The Internet of Medical Things (IoMT) – next step for healthcare

In the last few years healthcare domain saw a huge gain of popularity for medical devices with patients’ remote monitoring possibilities, like on-body biosensors, fitness bracelets, clinical monitors etc. However, recent events of 2020 showed how big the perspective of this market development is, where receiving  timely medical assistance regardless of patients’ whereabouts turned out critical and trying to provide real time country/region-wide control of the current condition of patients treated at home or at medical institutions placed a heavy burden on the healthcare systems all over the world.

In such hectic reality to ensure smooth transfer of medical data over a secure network also turned out a task yet to solve. And here the development and further advance of the Internet of Medical Things (IoMT) as an integral infrastructure and a separate and potentially state-level service can play an important role.

Firstly, what does the Internet of Medical Things mean? In a few words, the IoMT is a mix of devices and digital applications for health related services that connect the digital and physical world together to enable quicker and more efficient diagnosis and treatment processes and help to monitor and improve the patient’s health in real-time.

Derived from nowadays popular Internet of Things, IomT is likely to secure its own spot in the market. Overall, it is already estimated that by 2022, the potential budget for medical treatments with the help of IoT medical devices is expected to grow from $14.9 billion to $52.2 billion. With the arrival of new therapy methods, such as the first smart pill approved already in 2017 by the FDA, practitioners will have many interesting options for providing care in a more effective way.

This type of technology can also decrease costs for care significantly – some sources say that IoMT may save the healthcare industry $300 billion annually through remote patient monitoring and improved medication adherence.

So far there are several types of IoMT devices available in the market:

1. Fitness Tracking Devices

Nowadays such devices are most known and popular among people. These wearables, equipped with sensors, can collect, analyze, and transfer data of an individual’s physical activity to their mobile applications (for ex. wristbands, smartwatches, smart shoes, etc.)  All of these connect with their counterpart mobile apps to help users keep track of their fitness.

As an example of one of the most innovative and successful start-ups in 2020 there is Whoop’s fitness tracker. It was developed in the USA for elite athletes to monitor their workout intensity and sleep performance. Beside beautiful design such bracelets help get daily personalized fitness, sleep, and recovery data and with the course of time reduce resting heart rate (RHR), increase heart rate variability, provide better sleep and less injuries.

One more interesting project is a Sweden-based start-up for kids Lifee. This device is introduced in a form of the wristband, which motivates kids to stay active through gamification—getting points for moving, or for collecting creatures in a mobile app. This product allows group supervisors, teachers and parents to view statistics and motivate kids to have more physical activity which in a longer perspective reduces chances to get disorders or diseases.

2. Clinical Grade Wearables

These IoMT devices are usually advised by physicians and approved by the government. The main function of these devices is the improvement of chronic health conditions and illnesses.

The IoMT devices that are considered as the clinical-grade wearables include smart belts that are used by elderly patients to detect falls and provide protection; and chest straps that are embedded with ECG, heart rate, temperature, and respiratory rate sensors. The clinical-grade IoMT wearables give doctors access to the real-time health status of their patients and, moreover, increase patient engagement in medical treatments.

For example, Walk with Path created LaserShoes for people with Parkinson’s disease. This device provides visual cues by the user, after which he can get active feedback and assistance in making steps.

Swedish patented and commercial company Coala Life helps people with heart diseases through remote monitoring and self-screening of heart sounds and ECG.  This information quickly comes to the healthcare provider using smartphones.

Austrian company yband therapy with the help of ARYS™ me and ARYS™ pro develops a motivation system for the rehabilitation of arm and hand function of people with traumatic brain injury. ARYS™ version could be implemented by people at home, whereas ARYS™ pro is elaborated for use in the hospitals.

3. Smart Pills

As said above, the US food and drug administration approved smart pills a few years ago. These pills are used to help a patient be compliant with their prescribed medication. The sensor in the pill gets activated when it comes in contact with stomach fluids. Then the information is transferred to a smartphone application, illustrating time and date of taking the pill.  Moreover, such smartphone applications analyze the given data and could share with the doctors. After the drug is absorbed, these sensors are discharged via the patient’s tract.

For example, Keratin Biosciences wants to improve medication intake by getting rid of human error completely. Instead of a pill, the company makes a microchip with hundreds of hermetic compartments, each of which can keep to 1 milligram of a drug. The chip can be activated by a wireless signal that triggers the compartments to release the drug, based on a prescribed and preprogrammed dosing schedule.

4. Various Hospital Devices

The existing healthcare infrastructure also needs to be improved and upgraded. Wireless connectivity and cloud computing have been implemented to almost every department of hospitals.

Such things as clinical monitors include a wide range of IoMT devices that are used by physicians in their clinical setup. These devices are used to record and store patient’s health records electronically in the EHRs. Digital stethoscopes, implemented in the computers, that can store and transfer sounds to a mobile app.

IoMT is also helpful in healthcare asset management. With the use of RFID chips, hospitals can track their expensive equipment to ensure safety. It is also helpful in inventory handling, meaning that the hospitals will never be unknowingly out of supplies.

However, further development and spread of IoMT devices are accompanied by several on-going problems: safety, privacy and security. A report from the Ponemon Institute’s Sixth Annual Benchmark Study on Privacy and Security of Healthcare Data showed that 89% of healthcare operations had been the subjects of at least one data breach.

Attackers could tamper with the device, damaging its integrity and threatening patient lives. As an example, a blood-gas analyzer infiltrated by malicious software could lead to the movement and extraction of sensitive patient data.

Consequently, it is necessary to identify the main threats of using IoMT devices:

1. Increasing amount of cyberattacks

When it comes to consumer cybersecurity, the main thing to remember is the security of mobile medical devices involved. Now attackers explore a strategy called “destruction of service”, or DeOS, which completely disables the network.

2. The declining value of the medical record

Tendency to buy stolen medical records rather than to hack them is picking up speed nowadays. In turn, it leads to increasing demand for profitable exploits (hacking medical devices to control them).

3. Easily hacked devices

A large number of medical devices were built 15-20 years ago.  Many of them are still used in hospitals to decrease costs. Such things as pacemakers, X-ray machines and scanners use outdated security software that isn’t automatically updated. This leaves hospitals and patients very vulnerable.

4. Doctors must first of all treat patients

Clinicians are focused on patient care so, naturally, the prevention of cybersecurity hacks is not necessarily their No. 1 priority. Therefore, it is important that cybersecurity should be simple and easy to update, otherwise some clinicians may start using unsanctioned applications in order to keep up with their workflow.

Summarizing above, IoMT devices should be prevented from cyberattacks intensively. Here the security of data collection instruments (devices that are safe from hacking) should be always controlled, moreover, it’s important to provide control of the access to data and the limited amount of people/systems/devices that can look through such information.

Naturally, the problem of IoMT security has been raised among researchers, and despite having several options, Blockchain technology seems to be a powerful option. For example, electronic medical reports (EMRs) can be added to the blockchain as it is a part of IoMT network. When the new patient record is created, a new block of data is initiated in the patient network. The block contains the patient data, time of creation and the information of the initiator of the block. The special nodes called miners have to perform some working called mining to add a transaction into the network. The approval of the block is based on the proportion of the mining data.

So why do researchers think this type of security can be safe? Firstly,  the purpose of securing medical records cannot be completed without the involvement of a trusted intermediary avoiding performance-critical elements and a single point of failure.  Secondly, patients can access and have control over their data. Family members can also view the details of their patient condition. Also, distribution of data is accurate, consistent and timely in blockchain.  By the way, any change happening in the blockchain can easily be visible by all the members of the patient network and any unauthorized alteration can be detected trivially.

Moreover, except blockchain technology, there are three other ways in which healthcare organizations can create a holistic, effective device security strategy around software automation for IoMT devices:

  1. Start with the basics —The first step is changing your device passwords and gaining visibility into what’s on your network. For the devices that you know already exist and can’t be patched, start by addressing their vulnerabilities and putting better detection controls around them. Enhance the level of logging and monitoring of network traffic and other devices that talk to that device. Consequently, here comes the second point.
  2. Have a device security breach plan — If a device has a security issue while in use, is it turned off? Has it been swapped for another? Process and protocols must be predefined so both the clinician and IT professional can move forward together to address the security breach. Device assessment automation tools can help IT professionals determine where the breach came from and automatically alert the clinicians affected so the security risk is managed in real time.
  3. Simplify the process — If clinicians have to manually update their devices, or are given a drawn-out security procedure to follow in order to use the device, they are going to look for alternatives, and most are likely not secure enough for the organization’s network. The security process needs to be compatible with the clinicians’ typical workflow.
  4. Invest in technology defenses — Without a rock-solid digital technology foundation, it’s very hard to combat security risks within medical devices. A technology roadmap should be built that includes automation software to keep up with security patches, cloud-based security solutions and traffic analytics tools for better visibility across the network. In addition, companies should consider microsegmentation so devices are isolated from larger security risks and outsource certain tasks to security experts.

Conclusion

The IoMT market growth is expected to increase more in a few years. It is indeed possible with the help of correct and suitable implementation and acknowledgement of the main security rules. Integration of AI (artificial intelligence) can also add a lot to the expansion of IoMT; for example, it will make cases like automated prescription possible. Moreover, the rise of IoMT devices will create a sophisticated health-tech ecosystem that will pave the way for new technologies allowing to provide better healthcare services combined with lower cost and higher quality technologies.

Altabel Group is tightly engaged in the development of applications in both IoT and the eHealth domain. We have implemented a wide range of projects like medical imaging data analysis systems / advanced viewers for medical images / IoT platforms with GPS for the elderly care / EHR, EMR solutions, dashboards / medical reports flow management solution / clinical trials management platform / medical decision support systems with in-built AI / telehealth solutions / wellness & fitness applications / medical device specific solutions (for scanners, etc) / data-grounded ML-driven medical research app / VR educational app / AR surgery support solution / Performance Assessment Tool / connected health solution etc.

Please let us know if you have any medical projects in mind or would like to expand/scale up ongoing projects, we would be happy to hear from you and see if our team can assist you with your challenging and exciting plans!

Learn more about us at https://www.altabel.com/ or contact me for more information directly at julia.govor@altabel.com

Julia Govor

Business Development Manager