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Net gains: long-term care for an aging population

Zeljko Loncaric, marketing engineer at Congatec, comments on the impact the Internet of Medical Things might have on the quality of life of an aging, growing population.

A growing, aging population dictates that patient care resources within hospitals and homes will increase within this generation. This trend will create demand for even more long-term care and condition management. These facts, as well as the likely cost, are well known by the healthcare community and the administrative businesses associated with it.

While the high price of developing cures and condition-managing drugs has always been a given, the rising cost of administration can’t so easily be amortised. One-to-one interaction is probably the most expensive way to look after patients, but another, technology-based apporach could help alleviate the situation.

Putting technology in the hands of patients to help them self-manage ongoing conditions isn’t new, of course. Diabetes sufferers have had access to blood glucose testing equipment that informs them how much medication they need to take over many years. In the future, however, this could be managed autonomously by the equipment itself.

In turn, that equipment will be connected, via the internet, to a medical professional who can, at any time, monitor the patient’s condition and the effectiveness of medication, as well as identify longer-term trends that may indicate how the severity of the condition may be changing.

Blue-sky thinking

This isn’t just a vision: there are many trials taking place now, to assess the potential impact of this kind of care. Swedish company Aerocrine has developed a device that tests for fractional exhaled nitric oxide (FeNO), a biomarker for allergic airway inflammation linked with asthma.

The device is connected to the internet using Microsoft’s cloud-based service, Azure, allowing the data to be collected securely from anywhere in the world. Current trials of the device are taking place in Sweden, the UK and the US, with all data being fed back to Scandinavia for analysis.

In another example, a medical-grade device to monitor chronic obstructive pulmonary disease (COPD) – a term used to describe a number of lung diseases including chronic bronchitis, emphysema and chronic airways obstruction – has been developed jointly by Philips and Radboud University Medical Centre in the Netherlands. If certified by regulatory bodies, it could be prescribed by doctors to monitor physical activity, respiratory rates, sleep quality and heart rhythm/rate. The data it generates is intended to be shared using the Philips Healthsuite Digital Platform to FDA-approved clinical applications.

This highlights one of the main drivers for the Internet of Medical Things; the data the devices generate could be shared to not only improve care for existing conditions, but expedite diagnosis for new conditions.

These devices are, in effect, a natural extension of the sort of fitness devices now popular with smartphone users, so-called ‘appcessories’ that allow users to record their physical activity alongside statistics such as heart rate and sleep patterns.

Applying the same philosophy to monitor chronic conditions such as cardiovascular disease, diabetes and pulmonary conditions, as well as vital signs like heart rate, will generate a lot more data, which will also be much more sensitive.

"Lifestyle conditions will become even more significant, as dangerous diseases are combatted, but through the secure collection and analysis of data, patients with ongoing ailments, and those at risk of developing one, will continue to receive the very best care." 

The nature of the information isn’t just restricted to monitoring chronic conditions: any life signs can be monitored and used when caring for the old or infirm, for example. Once secure channels are established and proven reliable, they will quickly be used to dispense care in the form of medication, all under the close, but remote, supervision of a healthcare professional, where necessary.

Acting on information

These devices – now referred to as ‘actors’ – will comprise numerous examples of devices able to collect and, where required, act on data generated or commands issued. While the obvious benefits of the Internet of Medical Things are clear, so too are the regulatory hurdles manufacturers will need to overcome.

It should happen slowly, initially with devices intended to be used in the home, with larger hospital-based equipment to follow. For the data, the size or location of the device is largely irrelevant: it will need to be collected, stored and transferred securely, no matter how, or where, it originates.

In today’s network architectures, the point at which the data combines to join the backbone is typically an embedded server and, according to a white paper prepared by Tata Consultancy Services, today’s embedded servers won’t be able to cope with the expected data traffic.

As a result, new servers will be required, which will typically need to be as small as possible, but still meet the specific requirements. In order to remain commercially viable, this new swathe of embedded servers will probably be based on a standard platform using the latest high-performance processors.

Securing the Internet of Medical Things is not just a priority, but a prerequisite for success. In fact, medical devices may well need to be the most secure nodes on the broader Internet of Things and it will be the role of the embedded server to provide that protection for all actors on the local network.

The emergence of secure gateways is rapidly becoming seen as the most viable solution to managing the enormous level of data and actors that will form the Internet of Medical Things; they will provide connectivity, security and device management services for a wide variety of devices, connections and protocols.

Embedded servers based on Intel processors can take advantage of its Gateway Solution for IoT, which combines with technology from its subsidiaries Wind River and McAfee in single-source product. A major advantage of a single-source approach is that every aspect of the Gateway will be guaranteed to interoperate seamlessly.

This extends to include Wind River’s Intelligent Device Platform XT, which comprises a Linux operating system, prevalidated software stacks, hardware drivers, and matching libraries and tools. Key system elements are implemented in software, including administration, while security is handled by McAfee Embedded Control, providing features such as dynamic application whitelisting and change control.

The finished product is then validated by Intel, including the hardware and all firmware. Precertified hardware platforms for Intel’s Gateway Solution are now available.

Where the medical things are

Unlike the wider Internet of Things, which is so vast that it almost comes without prerequisites, the Internet of Medical Things will need to comply with the incumbent technologies, restrictions and regulations. This will make it challenging for developers but, ultimately, more accessible to users – patients, and the medical staff administrating to their needs.

There can be little doubt about the emerging need for a ‘smarter’ way to approach healthcare in an aging, growing population. Lifestyle conditions will become even more significant, as dangerous diseases are combatted, but through the secure collection and analysis of data, patients with ongoing ailments, and those at risk of developing one, will continue to receive the very best care.

The adoption by OEMS of a common platform able to meet the technical requirements of an embedded server and securely manage sensitive information will accelerate the development and roll-out of the Internet of Medical Things, enabling greater quality of life for more people, for longer.