The concepts behind the phrase “internet of things” (IoT) has been around for ten years among information and communication (ICT) professionals.  Put very simply it is about assigning any tool, device, machine or building — things — a unique electronic identifier so that these can be connected to electronic networks such the Internet or the telephone system.  

Being able to monitor air conditioning performance in a building from another location or from your smartphone is an example of how IoT may work. IoT has the potential to radically change health system productivity.  All smartphones and tablets, for example, have an Internet Protocol (IP) address enabling doctors and nurses to exchange administrative, health and patient information.  Examples from other sectors include smart grid for optimising energy consumption at home and the emergence of intelligent vehicles.  Cisco Systems Inc. predicts that by 2020, 50 billion devices will be connected to the Internet and this will generate huge volumes of data.

The more data that is created, the more knowledge people can derive.  IoT dramatically increases the amount of data available for people to process.  Data analytics and Big Data are currently emerging as two of the main ways to handle such huge volumes.  So focusing on the health system and health care delivery the implications of IoT include the following:

• Small wearable device worn by all nursing home residents across the country to monitor heart rate and falls, sending alerts to local nurses automatically via the Internet;
• Attaching Internet enabled location sensors to IV pumps and burns mattresses can reduce losses, nurse search time and patient stress;
• Within a large hospital, equipping all clinicians with smart tablets enable the exchange of patient information, medical images, clinician location details and general staff messaging.  Each device has a unique IP address and is connected to the hospitals intranet.  Queensland Health, Cleveland Health and many private hospitals have demonstrated productivity increases based on IoT;
• To reduce emergency room congestion and patient waiting times smart connected technologies have the potential to re-route patients to more appropriate services (such as the community nurse service) and to optimise staff resources based on historic patterns and current observations; and
• Whether data comes from fetal monitors, electrocardiograms, temperature monitors or blood glucose levels, tracking information is vital for some patients. Many of these measures require follow-up interaction with a healthcare professional. This creates an opening for smarter devices to deliver more valuable data, lessening the need for direct patient-physician interaction.

As data volumes increase issues associated with security, patient privacy and government regulation come to the fore.  It is inevitable that IoT will be adopted across all industries including health in much the same way as the telephone replaced message runners and letters – requiring both organisational and technological change.  Personally, I suspect that the most significant health care deployment focus areas for IoT in the near term will be for nurse equipment and work flow management; and in the management of medications across an entire hospital.

About Michael Gill

Most health care does not happen in the acute sector. Chronic disease management is handled poorly by both acute and primary sectors across global health jurisdictions.

Patient centricity is a myth and needs to be addressed by both patients and clinicians. Health care is not only about illness but also wellness. Care management is about matching and aligning these vectors to support a patient to their stated requirements and within their ability to cope.

Michael has 30 years management consulting experience across many industry sectors including the health and government sectors. He has chaired a number of telehealth national conferences and is currently a board member of the Health Informatics Society of Australia. He is also deputy chair of the Australian National Consultative Committee on Health. Michael was formerly the director of healthcare Internet strategies for Cisco Systems and has worked in the health systems of Australia, India, Singapore, Hong Kong and New Zealand.

In recent years Michael has developed severe rheumatoid disease and has journeyed extensively across the Australian health system as a patient. This frustrating experience coupled to his knowledge of Internet technologies has provided the impetus to establish Dragon Claw (www.dragon-claw.org). The concept behind Dragon Claw is radical in that it promotes patient centric self-care and attempts to provide coordinated care management.

It does not provide medical advice. Michael holds a degree in Statistics and Sociology and postgraduate studies from the Australian National University.