The Promise of IoT-Connected Healthcare: a Diabetic Emergency

The economic impact from the Internet of Things (IoT) on health and wellness could reach $1.6 trillion dollars a year by 2025. Much of that value will come from using IoT-connected sensors, wearables, and medical devices in the prevention, early detection, and ongoing monitoring of chronic health problems, including heart disease, pulmonary disease, and diabetes. To get the full benefit from IoT, healthcare experiences must be digitally connected at every phase in a patient’s care. It’s an ambitious goal, but it’s closer than you might think. Much is already in place. But work remains on several critical pieces before truly connected healthcare can become reality.

A Hypothetical: Type 2 diabetic emergency

Let’s consider a specific medical scenario: a Type 2 diabetic blood sugar emergency. Over 360 million people worldwide are diabetic, ninety percent have Type 2 diabetes, the kind mainly associated with obesity and sedentary lifestyles.

Scenario detail:

Our sample patient is in her mid-60s and lives alone. She has advanced Type 2 diabetes treated in part with a commonly-used medication that helps her body produce insulin around the clock to keep her blood sugar, also known as glucose, within safe limits. The most serious risk for diabetics like her is not high blood sugar, but low blood sugar, which can kill within hours. The most dangerous time: at night when patients are sleeping.

IoT-connected “lifesaver” step by step

1. Our patient begins using an IoT-connected glucose monitoring device with built-in alarms. One night, her blood sugar falls dangerously low while she sleeps. The alarm sounds, but she can’t hear it because her low glucose levels have rendered her unconscious. She needs a glucose infusion. Her device sends real-time alerts to first responders (EMS), hospital emergency staff, her doctor, and family.
2. EMS accesses her relevant data through the cloud while en route. They arrive knowing her current blood sugar levels and, from her electronic health record (EHR), the dosage and name of her insulin-boosting medication.
3. Simultaneously, hospital emergency staff prepare for her arrival. Most diabetics with severe low blood sugar can be treated and released in just a couple of hours, but she requires admission for observation for the next 24 hours.
4. Our patient recovers more rapidly and with fewer complications because all providers have access to her current status and health history.
5. All services are captured in a digital record, enabling healthcare providers to bill insurers for services automatically and with great precision.

What’s possible today.

Of the events listed in our sample scenario, everything that occurs in the first point is already possible. For example, Continuous glucose monitors (CGMs) have been around for more than a decade. Newer ones, like those from Dexcom, connect to the cloud for blood sugar trend tracking on mobile devices. The Dexcom CGM can also send alerts to family members and their doctors in the event of an emergency.

Making possibility a reality.

Our scenario begins to break down during event 2. EMS teams today can’t access CMG data from the cloud. Nor is it a given that they can tap in to a patient’s medical history through EHR systems. Due to ongoing issues with sharing digital patient data, all other events in our scenario are not yet possible in most healthcare settings. There are many reasons, but three stand out.

• Interoperability. EHR adoption has been rising for nearly a decade. By the end of 2016, 96% of hospitals had EHR systems in place. But hospitals need to be able to share data easily with any practitioner who needs it. Today, due to a lack of industry standards, only 6% of hospitals can do that, according to a recent survey. Scores of EHR vendors offer hundreds of products built with proprietary architectures and data models. Getting these solutions to communicate is an ongoing challenge with no clear resolution in sight.
• Device standardization. A greater obstacle involves the data output from devices. While there are hundreds of IoT medical, fitness, and wellness devices helping patients and their doctors monitor a widening range of health conditions, a lack of industry standards prevents the data from feeding seamlessly into EHR systems. Products like Apple’s HealthKit, which enable some degree of data integration, hold promise. But without industry consensus, these will remain patchwork solutions.
• Patient privacy and data security. When it comes to sharing patient data, the U.S has solved a main issue with The Health Insurance Portability and Accountability Act (HIPAA), which streamlines access to patient data. Patients need to give permission only once to share their data throughout an IoT-connected healthcare ecosystem. Unfortunately, the technology to maintain the security of the data is still evolving.

Why connected healthcare matters

It’s impossible to overstate the benefits when various elements of connected healthcare come together. For example:

• Comprehensive patient views. Data from wearable health and fitness devices shared in real time will give doctors a holistic view of patient health.
• Improved efficiency. A health system that automatically captures every medical observation and procedure in a patient’s care will be far more efficient and less error prone.
• Better outcomes. Comprehensive digital records will give health practitioners a massive database with which to analyzing effective treatments for individual patients and patient populations.
• Automated billing and insurance. IoT solutions will automate the notoriously difficult task of capturing medical services on a granular level for insurance and billing purposes.
• Cost/benefit analysis. And they’ll give medical providers and insurers a ready means for assessing healthcare costs versus results.

How close are we?

In the U.S., the Office of the National Coordinator for Health Information Technology (ONC) is spearheading efforts toward enabling connected healthcare. Its goal: to achieve a “nationwide learning health system” by 2024. Getting there will require government and private enterprise to work together with a shared purpose. Whether we can muster the collective will to bring all the pieces of connected healthcare together remains to be seen. But too much is at stake to leave the puzzle unsolved and let the opportunity slip away.

About the Author

Brendan O’Brien, co-founder and chief innovation officer of Aria Systems, introduced cloud billing and innovated database-driven, enterprise-grade Web applications — before the concept of “cloud” was even on the horizon. His company Aria, the number-one ranked cloud-billing provider, is at the forefront of the recurring revenue revolution, empowering enterprises to monetize IoT, secure predictive revenue streams while improving business processes and grow recurring revenue at scale.

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