packed into a living area, product makers will need to test device performance in the presence of several wireless access points, and to ensure robust enterprise-grade security. They should also check for performance in the presence of other wireless emitters, such as microwave ovens operating in the same frequency band.

 

Consumers

For consumers, the best strategy is to raise public awareness about the dangers of buying hardware that connects to the unsecured internet. Without the proper protections in place, hackers could easily take over a home’s automation and collect sensitive personal information without the owner’s consent. Perhaps what’s needed to protect or help consumers is a public safety warning on every IoT device, much like the safety warnings found on alcohol bottles.

 

Operators and Cloud providers

Most IoT devices and applications deployed in a cellular or cloud provider environment require low latency. Because of that, operators tend to move functionality and content to the edge (Edge Computing (EC)) of networks to automatically respond to IoT devices instantaneously.  However, sensitive data should move away from edges to cloud and secured with encryption. Cloud providers should  do their part in data security, by providing services such as local encryption and digital certificate to authenticate other third-party applications trying to communicate with the cloud service, for their customers.

 

Granted, there is not much we can do to stop cyber criminals from trying to hack the smart devices in our connected homes. But, we can work together to make that task harder, if not impossible. Test and measurement vendors can play a critical role in this process by providing the solutions needed to perform end-to-end testing on devices before they hit the market. At least that way, consumers can be more assured that the devices themselves are secure. And, if consumers do their part by implementing their own security strategies, such as using strong passwords that are routinely changed, we can together ensure our connected homes are indeed safer and more secure.

 

For more information on solutions for ensuring smart device security, check out the following links: IoT Testing, Monitoring and Validation and BreakingPoint, an all-in-one applications and network security testing platform.