Broadly defined as the creation, management and communication of health information using mobile and wireless devices, connected health is an important part of a general trend to make healthcare patient-centric. Historically, caregiving has often meant physical movement of patients from one caregiving office or establishment to another. Connected health turns this situation around by bringing healthcare to the patients instead. Healthcare organizations also see an advantage in reducing the need for caregivers to travel to see patients, which can be time-consuming and inefficient. Healthcare delivered and managed remotely, meaning connected health, therefore has advantages for all, but also some risks.
Meeting IoT Requirements
Remote healthcare devices and sensors are part of the Internet of Things (IoT). Whether the patient uses a specialized medical instrument or a smartphone running a healthcare application, IoT requirements apply:
- Functionality. The devices and sensors local to the patient must function properly, whether network connections are available or not. This includes suitable aggregation and local storage of information collected about the patient’s state of health, before uploading to a healthcare provider.
- Maintenance/Upgrades. Remote maintenance and upgrades for the devices must be easy, reliable and avoid any need for action by the patient.
- Security. Information must be transmitted securely to and from the devices. Interference or attacks on devices, especially those with a direct action on the patient’s state, could have serious health consequences.
Utilizing Existing Mobile Devices
When the platform is properly in place, meeting the conditions above, the opportunities to provide better, cheaper healthcare are numerous:
- Apps running on mobile devices such as smartphones and tablets can be made user-friendly and easy for patients to operate.
- Alerts, schedules and information can be generated and acted on locally and remotely.
- Connected health can also work in conjunction with other healthcare IT components, notably electronic health record (EHR) management systems.
Current-generation mobile computing devices (smartphones, tablets) have ample processor and memory resources for this. To boost networking capabilities, the Healthcare Connect Fund administered by the Federal Communications Commission (FCC) makes up to $400 million available annually from the Universal Service Fund for the support of high-capacity, broadband services to bring the benefits of remote healthcare to areas with the most important needs. It is still to be seen if these types of services will survive the expected budget cuts over the next few years.
The Role of IT Teams
IT teams will need to manage four categories of connected health applications:
- Synchronous applications, for example live video interactions with a remote patient.
- Asynchronous applications, such as email and messaging applications to make information available via store-and-forward functionality.
- Remote patient monitoring (RPM), using personal health and medical data collected from a patient, for processing local to the patient or for upload for processing at an agency or provider location.
- Mobile health (mHealth) using mobile communication devices, for example to download information or broadcast messages ranging from healthy living recommendations to disease outbreak alerts.
Blueprints for Connected Health Platforms
Healthcare systems for different agencies and providers have grown independently and heterogeneously. Connected health IT frameworks will therefore need to integrate hardware and software from multiple vendors. IT organizations will also have to manage the difference between the rapid rate of change of technology, and the slower pace of clinical research and tests for improved remote healthcare. Initial technology specifications at the device and system level may be out of date by the time clinical approaches have been approved.
For these reasons, IT frameworks for connected health will likely be platform-agnostic, using robust information exchange standards. In this way, they will absorb different rates of technological and clinical evolution without being dependent on them. This will be a condition for connected health implementations to scale properly from pilots for proof of concept to the management of many thousands of patients.