Healthcare IoT Q&A with Elmar Bouma, NFIA

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This interview is a follow up to NFIA’s previous article on healthcare IoT.

Elmar Bouma - Executive Director-SEA, NFIA
Elmar Bouma – Executive Director-SEA, NFIA

IoT is definitely making a huge impact on healthcare today and is here to stay in the future. However, there are so many digital health apps now on the market. How do users make the most of it?

My advice is to rely on apps from credible software providers. Well-known companies with a trustworthy reputation, both larger multinationals with their own comprehensive, all-encompassing cloud platform, as well as emerging medium-sized companies have systems protected by top-notch security standards to give peace of mind to those with data concerns. They also have access to a much greater ecosystem of existing users’ information to provide more accurate results based on everyone else’s aggregated data.

Wearables existing in the market come integrated with their own native health app and that is usually the safest bet. Such applications are designed by companies to work flawlessly with their own device and draw as much useful information as possible. Philips’ HealthSuite platform, for example, seamlessly compiles all information provided by their integrated medical grade devices including a health watch, blood pressure monitor, body analysis scale, and thermometer for a more holistic view of the user. If the patient has a regular GP or specialist they visit for routine checkups or chronic disease monitoring, it is also advisable to allow them access to data collected by fitness trackers for continuous remote monitoring by a professional or for when patients are unable to interpret the information themselves.

How is IoT going to revolutionize the medical record/public health system?

The good news is patients will not have to answer the same questions about their symptoms or take the same tests repeatedly when visiting multiple healthcare facilities for a single illness. Primary health providers now have the ability to log patient information into a cloud system for easy access by any specialist the patient is referred to. The moment a patient discloses his name at the front desk, the doctor will have a full record of his medical, family, and treatment history, and will be able to share his diagnosis and treatment quickly. Furthermore, medical records won’t be limited to only what previous physicians have collected, but also includes any information available from the patient’s own vital sign trackers for a truly longitudinal, in-depth perspective.

The Netherlands has taken strides in revolutionizing its entire healthcare system. Back in 2014, the Dutch government set specific targets to be achieved in five years for the healthcare sector. These goals will allow the public unlimited online access to their health data to remotely monitor their own health. Those receiving treatments for chronic conditions at home will have 24/7 access to remote consultations from physicians as well. This requires a culture change in the relationship between patient and practitioner, where the patient takes control over his or her own treatment.

Wearables provide the advantage to monitor one’s health and identify risks instead of going through medical examination when you experience any symptom. In the Netherlands, currently several innovative companies are active in this field – offering IT information systems, multiple telehealth and eHealth applications to empower and enable patients in terms of self-management and providing care at distance.

Remote Patient Monitoring
Remote Patient Monitoring

What are the disadvantages of remote patient monitoring?

Remote patient monitoring will always bring up certain ethical questions related to privacy. Elderly persons, for example, who may not have consented to being monitored themselves may unwillingly be subjected to the procedure anyway as it has been “greenlit” by a well-wishing family member or a health proxy. The issue with user-friendliness also crop up. Users must be able to understand how the technology or system works and make sense of the information that is being presented to them – as in what oxygen levels are normal and what aren’t, and what action to take. Even worse, systems tend to break down, and this can result in downtime, and patients having to replace or repair the device.

Cyber security is another pressing concern when talking about internet-connected technology. Health data can be abused by antagonists wishing to profit off of it. But now a more closeted problem has been niggling at professionals’ minds. Instead of information being misused, what happens if the data isn’t used at all due to its superfluous, unstructured nature, exacerbated by the lack of universality between monitoring system providers? The latter is a conundrum that must be solved before we can begin to tackle cyber breaches.

Philips' devices help patients to measure and monitor their health.
Philips’ devices help patients to measure and monitor their health.

There is a lot of buzz about health issues and implications of wearable technology; any thoughts on this?

Once again most of the concerns surrounding wearable technology deal with users’ safety, privacy, and their reluctance to accept unfamiliar technology. The fact that many invasive and implanted devices on the market aren’t covered by the Health Insurance Portability and Accountability Act (HIPAA) and aren’t FDA approved may make consumers believe the entire market is highly unregulated when that is, in fact, completely untrue.

Companies are constantly making breakthroughs in diagnostic wearable devices with the aim of moving towards safer and more user-friendly standards but that are still providing all the data users would expect. The growing demand for early diagnosis and preventive medicine will continue to push the growth for wearable medical devices. Such devices have evolved from mere step trackers into the realm of neuromonitoring devices, biosensing cloths and glucometers, all while being perfectly noninvasive and autonomous.

A recent survey done by PwC revealed three out of four people would be perfectly open to sharing information collected by wearables with their caregivers and insurance providers if it will benefit their wellbeing. Health was found as the number one reason for purchasing a fitness wearable to begin with and they surprisingly found that the respondents claimed cost as the biggest barrier to adopting wearables as they were concerned whether they would eve use it. Privacy concerns have decreased year on year and, while consumer confidence in sharing data with product providers may have stagnated, they have become more open to transferring said information to doctors.

I believe it is safe to say that wearables will pose more beneficial than harmful, at least for the foreseeable future. The technology has gone as far as to anticipate heart attacks before they occur like Philips’ IntelliVue Guardian monitoring system has demonstrated. It is no wonder they have the reputation for making 40% of the world’s patient monitors. As the world’s first country with a nationwide Internet of Things network, the Dutch are keen on easing wearables as smoothly as possible into the adopters’ lives to maintain their excellent health reputation.

Overall, where do you think the future of healthcare stands? Will there be no need for doctors and nurses, say, in about 30-40 years’ time?

The boom in both demand and supply for health monitoring technology will no doubt lead to economies of scale and make IoT-enabled tech more easily attainable for the majority of the public. A priority for health solution manufacturers would be total interoperability between devices from different providers to prevent caregivers from having to consolidate information from multiple sources that are often duplicated and in differing formats. It is also a healthcare staff’s responsibility to familiarize themselves with the novel technology in order access the full potential of these devices and make the data collected actionable.

2018 is the year set for the EU’s General Data Protection Regulation implementation aimed at putting in place better protection rules to strengthen its citizens’ rights to control how their personal data is being handled and used online. Keeping in mind the end of goal of allowing information to be collected for digital health purposes, these protocols represent the first step to bridging the gap of trust consumers have towards device manufacturers. The Netherlands’ Dutch Personal Data Authority (PDA) recently reprimanded employers wrongfully processing their employees’ sensitive health data in an act of reassurance towards workers that employers possess virtually no legal ground in using their information.

To answer the second part, artificial intelligence and computers are becoming increasingly useful in taking over primary healthcare services such as diagnostics and health screening, but there is still much to improve before they can perform physical tasks demanded of healthcare providers, from something as simple as intubating a patient to something as incredibly complicated as unassisted surgery.

Even with all the recent advancements, computers still do not have the same accuracy rates as humans. Take an example from the International Symposium for Biomedical Imaging where an AI was tasked to identify signs of breast cancer in lymph node images. Pathologists’ historical accuracy rating for manual detection has been clocked at around 96% in such tasks while the computer managed to reach a close 92%. The truly amazing thing was when the AI and pathologists’ abilities were amalgamated. Their combined accuracy rate skyrocketed to a near perfect 99.5%.

Humans and machines are meant to function in a perfect partnership, feeding off each other and thereby improving their offerings in a way they can never manage individually.

For more information on IoT innovations in healthcare or investment opportunities in the Netherlands, contact: Mr Elmar Bouma, Executive Director-SEA, the Netherlands Foreign Investment Agency (NFIA), Tel: +65 6739 1135, Email: bouma@nfia-singapore.com or Ms Adeline Tan, Country Manager, Tel: +65 6739 1137, Email: tan@nfia-singapore.com or visit www.investinholland.com.

 

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Scientist-entrepreneur-manager-journalist: -Co-founder, Author; Former Assistant Editor and Director, Biotechin.Asia, Biotech Media Pte. Ltd.; -Founder & CEO, SciGlo (www.sciglo.com); -Programme Management Officer, SBIC, A*STAR (former Research Fellow). --Sandhya graduated from University of Madras, India (B.Sc Microbiology and M.Sc Biotechnology) and received her Ph.D from the Nanyang Technological University, Singapore. She worked on oxidative stress in skin, skeletal, adipose tissue and cardiac muscle for a decade from 2006-2016. She is currently working as a Programme Management Officer handling projects and grants at Singapore Bioimaging Consortium (SBIC), Agency for Science, Technology and Research (A*STAR). Earlier to this she was a Research Fellow in the Fat Metabolism and Stem Cell Group at SBIC. Sandhya was also the Vice President and Publicity Chair of A*PECSS (A*STAR Post Doc Society) (2014-2016). Recently she founded a platform for scientists - SciGlo (www.sciglo.com) and is a startup mentor at Vertical VC (Finland). She is an ardent lover of science and enjoys globe trotting and good vegetarian food.