According to the CSIRO’s definition, the IoT connects networks of sensors, actuators and smart objects with physical 'things' in a way that makes them intelligent, programmable and more capable of interacting with humans and each other.
For example, many of us now take it for granted that wristbands can sense what our bodies are doing and transmit that information to a smartphone or tablet – and David Hansen, Chief Executive Officer of the Australian E-Health Research Centre (AEHRC), CSIRO Health and Biosecurity, says use of these technologies is on the rise.
“We’re seeing a real increase in people using measuring devices to monitor their own health and physiological signals,” Hansen says.
There will also be in-body sensors which use IoT protocols to monitor and transmit information such as blood glucose levels, he says. Some will be capable of releasing medications into the body as they’re required. And, in the background, our everyday activity could be monitored by a network of sensors in the home.
“IoT sensors are capable of collecting information continuously over long periods of time,” he explains. “This provides medical professionals with a much more complete picture of patient health and behaviour than measurements taken on sporadic visits to the GP or hospital.”
Regular and longer monitoring and feedback could help GPs to pick up a problem before it develops into a medical emergency. It could also cut down the number of times patients need to visit a GP clinic, particularly for unplanned consultations, which would make it easier for doctors to plan and control their schedule and run their practices more efficiently. GPs and their teams could also spend less time performing routine tasks such as checking weight and blood pressure.
Hansen points out that, in the United States, many patients now Skype their GP instead of visiting the surgery in person. If they wear a smart device such as a Fitbit, they can transmit information for discussion during the consultation.
“That’s not common in Australia yet but I think it soon will be,” he says.
Smarter Safer Homes
For a number of years, the AEHRC has been developing a low-cost and non-invasive sensor, monitoring and support system known as Smarter Safer Homes. The system includes sensors that can track both the physical environment and human activity along with health monitoring equipment and video conferencing technology.
“We can capture information such as how much sleep a person is getting and how much they move during the day,” says Hansen.
“We then try to extract a measure called Activities of Daily Living, a tool used to determine someone’s functional independence – how well are they able to look after themselves at home alone. So far we’ve run four trials to assess the technology and the value it can provide for older people and people with disabilities or chronic diseases.”
An iPad application feeds information to the user. Says Hansen: “To develop the technology we held a number of workshops with people who were taking part in the trial. They helped us design the application so that it’s easy to use and provides the information they want.”
A clinical portal then enables users to share information with their medical support team.
“This is where the opportunity lies for doctors to engage with patients in their own homes to improve their health, wellbeing and quality of life,” says Hansen.
The challenges of new technology
As with any system that collects and stores personal information, data security and privacy are serious concerns.
“We manage the privacy issue by giving participants full control of their personal information,” says Hansen. “We put all the data into their hands and it’s entirely up to them how much they share with their doctors or family members.”
“While there are clear regulations around medical devices and the software on those devices, regulations for mobile health and IoT applications are still being developed,” says Hansen. “One of the big questions is where decision-making should happen. For example, if a patient is wearing a device capable of releasing medication, should the dose and timing be programmed into the device or should information be sent back to a clinician who can then makes those decisions?”
Preparing for change
Hansen suggests that doctors discuss emerging technologies with their patients.
“People should be thinking about information that would help their doctors provide care and how they could supply that,” he says.
He also recommends GPs take an interest in what other clinicians are doing, in Australia and around the world.
“There are some very interesting service and engagement models being developed,” he says. “It’s much easier to take advantage of opportunities when you’re prepared for what’s ahead rather than trying to catch up when the changes have already happened.”