Your thermostat has an app. So does your doorbell. Your refrigerator can show you a digital display of what’s inside, while pulling up your favorite recipes using those items. There are even dog collars with built-in GPS trackers. The Internet of Things (IoT) reaches deep into a wide span of everyday products. In fact, there’s little, if anything, that doesn’t boast an internet-enabled version. The ability to connect through the internet has even expanded to cover health and wellness. The Internet of Medical Things (IoMT), as you might expect, presents a mixture of pros and cons.

What Is It?

The IoMT bridges computer technology with health IT applications and medical devices. In layman’s terms, this is your Apple Watch doubling as a heart rate monitor. It’s your mobile phone interacting with your glucose monitor. It’s the medical devices that allow your healthcare practitioner to monitor you from home. It also extends to devices that are based in clinical settings, which can span from patient monitoring systems to recordkeeping. These are just some of the examples of IoMT devices in use today.

Challenges of IoMT

As with any new technology, IoMT presents a series of challenges that we must overcome. Let’s be clear: These challenges are not insurmountable, nor do they outweigh the benefits we’ll discuss shortly. These are weakness, however, that product developers are going to have to improve before widespread medical use is realized.

To begin with, the lack of interoperability is a factor. With devices operating within proprietary structures, the ability to share information between patient and provider(s) is limited. Heart health data collected on your wearables should be able to be downloaded to the EHR system your doctor’s office uses. The post-surgical data your specialists are tracking via remote monitoring should be easily connected to your primary care physician’s records. Today, a lack of standards impedes this cross-connectivity. A move to a new set of standards that allows interoperability will improve this.

Connected devices are inherently a cybersecurity risk. Until device makers focus on this and make mitigating the risk of data breeches a priority, IoMT adoption may be hindered. This category goes beyond the fitness tracker on your wrist. Connected devices include pacemakers, implanted defibrillators, and insulin pumps, as well as hospital-based equipment. With these devices, cybersecurity becomes a matter of patient safety. Similarly, the same issues with insecure remote access that cause some to pause over security concerns, can present challenges to HIPAA, as well.

Strengths of IoMT

The benefits of IoMT make the efforts to overcome or mitigate the above-mentioned challenges worth pursuing. Devices that track our vitals, monitor various health and wellness markers, and even remind us to stick to our prescribed medications can improve patient experiences and outcomes while simultaneously keeping costs in check. For example, the combination of an aging baby boomer generation and a shortage of healthcare providers can stress our already taxed healthcare system. IoMT devices are a natural fit for telehealth solutions that increase access by circumventing geographic barriers to care.

Goldman Sachs estimates IoMT devices will reduce healthcare costs by $300 billion. Being able to effectively remote-monitor decreases hospital admissions. Reduced cost of care is a natural byproduct of this. In addition, the function of hospital-based connected devices can be more effectively monitored, which can help reduce downtime and the costs associated with it. IoMT devices, as previously noted, can improve patient adherence, which has a positive impact on overall healthcare costs.

Further, with interoperability challenges resolved, IoMT would give providers access to more accurate data than traditional patient reporting methods in use today. Did you complete your prescribed physical therapy exercises today? Did you complete each exercise properly? IoMT devices can collect precise data to answer these questions, helping physicians track patient adherence, and amend the course of treatment as needed.

Of course, as the technology evolves, the benefits and the challenges of IoMT will evolve as well. What we do know is this: The IoMT will play a key role in the future of healthcare, and the more time, energy, and resources we devote to this category of technology, the more benefits we will achieve.

In 1974, Star Trek’s animated series introduced its audience to the holodeck, a bit of futuristic technology that would eventually appear in multiple iterations of the science fiction classic from television programs to the big screen. This recreation room was designed to create simulated, alternative versions of reality. In this simulated world, crew members could engage with their virtual environment as if it was the real world. Sound familiar?

Today, you don’t need a full deck on a spaceship to experience an alternate reality. We have virtual reality headsets and augmented reality apps that run off our mobile phones. While there’s certainly a home for these applications as an entertainment medium, we are increasingly seeing the strength of extended reality (XR) as a health and wellness tool that can improve patient outcomes.

What’s XR?

Before we can explore how this technology can improve quality of care, and thereby improve outcomes, we need to define the category. Extended reality is the umbrella term that encompasses all real and virtual combined environments. It includes:

• Virtual Reality (VR) – full immersion in a digital environment.
• Augmented Reality (AR) – overlays virtual objects on the real-world environment.
• Mixed Reality (MR) – anchors virtual objects in the real world. Objects here are not just overlaid into the real world–the real world can interact with these virtual objects.

Improving Quality Through Training

According to the Association of American Medical Colleges, a traditional med school curriculum combines two years of pre-clinical science training – where students learn basic medical concepts – with two additional years of clinical study. In these clinical study years, students are given hands-on experience with patients.  Extended reality technologies add a new twist to this educational model. Virtual simulations of real-life medical scenarios allow students to make medical decisions in a safe environment before they engage with actual patients. Today’s technology isn’t a replacement for real-life clinical rounds, but it can be a good supplemental component that gives students an opportunity to prepare for direct patient engagement.

Improving Quality through Surgical Walk-Throughs

Imagine if your physician could walk through your surgery before you slip into a hospital gown the day of your procedure. Facilities like Stanford Medicine are using virtual reality to change the way physicians prepare for surgery. Stanford’s Neurosurgical Simulation and Virtual Reality Center feeds conventional MRI and/or CT scans into VR technology, which allows their physicians to see the brain in 3D and walk through complex procedures via a simulated surgery. This process can help mitigate any unexpected challenges the surgery may present.

Improving Quality through Surgery Guided by Extended Reality

In 2017, a team of researchers conducted a proof-of-concept study to explore the potential benefits of using augmented reality to superimpose digital images on top of the visual field during surgical procedures. In December of that year, a surgeon used an MR headset to access patient medical data and data of the operative technique during a procedure to implant a prosthesis into an 80-year-old patient.  The surgeon was also able to share his field of vision with four additional surgeons via Skype, which would allow collaborative input during the procedure. The study’s authors concluded that, “surgical practice and education can derive significant benefits from the implementation of AR and MR tools in daily practice.”

Improving Quality Using Extended Reality as Treatment

A number of studies have looked at virtual reality’s value as a treatment for psychiatric disorders and pain management. Through the course of these studies, virtual reality has proven to be an effective tool, particularly, as noted in a systematic literature review published in Harvard Review of Psychiatry in 2017, “with the most strength of evidence for use in exposure therapy for patients with anxiety disorders, cue exposure therapy for patients with substance use disorders, and distraction for patients with acute pain requiring painful procedures.”

Looking to the Future

As with any medical technology, extended reality’s value lies in its application as a tool. Effective use, for example, in medical training lies in recognizing that virtual experiences don’t replace real-life patient interaction. Simulated experiences offer supplementary practice, not substitution. Applications that tap into extended reality’s strength in pre-surgical planning, pain-management, or psychiatric treatment require thorough physician training prior to use. Like any other medical tool, medical personnel must be trained on how to appropriately utilize the technology for the benefit of the patient.