Internet of medical things: The future of networked biosensors
The emerging internet of medical things (IoMT) is a subset of the internet of things (IoT). The IoMT will enable the digital patient and will facilitate human-machine interaction.
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Three pillars will contribute to the successful construction of the IoMT:
Sensors and systems – Hardware to accurately deliver data and a platform on which to capture data
Intelligent diagnostics – The potential flood of data is captured and presented in a way which is quickly comprehensible and actionable
Quality assurance – Users, be they patients, clinicians or those seeking to enhance their wellness, trust the system with their data
The IoMT will bring healthcare closer to the patient. It will do this by enabling health tools for reliable diagnosis and monitoring at the point-of-care and away from medical centres. The IoMT will provide real time and personalised feedback to users while being aware of context and situation. In order to ensure trust, a number of measures must be guaranteed, independent of device, location or user. These include safety measures, reliability, and integrity of systems and data quality.
The IoMT will create big data within healthcare services. The huge databases will be developed that will serve different interest groups. Researchers will have much larger data sets against which to test assumptions. Business will be able to build new models and seek market place advantages. End-users, healthy or non-healthy, will be able to access their big data in small, digestible, context-dependent packages.
Use case: Monitoring wounds
Chronic wounds heal only slowly. ETH Zurich, in collaboration with University Hospitals in Zurich and Geneva, is developing a tool where patients can take a photo of their wound that can be automatically assessed by algorithms. (Source: Mobile Health Systems Lab, ETH Zurich)
The ecosystem of the IoMT and mobile health services (m-health) will create big medical data. M-health provides services for individuals, such as emergency hotlines and telehealth. It will allow patients access to their health records at the point of care. M-health will provide feedback for health surveillance at a macro level; and self-monitoring at a micro level. It will further be an enabler of participatory health systems. Health systems will move away from a top-down hierarchy to a more co-operative basis in which citizens will have a greater say over their health data and health care. It could be the start of citizen science.
Use case: Childhood pneumonia
Pneumonia, a major killer of children under 5s, can only be diagnosed through clinical observation in low resource settings. A digital tool, administered over a smart phone, can provide more accurate assessments and recommend treatments. (Source: Mobile Health Systems Lab, ETH Zurich)
There are challenges, which all IoT systems face. Most significant is security, either through hacking or data theft. Data has to have integrity, and should data sets be incomplete, data architects have to consider how they best cover holes in their time series and prevent data manipulation. Of particular concern to the IoMT are regulatory requirements for data; the clinical validity of data; and untrained users seeking to administer medical devices.
The digital patient is arriving. It will change the way how healthcare is administered.
Summary of Walter Karlen's presentation at the Centre's Health monitoring event in November 2016. Walter is Assistant Professor, Department for Health Sciences and Technology, and Head Mobile Health Systems Laboratory, ETH Zurich. Summary by Simon Woodward.