Healthcare IoT uses on-body sensors in the form of implantable devices, adhesive patches, and wearables to collect vital signs in the human body. These sensors are connected to smartphone apps through communication technologies like RFID, Bluetooth, Zigbee, or WiFi. Smartphones work as relay devices that send sensory data to remote healthcare providers. The healthcare providers can then prescribe medications according to the physiological parameters, which are sent to the smartphone app of the patient. H-IoT is all set to revolutionize the life of patients by reducing visits to hospitals, eliminating invasive procedures of drawing blood for tests, and waiting for results. H-IoT will also reduce the need for personalized medical staff by providing online tools to monitor the patients virtually. According to , The number of active healthcare IoT connections is expected to reach 10.34 million connections by 2025. Statista Remote health through H-IoT and Covid-19 Social distancing is one way to prevent virus spread. Yet, people with medical conditions like hypertension, diabetes, and heart problems need regular clinical visits. These patients and elderly people are most susceptible to the coronavirus. Keeping in mind the virus prevention, safety, and well-being of individuals, automation of healthcare services is a must. Utilizing H-IoT publically will reduce the risk of virus transmission. H-IoT ensures continuous care to the community, yet preventing direct physical contact. Healthcare examples of IoT Below are some use case examples of what H-IoT is up to! 1. Smart Blood Glucose Monitoring Blood glucose monitoring is essential in the case of young children and elderly diabetic patients, who cannot keep track of their regular insulin dosage. The research in smart insulin monitoring and delivery has resulted in some excellent IoT-enabled apps that alert caregivers for the need for insulin at right time. has introduced a smart Continuous Glucose Monitor (CGM) that comes with a sensor, transmitter, and smartphone app. The sensor is installed inside the skin which wirelessly communicates with the transmitter to send glucose levels at regular intervals. The transmitter then sends the glucose levels to the smart app on the patient's watch or phone. The readings can be sent to care providers for real-time dosage adjustments in case of hyperglycemia and hypoglycemia. Eversense Other blood glucose monitoring devices include that delivers the required amount of insulin into the bloodstream automatically without the caregiver's intervention. Closed-loop (automated) insulin delivery was initiated by OpenAPS (Open Artificial Pancreas System). closed-loop (automated) insulin delivery ( Adopted from BMC Medicine) An illustrative representation of a closed-loop insulin delivery system. (A) A sensor (black rectangle) transmits information about interstitial glucose levels to a handheld device. An insulin pump (blue box in the pocket) delivers a rapid-acting insulin analog subcutaneously. The communication between the system components is wireless. (B) The closed-loop replicates the physiological feedback normally provided by the β-cell. 2. Stroke Rehabilitation through H-IoT Rehabilitation management after stroke is a two-stage process i.e, acute and subacute stage (< 6 months) and chronic stage (after 6 months). During the acute and sub-acute stage, patients are under constant supervision of healthcare providers in specialized rehabilitation centers. After the patients are discharged from the rehabilitation centers, 65% of the patients require to find difficulty in performing their daily life activities and require extended treatment. There is a recent trend in self-managed stroke rehabilitation, where a virtual environment is provided to the patient within the comfort of their home. Specialized wearable devices like , and other flexible sensors are designed to assist the patients in their at-home rehabilitation training. IMU (Inertial Measurement Units), Surface electromyography (sEMG), Conductive elastomer (CE) 3. Ambient Assisted Living Ambient Assisted Living (AAL) technology is introduced to support elderly individuals to lead an independent life. Smart devices, medical sensors, and software applications are employed to cater to the daily life needs of elderly people. Some of the daily life assistance of AAL includes turning on/off the lights, switching on the TV, preventing kitchen fire in case you forgot to turn off the gas, smoke detection, adjusting room temperature through a smart thermostat. Apart from daily life assistance AAL provides support in the disease management and of the patient. The smart wearables, sensors, and smart devices connected with AAL monitor the activities of the patient like fitness tracking, gait movement abnormalities, fall detection, human tracking, and localization and sends an alarm to the healthcare provider in case of an emergency. AAL is also a boon for alzheimer’s and parkinson’s and Huntington's disease (PD/HD). activity recognition 4. Sleep Monitoring Sleep monitoring i.e., recording breathing patterns and heart rate at night can provide vital indications of patient's general health or some underlying disease. Moreover, it is also important to monitor patients with serious sleep disorders like obstructive sleep apnea (OSA). OSA is a dangerous sleeping disorder that pauses breathing for a few seconds several times at night, while the patient is asleep. Traditional diagnostic approaches for OSA include Polysomnography (PSG). PSG is a very invasive and uncomfortable procedure that includes a lot of wires attached to the human body at night which forces them to stay in a fixed position all night. Healthcare IoT researchers are exploring new ways to monitor the patients in real-time during the night in a non-invasive manner. is recently designed which includes sensors that record heartbeat and spo2 levels. In case of abnormality in the recorded values, an emergency alarm signal is sent to the caregiver via a smart app. A sensor-enabled glove 5. Cardiac Monitoring Continuous cardiac monitoring for out-of-hospital heart patients is a necessity. Vital signs of cardiac patients such as needs to be tracked in real-time. Regular pacemakers and implantable cardioverter-defibrillator (ICD), when connected to the internet for real-time tracking, will surely decrease the chances of adverse and fatal effects to cardiac patients. blood pressure, ECG, SpO2, heart rate, pulse rate, blood fat, and blood glucose 6. Asthma Monitoring Asthma is a respiratory system disease that narrows the airways, resulting in shortness of breath and trouble breathing. Asthma patients need daily medications of anti-inflammatory drugs and inhalers. Failure to take the medication at a right time might trigger an asthma attack. IoT-enabled asthma monitors use machine learning algorithms to 'learn' the normal breathing patterns of the patient. The asthma monitors alert the patient before the actual attack happens so that he can prepare before it gets worse. The asthma monitor also sends alert signals to caregivers through a smartphone app in case of an attack. The smartphone app also keeps track of inhaler usage and alerts if the patient forgets to use the inhaler. Security and Privacy concerns in H-IoT Despite seeing promising applications of IoT, there are some cybersecurity loopholes that need to be addressed. The sensors usually use Bluetooth technology to send and receive signals from smartphones. Bluetooth device is taken as a harmless device as its transmission is 10-100m. Yet there was a major security flaw called which had approximately 500 IoT devices including medical devices. Moreover, Muddy water a report where they claimed major security flaws in pacemakers and ICD of St. Jude Medical, Inc. (STJ US). which was identified by FDA Swynetooth published Security vulnerabilities in H-IoT cannot be ignored as they can pose fatal side effects on a patient's life. Also published here .
