“There’s no doubt that the emerging IoHT has vast implications for the healthcare industry, but it will equally impact those who are not in the business of healthcare. Soon, anything will be able to link up to the IoHT.”

Joseph Kvedar, M.D., Senior Advisor, Virtual Care, Mass General Brigham

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In healthcare, the Internet of Things is not a new concept. The healthcare industry has been using telemetry for many years. Telemetry is similar in that it gathers data remotely and transmits it via radio or cellular signal. Still, the healthcare industry has made little progress in incorporating Internet of Medical Things technologies into healthcare in recent years. The technologies we see today may offer a glimpse of what is to come. Hospitals, clinics, diagnostic laboratories, and surgical centers worldwide are already using various implanted, stationary, and wearable medical devices for patients. Web applications also incorporate the technology of the Internet of Medical Things to improve workflow management, patient monitoring, medication management, telemedicine, and more.

If you are interested in a comprehensive discussion on the Internet of Medical Things, the best resource I’ve found is this book by Dr. Joseph Kvedar, Vice President, Connected Health, Partners HealthCare. Connecting to the IoHT presents a huge opportunity for all sectors of business and society, including payers, providers, pharma and biotech companies, technology vendors, and newcomers to the space with fresh, creative ideas. This book shares Dr. Kvedar’s observations as a 20-year veteran in the field.

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First, some basics – The Internet of Medical Things (IoMT) is an amalgamation of medical devices and applications that connect to information technology systems using networking technologies. The IoMT market consists of intelligent devices, such as wearables and medical/vital monitors, strictly for health care use on the body, in the home, or in community, clinic, or hospital settings; and associated real-time location, telehealth, and other services.

The best depiction of what the IoMT might be like is shown in this excellent video from Cable Labs. I’ve shown this in conference presentations over the years, and it always strikes an emotional chord with the audience.

How I like to segment the IoMT market – If you review the literature on the topic, you’ll find multiple segmentation models proposed by different stakeholders in the industry. In my previous work, I’ve found that the easiest way to communicate the breadth of applications for the IoMT was to use a segmentation model by location, namely: on the body, in the home, in the community, in the clinic, or in the hospital settings. Let’s look at each in a bit more detail:

On the body applications – The on-body segment can be broadly divided into consumer health wearables and medical and clinical-grade wearables. Consumer health wearables include consumer-grade devices for personal wellness or fitness, such as activity trackers, bands, wristbands, sports watches, and smart garments. Clinical-grade wearables include regulated devices and supporting platforms that are generally certified/approved for use by one or more regulatory or health authorities, such as the U.S. Food and Drug Administration. These devices are used with expert advice or a physician’s prescription (e.g., Kardia ECG device).

In the home applications – The in-home segment includes personal emergency response systems (PERS), remote patient monitoring (RPM), and telehealth virtual visits. A PERS integrates wearable device/relay units and a live medical call center service to increase self-reliance for homebound or limited-mobility seniors (e.g., LifeAlert). RPM comprises all home monitoring devices and sensors used for chronic disease management, which involves continuous monitoring of physiological parameters to support long-term care in a patient’s home to slow disease progression; acute home monitoring, for continuous observation of discharged patients to accelerate recovery time and prevent re-hospitalization; and medication management, to provide users with medication reminders and dosing information to improve adherence and outcomes. (For a more detailed look at Remote Patient Monitoring, check out my previous blog post on the topic here). Telehealth virtual visits include virtual consultations that help patients manage their conditions and obtain prescriptions or recommended care plans.

In the community applications – This is a fairly broad segment that generally consists of five applications. Mobility services allow passenger vehicles to track health parameters during transit. Emergency response intelligence is designed to assist first responders, paramedics, and hospital emergency department care providers. Kiosks are physical structures, often with computer touchscreen displays, that can dispense products or provide services such as connectivity to care providers. Point-of-care devices are medical devices used by an advanced practice provider outside of the home or traditional health care settings, such as at a medical camp. Logistics involves the transport and delivery of health care goods and services, including pharmaceuticals, medical and surgical supplies, medical devices and equipment, and other products needed by care providers.

In the clinic applications – This segment includes IoMT devices that are used for administrative or clinical functions (either in the clinic, in the telehealth model, or at the point of care). Examples include Rijuven’s Clinic in a Bag, a cloud-based examination platform for clinicians to assess patients at any point of care, or the Tytocare platform.

In the hospital applications – This segment is divided into IoMT-enabled devices and a larger group of solutions in several management areas:

• Asset management monitors and tracks high-value capital equipment and mobile assets, such as infusion pumps and wheelchairs, throughout the facility.
• Personnel management measures staff efficiency and productivity.
• Patient flow management improves facility operations by preventing bottlenecks and enhancing patient experience—for example, monitoring of patient arrival times from an operating room to post-care to a patient room.
• Inventory management streamlines ordering, storage, and use of hospital supplies, consumables, and pharmaceuticals, and medical devices to reduce inventory costs and improve staff efficiency.
• Environment (e.g., temperature and humidity) and energy monitoring oversees electricity use and ensures optimal conditions in patient areas and storage rooms.

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Where we are today – The IoMT brings together the digital and physical worlds to improve the speed and accuracy of diagnosis and treatments and monitor and modify patient behavior and health status in real-time. It also improves health care organizations’ operational productivity and effectiveness by streamlining clinical processes, information, and workflows. The global IoMT market was valued at $44.5 billion in 2018 and is expected to grow to $254.2 billion in 2026, according to AllTheResearch. The smart wearable device segment of IoMT, inclusive of smartwatches and sensor-laden smart shirts, made up for the largest share of the global market in 2018, at roughly 27 percent, the report finds. This area of IoMT is poised for even further growth as artificial intelligence is integrated into connected devices and can prove capable of the real-time, remote measurement and analysis of patient data.

My take – If you’ve been following this blog for any time, you’re probably seeing a pattern developing. Many of the technologies I’ve been reporting on are linked. That’s the beauty of exponential growth technologies. An increase in functionality in one technology has a multiplier effect on others. The potential for the Internet of Medical Things is promising. As more healthcare providers successfully adopt these technologies, approval for more devices will increase. This increase will likely be cautious, but it will change how we give and receive care for the better. Inclusion of IoMT devices into healthcare will enhance efficiency, reduce costs, save time, improve health record storage, foster informed decision making on delivering proper treatment to patients, and improve the operational efficiency of systems and processes, all leading to the creation of an intelligent patient-centric healthcare system.