Remote medical care is undergoing a revolution and the future is bright. Thanks to wireless networks and cloud connectivity across a growing spectrum of health-monitoring devices, home-based patient care has witnessed dramatic improvements over the past few years. These devices and networks have significantly lower costs, offer greater levels of security, and device manufacturers can rapidly prototype and accelerate product and service rollouts with less engineering effort. (See Figure 1)
It all adds up to a compelling opportunity for designers, manufacturers, and, more importantly, patients. But to achieve those improvements, device designers must learn to harness the value of remotely connected devices—powered by and secured in the cloud.
The Legacy Business Model
For years, remote patient care has relied on clunky, hands-on monitoring. Traditionally, the recertification process of a home-based medical device has been done by a field technician performing on-site maintenance or has required the patient to return the device to the manufacturer or distributor for software or firmware updates. While it only takes a few minutes for a technician to recertify a device, the underlying costs for the service call and cross-shipping and tracking of devices present significant expenses across the customer base.
In addition, managing these medical devices places a heavy burden on care provider organizations that must not only know where the devices are physically, but also their operating status, such as whether the device has been properly calibrated for the next patient. This outdated model is significantly more expensive because more devices are distributed among a large number of home-based patients.
The Internet of Things Is the Future— And It’s Here Today
What is the solution to costly, inefficient, single-use remote patient care? It starts with remotely connected medical devices that leverage the cloud, Machine-to-Machine (M2M) connectivity, and cellular networks. The Internet of Things (IoT) has significantly cut the costs of connecting remote medical devices so that manufacturers can now implement solutions to not only remotely monitor patient health, but also device status. That means manufacturers can now troubleshoot, repair, and update devices without the cost of sending a service technician on site or shipping a device to a service depot. The arrival of remotely connected patient tools several years ago was initially characterized by proprietary solutions that did not encourage innovation from the broader healthcare ecosystem. Patients were paying premiums for these connected devices without the opportunity to individualize or enhance the associated apps. (See Figure 2)
Traditionally, if a customer reported an issue with a medical device, the device was typically replaced. But, that came at a high cost for the provider and manufacturer. With a remotely connected medical device leveraging the cloud, M2M connectivity, or cellular networks, the manufacturer can instantly diagnose any issues with the device and, in some cases, add new updated features. For instance, many devices use a steady stream of consumable supplies. A remotely connected device can help automate the supply chain to replenish those disposable items, further cutting costs, increasing revenue streams, and ensuring greater patient compliance with therapeutic regimens.
Today, networked medical devices allow patients to remain in the comfort of their homes while receiving medical treatments. This also streamlines visits to the doctor’s office, as remote diagnostic testing solutions mean the patient can discuss lab results during the visit and not wait days for results.
Remotely connected medical devices demand more than just incorporating a radio into the design. While there are many types of large, fixed medical devices, manufacturers are increasingly creating devices for mobile lifestyles, meaning that connectivity is becoming a major design consideration. For instance, smaller, more mobile devices could use built-in cellular interfaces and operate as smartphone apps. However, many variables must be taken into account, including cost, size, battery life, and bandwidth. Device manufacturers must also consider what options are needed to support thousands, perhaps millions, of devices globally.
Currently, there are several cost-effective options for connecting medical devices: wired LANs, Wi-Fi, ZigBee mesh, Bluetooth, cellular, and cloud. Understanding the use cases and how patient data will be used can help manufacturers identify the optimal networking technology. One of the bigger design issues that manufacturers face is how to reliably scale these solutions across hundreds of thousands of devices and determine which supporting devices should be involved.
One logical approach is to leverage an existing “device cloud” platform that addresses reliability and security needs. Some device-cloud products also feature the ability to forward equipment information so that manufacturers can create alarm systems that automatically schedule service calls and order product or parts replacements.
However, not all clouds are equal. The cloud for connecting video streams would be architected much differently from a cloud that is optimized for IoT/M2M applications. For example, most connected devices don’t require large amounts of bandwidth. So, one of the first things a designer should consider is how a specific device must “talk” to the cloud. A second vital consideration is where the data from the device must go. For example, medical devices typically have both machine data and clinical data. Machine data is information regarding the device and clinical data would typically be kept in medical records requiring a cloud service to securely deliver information to multiple applications. As a result, manufacturers must look for the appropriate device-cloud architecture that supports sophisticated load balancing to enhance reliability.
Security is another important consideration. Device and network security continue to mature just like other traditional IT and public networks. The first step is to keep all connections— wired and wireless alike—encrypted. End-to-end encryption provides peace of mind to a supplier, confidence to the patient, and stronger HIPAA compliance to the healthcare provider. The device-cloud service does not need or want the responsibility of non-encrypted information. In fact, leading device-cloud suppliers want to help their customers build secure end-to-end solutions. It’s important to partner with a vendor with deep experience in the hardware and communications technology used in IoT and M2M systems.
More open interface options are emerging to enable the next generation of innovation in healthcare. Within the next two years, manufacturers will begin to transition their business models to prioritize applications that leverage device data rather than the devices themselves. Imagine a software as a service business model for treating congestive heart failure. It’s possible now, through remotely connected medical devices and automated monitoring that capture essential data from devices such networked scales and pulse oximeters to spot unfavorable clinical trends before they worsen. (See Figure 3)
It’s important to keep in mind that patients rely on these new connected devices for their well-being. Today, we are at a tipping point of being able to provide great care in hospitals, and extending that great care to the home. Working with health care providers, patients can take charge of their own care and manage their health confidently, securely, and cost effectively.
The future is bright, indeed.
This article was written by Steve Popovich, Vice President of Business Development, Digi International, Minnetonka, MN. For more information, Click Here .