Internet of Things gives new dynamism to digital health

There is a new vigour in the digital health space write Dr Therese Cory, a senior analyst and Saverio Romeo, a principal analyst with Beecham Research.

There are a number of health challenges – aging population, migration, critical diseases, mental illness – that we are facing as a society that require an almost immediate response. And there is a common consensus that technology can be part of a strong response to the health challenges of the future in terms of quality of caring, innovative solutions for care delivery, and cost of caring. There is also an increasing collaborative enthusiasm among stakeholders on how to make the use of technology feasible from a cost perspective and a business model perspective. All this could be felt and seen at the Digital Health World Forum in London in December.

The event revolved around four main streams; Data, The Digital Hospital, Connected Care and mHealth and Applications. The participants represented the long and complex supply chain of digital health delivery, including UK NHS (National Health Service) and other trusts, policy makers, academics and research institutes, patient forums and alliances, local action groups, general practitioners and health workers, legal people, IT and telecoms companies, and health application developers for mobile devices. All of these possess a wealth of information, much of which is not accessed by all the parties that need it.

The conference also showed the move in thinking towards a systemic view of healthcare provisioning. The system of healthcare systems glued by the flow of data – clinical and non clinical – managed by Healthcare Platforms to create a continuum of healthcare that goes from the individual up to the largest hospital centres and including pharmacies, surgeries and other healthcare provision spaces.

The impact of IoT in healthcare provisioning

Beecham Research has identified four areas of that continuum in which the impact of the Internet of Things vision is strongly transformative.

• Hospital and clinical environments, fully instrumented for inpatient and outpatient care
• Doctors’ surgeries and close-to-people caring environments such as residential care homes
• The patient at home assisted by wearable technologies and remote monitoring; this segment offers real possibilities, particularly for patients who prefer to remain at home and who may fear the risk of infection in a hospital environment (e.g. cystic fibrosis patients)
• Mobile healthcare – patients in transit in a fully instrumented ambulance on its way to hospital.

All of these can benefit from access to an up to date electronic health record detailing the patients’ condition and treatment, affording access to their information, medical history, services and diagnostics.

Successes of  and challenges to digital health solutions

In the UK, a variety of digital projects and test beds are underway, funded partly privately, partly publicly, often within hospital environments. The view is that if these prove successful and afford real benefits, they could be taken into the mainstream of care.

The Digital Health conference provided examples where Telemedicine can reduce hospital admissions and visits to the general practitioner. Telemedicine enables clinicians to select the environment that provides the optimal care for the patient, whether this be at the hospital, surgery or at home.

It is also important in designing any kind of virtual consultation and remote treatment to consider the patient’s response, including whether the patient feels comfortable with this form of interaction. For example, a London based programme for assisting alcoholic sufferers successfully uses Wi-Fi communication between subjects and their counsellors, avoiding the hospital because of the stigmatisation that accompanies the condition. Some 10 to 20% of hospital emergency admissions are alcohol related, and this is believed to be an underserved area. Unfortunately, the NHS does not currently support the use of Wi-Fi in its conventional treatments.

The NHS has been criticised for being late in adopting some technologies in some areas, for example a uniform electronic health record shareable by all concerned in a patient’s care; this includes the four areas discussed above, plus the pharmacological and biotech companies developing the medicines used in the treatment of patients who must take full note of the patient outcomes to improve processes. Residential care homes were also said to be behind in the use of digital technologies the care of their residents, compared with other healthcare environments.

The role of digital technologies in the healthcare sector has been explored for some time now. The first wave, which we can call e-health, was focused around electronic patient records and e-prescriptions. As smartphones became ubiquitous, the digital healthcare space focused on exploiting the mobility and intimacy natures of smartphones bringing healthcare provisioning to us through mobile devices. In parallel, new IT and telecom solutions – cloud-based and data analytics centric – are offered to hospitals and other healthcare institutions. Telemedicine solutions have also gained new momentum also driven by the opportunities offered by wearable devices. All this was discussed at the Digital Health World Forum. The Forum also discussed the well-known challenges of digital health such as regulation, adoption, and financial issues. However, the Forum showed a renewed enthusiasm of the digital healthcare ecosystem. Enthusiasm that Beecham Research has observed in other similar events. There is also an embracement of the Internet of Things as vision able to create that continuum of healthcare provisioning that goes from the individual to the hospital. The digital healthcare community in all its diversity shows a new dynamism. It is conscious of the specific features of the space. It is not expecting unrealistic growth, but it believes that the time for digital health has come and the Internet of Things vision is the key driver.