The phrase “bringing healthcare in into the home” has been the moto of many a start-up company and evokes a rosy picture of young and elderly people alike smiling and enjoying life while caring for themselves and their loved ones. The benefits of moving healthcare and monitoring to the home are obvious and include comfort, reduced risk of infection from the hospital environment, and cost. Furthermore, a home healthcare infrastructure could have saved countless lives during the COVID-19 pandemic. Research has shown that 10% of emergency room visits are non-urgent [1] and 50-75% of hospital readmissions cost upwards of $28 billion a year, which can be substantially prevented or reduced with daily patient vital sign monitoring [2]. The wide-spread availability of the internet for the last 10 years should have made telemedicine adoption much faster and remote monitoring more common. In addition, medicare approved the current procedural technology (CPT) codes for remote patient monitoring (RPM) in January of 2019 which provides doctors with a medical incentive to monitor their chronically ill patients remotely. However, the United States, and the rest of the world still relied on ambulatory health and hospitals during the COVID-19 pandemic.
The reason that healthcare is making its way to the home so slowly is since the internet of things (IoT) faces more barriers in healthcare which include devices that are easy to use for patients, the fragmentation of the cloud systems for sharing data, the legal implications of sharing data across platforms, and the setup and configuration of systems in the home. Most solutions in the past ten years have relied on Bluetooth and WiFi devices connected to a hub in the home to transmit data. However, these types of solutions require a person to setup and configure the system as the general user cannot be expected to do this themselves. Furthermore, the lack of a cloud services which can operate in a secure manner and transfer the data to hospital electronic medical record platforms (EMR) was also not commonplace.
COVID-19 has accelerated telemedicine and RPM. However, the wide-spread availability of Cat M1 LTE chips and the data plans associated will be the tipping point. Cat M1 cellular technology and the IoT platforms associated with them enable a plug and play experience for the user: simply open the box, charge the tools and you are set to go. In the next 5 years, many more common devices like blood pressure cuffs, pulse oximeters, even thermometers will integrate with cellular hubs or have cellular chips integrated within them for “health-on-the-go” applications. The continuous stream of data from devices will also enable artificial intelligence (AI) to alert providers when there is an issue. AI also has the potential to predict what direction a person’s health is going which can help engage people in their health before it is too late. There are several population health benefits to taking healthcare into the home. Image a scenario where de-identified data was available for regions (e.g. zip codes) and could show elevated temperatures and other parameters which could signify an outbreak of a disease.
The major challenge left for the IoT in healthcare in the interoperability and the privacy and security of patient data. The data is healthcare is very fragmented compared to the consumer space. A large majority of the EMRs on still on-premise and controlled by hospital groups. However, with the recent move from big-tech to get into the healthcare space, data will be available in the public cloud sooner than later. This will allow for users to take control of their health by taking control of their data and share it with any provider via API to get the best service. The security of the data is another challenge which will have to be overcome. A breach of ones health data provides as serious a risk as someone breaking into your home. Multi-factor authentication and biometrics are tools that can help provided people trust big-tech with their data. The recent history of big-tech using data for marketing does not help people get over the hurdle of putting their data an accessible cloud system even with the benefits its could provide them. Maybe there is room for some new players in this space? Regardless, IoT will play a pivotal role in enable true health care which can help prevent chronic diseases instead of waiting until people get to the hospital to provide “sick care.”
- American-Counts-Staff. 2020 Census Will Help Policymakers Prepare for the Incoming Wave of Aging Boomers. 2019; Available from: https://www.census.gov/library/stories/2019/12/by-2030-all-baby-boomers-will-be-age-65-or-older.html.
- Wilson, L. MA patients’ readmission rates higher than traditional Medicare, study finds. 2019; Available from: https://www.healthcaredive.com/news/ma-patients-readmission-rates-higher-than-traditional-medicare-study-find/557694/.
