The Internet of Things can tell you what’s in your refrigerator, but it’s what it can tell you about your body that has medical experts excited.
Yet, as great as the promise to improve healthcare using this technology, it’s being bogged down by challenges.
Apple Watches and Fitbits notwithstanding, the idea of using connected devices more widely to monitor health and administer care “is still frankly a developing area,” says Colin Zick, co-chair of the healthcare and privacy and data security practices at the Boston law firm Foley Hoag.
A growing body of research showing the undeniable effectiveness of using IoT technology to track activity, monitor people who may be at risk, and help patients take the proper medications, has crashed up against concerns about privacy, security, cost, emerging regulations, and whether human interaction might be lost to an Orwellian remote surveillance of the most personal aspects of people’s lives.
“How do we retain the human values of a physician holding the hand of a patient?” asks Teo Forcht Dagi, a neurologist and professor at Harvard Medical School and a venture capitalist who concentrates on information technology in healthcare.
Dagi, Zick, and other experts convened at a recent forum held by the Medical Development Group Boston—an organization of scientists, engineers, healthcare providers, corporate leaders, and investors.
This uncertainty around IoT and medical care is easing, thanks in part to early research showing the impressive capacity of the IoT to keep people healthy, and intensifying pressure to lower healthcare costs.
“Worries about such things as privacy may prove tricky,” says Joseph Kvedar, director of the Center for Connected Health at Partners HealthCare, “but the flip side is that, as a society, we’re spending 20 percent of our GDP on healthcare.”
So far, the dramatic positive gains recorded from health-related IoT technology have come from simply providing information that affects people’s behavior, much the way those “Your Speed” digital readouts on highways make drivers reflexively go slower, according to Kvedar.
In one research project, for example, people with Type 2 diabetes got daily text messages suggesting ways of staying active. “The resulting improvements were better than those produced by drugs,” Kvedar says.
In another experiment, technology used to remind patients when to take their medications cut their visits to emergency rooms by 75 percent.
“When things are personal and they come to you on your mobile screen, you pay more attention,” Kvedar says.
And using IoT devices to let patients take their own vital signs encourages them to do it more devotedly. When diabetics in yet another study knew their blood glucose readings were being monitored, 69 percent changed their behavior enough to lower their own blood pressure.
The next step is to collect that data and develop software that can analyze and even act on it, and here’s where worries over things like privacy have made healthcare slower to adopt.
Such hesitancy is likely to be overcome by something even more powerful than privacy fears: money.
The federal government is leveraging its Medicare program to pay doctors for the quality of care rather than for every office visit or service. That gives them a financial incentive to avoid redundant or unnecessary tests, hospital readmissions, and other expensive problems. Many private insurers already do this.
“That opens the door for all kinds of virtual care,” Kvedar says. “The whole business of healthcare for thousands of years has been, you come to me when you have a problem and I’ll fix you.”
Some employers, facing massive benefits costs themselves, are also turning to the IoT.
The international data-storage company EMC, for instance, with 60,000 employees and a $1 billion-a-year healthcare bill, provides employees with personalized portals tracking not only their own health, but the actual cost of the healthcare they receive, which is often obscured in the paperwork of claims, says Delia Vetter, senior director of benefits and programs at EMC. It also works with WebMD to provide personal health tips based on workers’ medical histories.
All of this has saved the company $501 million in avoided medical services since 2004, Vetter says. Employees’ payments for deductibles and doctor visits haven’t increased since 2003.
Even if insurers and employers weren’t putting pressure on physicians, demographics are, according to Piali De, founder and CEO of Sensico Systems, which creates home healthcare sensors.
As the population ages, she says, it will become impossible for human healthcare workers to check on all of their medical issues around the clock. Only technology will be able to do that.
“There aren’t enough people in the world to process all the data that could and should be harvested,” De says.
Which brings the subject back to privacy and regulation, concludes Zick.
“Connected healthcare improves the quality of care,” he says. But, “If they can’t solve the security concerns, connected devices don’t go anywhere. The data is worth nothing if you can’t use it.”
“People are willing to look past some of these concerns,” Zick said, “because they see the benefits.”
Photo courtesy of Carestream.