The Internet of Medical Things (IoMT): Driving Innovation in Healthcare

Traditional medical care is experiencing a dramatic shift as digital transformation gives patients better access to medical care facilities even in the most remote areas. [1] Most of the conventional healthcare utilize manual management and maintenance of patient demographic data, diagnostics, case history, medication, drug stock maintenance, billing that results in human errors and can considerably impact the lives of patients. [2]

Internet of things (IoT)-based smart healthcare aids to overcome such human errors. It also assists the doctors in accurate diagnosis of the disease by interconnecting all the vital parameters monitoring devices over a network with a system for decision support. Those medical things that have the facility for transferring data over a network without demanding human to computer or human to human interaction are known as Internet of Medical Things (IoMT). [2]

IoMT, a subcategory of IoT, plays a vital role in the field of healthcare and its impact on the healthcare market is irreversible and undeniable. [3,4] Such solutions can help to overcome the common challenges witnessed in medical settings. [5] Paired with smartphone apps, the emerging technology of IoMT enables patients to send their health information to medical caregivers. [6] IoMT devices are connected to medical care provider networks and transmit their data to internal servers or cloud repositories. [7]

For both patients and doctors, IoMT assists in better surveillance of diseases and play a fundamental role in tracking and preventing chronic illnesses. [6] Let us dive a little to explore how IoMT has revolutionized and transformed the healthcare experience.

What is IoMT?

Before discussing the benefits of IoMT technology for the healthcare sector, let us first understand what exactly IoMT is?

IoMT is an amalgamation of medical devices, hardware infrastructure, and software applications that are utilized for connecting healthcare information technology by using networking technologies. [3]

The smart system of IoMT primarily consists of smart sensors and electronic circuits for acquiring biomedical signals from a patient. It also comprises a processing unit for processing the biomedical signals, a network device for transmitting the medical data over a network, a temporary or permanent storage unit, a visualization platform with artificial intelligence plans for taking appropriate decisions as per the convenience of a clinician. [2]

Benefits of IoMT for healthcare sector

Using IoMT yields a myriad of advantages and certainly, there is even more to be unveiled. Below are a few benefits of IoMT:

• Results in fast and more accurate diagnosis of disease [4]
• Improves patient experience by reducing the need for unnecessary and frequent hospital visits [7]
• Decreases the burden on the medical care system by connecting patients to their doctors [8]
• Minimizes medical care costs [7]
• Facilitate the provision of effective medical care even in remote locations [7]
• Enables wireless and remote devices for securely communicating over the internet for rapid and flexible evaluation of medical data [3]
• Improves patient outcomes and enhances the quality of patient care [5]
• Automation of device and treatment records minimizes human error and false reporting within hospitals
• IoMT devices  quickly process the data of patients, therefore boosting productivity [4]
• Enables secure transfer of medical data over computer network [8]
• Leads to efficient healthcare service delivery [4]

How is IoMT impacting healthcare?

Affordable medical care services are the need of the hour. With their promising ability to generate, collect, analyze and transmit health data or images, IoMT technology is expeditiously altering medical care delivery. [6]

(a) In-home IoMT

The in-home segment includes the following:

1. Personal emergency response systems (PERS):

It includes wearable device/relay units and a live medical call center service for offering security and boosting self-reliance for people at high risk (like homebound or limited-mobility senior citizens) that want to live at home without compromising their safety. It enables users to promptly communicate and get emergency medical care. [1] For instance, PERS can track events like a heart attack to automatically call for assistance. [3]

2. Telehealth virtual visits:

It includes virtual consultations that assist patients to handle their conditions and getting prescriptions or the recommended healthcare plans. Examples include video consultations, and assessment of lesions or symptoms through digital tests and video observation.

3. Remote patient monitoring (RPM):

RPM is valuable in the following management areas:

• Chronic disease management: Continuous supervision of physiological parameters (such as blood pressure) aids in supporting long-term care in a patient’s home in an attempt for slowing disease advancement.
• Acute home monitoring: RPM allows continuous observation of the discharged patients. This accelerates recovery time and also may help to prevent the rate of re-hospitalization.
• Medication management: It offers medication reminders and dosing information to the users. This helps in the improvement of adherence and outcomes. [1] 

(b) On-body IoMT

It is the utilization of wearable devices that are connected to the remote monitoring systems. Contrary to in-home IoMT, on-body IoMT can commonly be utilized outside of the home as individuals live their normal lives. [3] They can be broadly divided into consumer on-body IoMT devices and clinical on-body IoMT devices.

(1) Consumer on-body IoMT devices:

They are wearable medical devices that a person can buy for tracking health metrics for both personal usage and for sharing with the caregivers. [3] The majority of these devices are not regulated by the healthcare authorities. However, on the basis of consumer studies and informal clinical validation, experts can endorse such devices for particular health applications. [1] Besides monitoring a standard metric (like heart rate), these smart devices can be early warning signs for more severe health problems. For instance, an Apple Watch can alert a person about irregular heart rhythms. [3]

(2) Clinical on-body IoMT devices:

They encompass regulated devices and supporting platforms which are usually certified/approved for usage by 1 or more regulatory or health authorities. The majority of these IoMT devices are used in conjunction with the expert advice or prescription of a clinician.

Examples include:

• A wearable neuromodulation device that taps into sensory nerves to offer alleviation of chronic pain
• A smart belt which assists in the detection of falls and deployment of hip protection for elderly wearers [1]
• Glucose sensors worn by diabetic people can warn them about the fluctuations in glucose levels [3]

(c) Community IoMT

It is the usage of IoMT devices and tools throughout a broader geographic area. It includes five components:

• Mobility services: It enables passenger vehicles in tracking health parameters during transit.
• Emergency response intelligence systems: They are utilized by paramedics, first responders, and hospital emergency department care providers for tracking patient metrics outside the hospital setting.
• Kiosks: They are utilized for dispensing medicines to patients in rural areas with limited or no access to the traditional infrastructure.
• Point-of-care devices: These devices are utilized by medical care providers outside of the home or traditional medical care settings like a medical camp or a field hospital.
• Logistics: It encompasses the transport and delivery of medical care goods and services including medical devices, pharmaceuticals, medical equipments, medical and surgical supplies, and other products required by healthcare personnel.

For instance, sensors can be used in pharmaceutical shipments for monitoring pressure- or temperature-sensitive shipping containers. This helps in ensuring that the quality is sustained throughout the shipping process. [1,3]

(d) In-Hospital IoMT

This segment includes the following areas:

1. Asset management: IoMT aids in monitoring and tracking of high-value capital equipment and mobile assets (like wheelchairs and infusion pumps), throughout the facility.

2. Personnel management: It assists in the measurement of efficiency and productivity of medical care staff.

3. Patient flow management: It leads to improvement in facility operations by preventing bottlenecks and improving patient experience. For instance, Using IoMT, the arrival time of a patient from the surgery room to post-care to a wardroom can be supervised.

4. Inventory management: It aids in streamlining ordering, storage and usage of hospital supplies, consumables, medical devices, and pharmaceuticals. This minimizes inventory costs and enhances staff efficiency.

5. Environment (such as humidity and temperature) and energy monitoring:  It helps in overseeing electricity usage and ascertains optimal conditions in patient areas and storage rooms.

Innovative devices include:

• A wearable defibrillator that constantly monitors people at risk of ventricular fibrillation or tachycardia
• GPS-based MyWay app that guides visitors to their destination through the fastest route
• A hand hygiene compliance system that consists of a real-time location system receiver and an occupancy sensor. This assists in tracking the identity of employees via the dispenser and utilizes analytics to check whether employees are following hygiene protocol [1]

Future Directions

Advancements in technology are transforming our lives and providing smart solutions for every sector. One such sector is healthcare. The utilization of IoMT concepts and tools has substantially altered the healthcare services. [9] The connectivity between devices and sensors is an innovative way to streamline clinical workflow management and ultimately head to a comprehensive enhancement in patient care. [6]

These internet-connected devices improve therapeutic efficiency, minimize costs of care and drive better outcomes in the field of medical care. [6] Due to the nature of IoMT networks, communication security is one of the most crucial elements to ensure the privacy and security of a patient. [7] IoMT is poised to evolve the future of healthcare. [6]

In the future, even the most remote areas will benefit from improved access to care, as the connected medical devices continue to discover their way into the hands of both doctors and patients. The evolution of the IoMT ecosystem is paving the way for other novel technologies too. It is anticipated that implementing IoMT would lead to more accurate diagnosis, and fewer mistakes, at reduced costs. [7] Irrespective of a patient’s location or condition, the evolution and expansion of the IoMT ecosystem will indeed become more impactful. [6]

References:

1. Internet of Medical Things Revolutionizing Healthcare. Available from:

https://aabme.asme.org/posts/internet-of-medical-things-revolutionizing-healthcare

[Last accessed on: 22 November 2021]

2. Vishnu S, Ramson SJ, Jegan R. Internet of medical things (IoMT)-An overview. In 2020 5th international conference on devices, circuits and systems (ICDCS) 2020 Mar 5 (pp. 101-104). IEEE.

3. What is IoMT? Available from: https://ordr.net/article/what-is-iomt/

[Last accessed on: 22 November 2021]

4. Why Internet of Medical Things is the future of healthcare? Available from:

https://webmedy.com/blog/why-internet-of-medical-things-is-the-future-of-healthcare/

[Last accessed on: 22 November 2021]

5. IoT in Healthcare: Enhancing Medical Environments With Innovative Solutions. Available from:

https://www.igor-tech.com/news-and-insights/articles/iot-in-healthcare-enhancing-medical-environments-with-innovative-solutions

[Last accessed on: 22 November 2021]

6. How the Internet of Medical Things Is Impacting Healthcare. Available from:

https://healthtechmagazine.net/article/2020/01/how-internet-medical-things-impacting-healthcare-perfcon [Last accessed on: 22 November 2021]

7. The impact of the IoMT on the Healthcare Industry. Available from:

https://waterstream.io/2021/02/15/the-impact-of-the-iomt-on-the-healthcare-industry/

[Last accessed on: 22 November 2021]

8. Toor AA, Usman M, Younas F, M Fong AC, Khan SA, Fong S. Mining massive E-health data streams for IoMT enabled healthcare systems. Sensors. 2020 Jan;20(7):2131.

9. Singh RP, Javaid M, Haleem A, Vaishya R, Ali S. Internet of Medical Things (IoMT) for orthopaedic in COVID-19 pandemic: Roles, challenges, and applications. Journal of Clinical Orthopaedics and Trauma. 2020 Jul 1;11(4):713-7.