My guest for this edition is Dave Ryan, Intel GM for Health and Life Sciences at its Internet of Things Group. We spoke at the Connected Health conference in Boston, an annual get-together of innovators in digital health and healthcare transformation which has long been on my list of regular stops on the conference circuit.
Kicking things off, I asked Dave to define the Internet of Things, or IoT (noting that I had recently nearly been laughed out of the kitchen at home by some Luddite family members when I brought up IoT at dinner). Dave said, “All of the things in our lives are connected and if they aren’t they will be – your refrigerator is a thing, your refrigerator, connected to your shopping list, is a thing that’s part of the internet of things.” It’s about taking things that have been around before, “making them smart and through connecting them to the internet making the product perform better for the person who’s using it.”
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IoT is not necessarily just about remote sensors, and in fact the IoT story is two different stories – one inside the health care facility, and one outside. Over the past ten years, every device in the hospital has gotten connected – all information on the device digitized, and put in the hands of clinicians and caregivers. At home – as care shifts to be able to be delivered where people are – “sensors are key” per Dave – healthcare in the home is about helping the individual managing someone’s case get better information about how that person is doing between office visits.
The range of issues detected by sensors range from detailed clinical readings to the very simple: “are you in your apartment?” Dave noted that in some countries someone would go over to check on someone who had left their apartment when they normally don’t.
Since a key broad goal is keeping people at home rather than in healthcare facilities, Dave notes that it is important to recognize the potential for IoT devices to help promote social connectedness, connectedness to the family. It is critical in terms of health and wellness. “IoT technologies that can be used in the home can bring more connectedness to the family, not just caregivers,” and that’s really a key part of the health strategy – it’s not just about taking vital signs.
We explored further the question of whether IoT in healthcare simply provides a new platform for old services and ideas or whether it enables something entirely new. Dave advanced the idea that “it’s a whole new chapter, a whole new model of how to care for folks,” stepping away from a nineteenth-century model “still deployed pervasively today” where an individual sees a PCP every three months or every six months, has a six or twelve or seventeen minute appointment and then disappears. IoT allows information and communications “connectivity between the patient and the care system” when they want it, every day, all the time.
Dave highlighted some research sponsored by the Michael J. Fox Research Foundation on connected measurement through IoT devices for people with Parkinson’s. This let patients and clinicians see the changes in the effects of medication over the course of a day or a week, not just based on self-reported history during a six-minute office visit. IoT doesn’t replace office visits, but “shines a light on the dark corner of the health care system” (i.e. everything that happens between visits).
Obviously, we don’t want just a flood of data, we want the data turned into insights and actionalble alerts. Dave notes that there are lots of innovations in advanced analytics and artificial intelligence that can mine these remote sensor readings and “convert data into nuggets of insight and critical triggers of action,” so that. For example, a pattern of sensor readings can lead to an automatic change of the three-month followup visit to a one-month followup visit, or an outbound call from a clinician. Device design and analytical tool design are key areas of innovation and development.
Dave notes that healthcare organizations are dealing with a data tsunami and need a way to better manage the flow of data and harness it, turn it into usable information and actionable insights. Some data-intensive areas like imaging and genomics are ripe for disruption using analytics. This is different form the initial more passive forays into IoT in healthcare, that simply involved taking measurements and uploading weight, blood pressure etc. from home monitors to clinicians. “1.0 didn’t work.”
Today, Dave says, “proactive solutions, intelligent monitoring” are key; things that are “interactive with the individual,” that relate to “behavior modification, improved medication adherence” and “more connectivity with the patient’s caring circle” are more effective than traditional healthcare, and when they are well-integrated into the clinical workflow within the healthcare system, with AI-generated insights, they can be extremely useful to the care management team.
This has been a twenty-year process, and today over ten million patients are served by healthcare IoT tools, and this number is now growing at an annual rate of 40-50%.
As the use proliferates and as concerns about connectivity and security have increased, Dave says that Intel works closely with device manufacturers to design security in from day one. Historically, the focus was on securing the healthcare IoT devices from outside cyberattack, but over the past five years, there has been a growing recognition that the bigger threat is deliberate infection of an insecure medical device by an attacker and using it as a vector for attack inside a hospital. Security protecting against the latter kind of attack is on its way to becoming “table stakes.”
Dave expects that as provider satisfaction with IoT medical devices continues to improve, adoption inside hospitals will continue to expand. And when I asked him how the world will be different in five years he responded: “Mark 2018 on your calendar. In the future, we will agree that in 2018 the lights turned on for remote care – things changed and remote care became the standard of care.”
I spoke with Dave as part of my ongoing series of fireside chats with healthcare innovation leaders – Harlow on Healthcare, on HealthcareNOW Radio. Listen to our radio station online, or ask your smart speaker (Amazon Echo or Google Home): “Find Tune In station HealthcareNOW Radio.” You can catch me live weekdays at 8:30 am, 4:30 pm and 12:30 am ET. As each new show goes live, the last one joins the archive, available via SoundCloud or your favorite podcast app (iTunes, Stitcher, iHeartRadio). Your comments are welcome here. Join the conversation on Twitter at #HarlowOnHC.