A lot of changes have occurred in the health care industry as a result of the emergence of new innovations. A big increase has been realized in the number of patients who visit health facilities on a daily basis to seek medical attention. Medical practitioners are expected to provide the best possible health care by use of innovative means so as to achieve the objective of improving the health conditions of patients (Gibbs, 2007). However, the new trend has led to a particular concern since the number of patients is not proportional to that of the available health practitioners. Therefore, several measures have been taken to boost the efficiency of service delivery in the health sector in response to the current demands. Among the improvements in the adoption of innovative ways of communication that facilitate the occurrence of easy, timely, and effective communication among health practitioners and between them and their patients. In the process, networking and medical device connectivity have gained popularity over years. Today, it is understood as a viable initiative that is targeted at cutting costs of providing health care, responding to an increase in the number of patients with respect to the relatively low number of health care providers, improving the quality of care that is provided to patients by enabling adoption of new care models and empowering patients so that they can be active participants in their own care plans. As with all other industries, effective communication is essential in health care as it enables timely dissemination of vital information that can be used to save human life (Gibbs, 2007).
The information age is slowly making paper documentation irrelevant due to the challenges that are associated with the use of paper and manual filing systems in record keeping. The deviation from the norm is evident in health care where patients’ health records, drug information, and other vital information are kept in an electronic format for ease of retrieval and to enable concurrent access by authorized persons. It is notwithstanding concerns about security demands on the manner in which patient’s health records should be handled. Networking and medical device connectivity has taken care of all ethical issues and legal requirements of information dissemination within the industry. However, Gibbs (2007) suggests that it is necessary to understand that despite the milestones that have been made as a result of networking and medical device connectivity, there are a number of challenges that are associated with the new innovation. This discussion focuses on networking and medical device connectivity with a view to give a clear understanding of the applications of medical device connectivity, its importance, the networking structure, and how the Internet of Things (IoT) has caused a great transformation to medical devices (Gibbs, 2007).
The federal stimulus for Electronic Health Records (EHRs) and Electronic Medical Records (EMRs) has given rise to various concerns on the in availability of proper connectivity when it comes to medical devices. It has also resulted to an increased demand for information pertaining to particular requirements for implementation of some vital applications that are believed to be capable of benefitting from data communications networking across medical equipment (Gibbs, 2007). Among the main applications of medical device connectivity are in the lab environment, IUC beds, patient rooms, anesthesiology, lab environment, mobile cart and home monitoring. By looking at these applications, it will be clear that networking and medical device connectivity has played a significant role in boosting health care provision besides reducing the bulk of work for health practitioners who have an overwhelming pressure to provide quality health care for all.
Medical Device Connectivity Defined
According to Gibbs (2007), medical device connectivity involves the process of having medical data onto a type of network to facilitate the record’s integration with some EMR system. The process of sending the record onto a network is achievable through two means, by use of a built-in network port available on the device or using an adapter. There is a lot of security protection for medical records and devices. The devices have a long product life cycle and due to security concerns, it is always difficult to make any changes to the devices as such may only be done after getting approval from the U.S Federal Drug Administration (FDA). Technological developments have presented an opportunity for healthcare organizations to adjust to the increasing pressure that requires them to improve the quality of health care while also ensuring that the patient’s safety is not compromised (Biswas & Martin, 2011).
Apart from the desperate need to reduce costs, networking and medical device connectivity is a move towards the right direction as it applies the use of technology to facilitate creation of an integrated system of care that is effective in connecting patients, clinicians, support organizations and all key stakeholders in the health care industry so that they can effectively change information. With regards to information dissemination, a lot of care is taken to ensure that the health care industry’s specific framework that should be met with regards to security requirements, availability, productivity, interoperability and flexibility are achieved. The Cisco Medical-Grade Network (MGN) has enabled realization of networking and medical device connectivity while taking the necessary precaution to avoid violation of the health industry’s specific needs (Irvine, n.d).
Most of the infrastructural elements processes and off-the-shelf technologies that are used in other industries are also applicable in health information technology (IT). However, there is a difference in the sense that health care networks are used in the transmission of information that is highly sensitive and that is protected by industry-specific regulations as set by the U.S Health Insurance Portability and Accountability Act (HIPAA). The level of complexity, device diversity and the number of network-connected devices that constitute the infrastructure often make health susceptible to several security and privacy risks than that which is observed in other Information technology networks. There are a number of converging trends that are currently making networking in the health care industry become a great risk. The trends include the increased volumes and sophistication of malware that increase the possibility of occurrence of a malware attack on and damage of health records (Irvine, n.d).
There is also an increase in medical devices that mainly incorporate off-the-shelf hardware and software; hence, making them more vulnerable to malware, hacking, and theft of data. Besides, there are new government incentives and requirements to have patients’ information electronically shared and which are aligned with severe penalties in case of any loss, diversion, or exposure. The great concern that is shown by the government over the need to protect patient’s health records is due to the level of privacy of such records and the need to ensure that patient’s health records are privately handled. As such, networking and medical device connectivity should not be perceived as an overly simple undertaking as with other information technology applications in other fields (Irvine, n.d).
Applications of Medical Device Connectivity
The application of medical device connectivity can be looked at in their order of acuity. High acute or critical health care environments call for real-time and simultaneous monitoring of a lot of data and being keen to observe every detail of such data. It means that the need for networking and medical device connectivity is highest in high acute environments and it reduces with a reduction in the urgency and complexity of the health care environments (Gibbs, 2007).
The highest application of medical device connectivity is observed in the operating room or anesthesiology. In this environment, there is a typical application of several monitoring and life-sustaining devices that are used concurrently to help clinicians save the lives of patients who are in critical conditions. The information that is derived from the devices is subjected to professional analysis and interpreted and used to offer the necessary attention to patients who are in the acute care units (Gibbs, 2007). The Operating room is an atypical example of a situation where medical device connectivity has helped to improve health care. Without the use of such innovation, it would be difficult to understand the health condition of patients in the operating room and to provide viable responses that can help save their lives. The operating room is also a harsh environment for the medical equipment that are used due to their exposure to saline solutions and other fluids. Therefore, the environment calls for the application of a properly-sealed network connectivity unit that offers between eight and sixteen ports so as to have all the medical equipment used in the operating room. The environment typically uses a wired network application as initiatives are made to change the situation to adopt the application of wireless networks as new medical devices are launched in the advent of new technologies (Gibbs, 2007).
The Intensive Care Unit (ICU) bed is the second acute environment which has almost similar requirements as the operating room or anesthesiology. Most of the equipment that is used in the environment are stationery; hence, it calls for the application of a wired network or wireless network provided that the network has a wired unit with between 8 and 16 ports. As is the case with the operating room, the ICU is an environment where clinicians rely heavily on a critical examination of patient’s medical data so that they can effectively provide care to save their patient’s lives.
The patients’ room is a lower acuity environment in comparison to the Intensive Care Unit. The environment often has fewer monitoring devices based on the understanding that patients in the room are out of danger and that they are on their way to recovery. The connectivity in the patient’s rooms can either be wired or wireless provided that the port density of four to eight ports is achieved (Gibbs, 2007).
In hospitals, the connectivity requirements for labs are less critical in comparison to those of various patient areas (Gibbs, 2007). The devices that are found in lab environments are typically similar in all organizations. Connectivity for lab environments is often done by the use of single or dual-port devices with either a wired or wireless connection. After configuring the basic connection settings, the devices that are used in the lab environments do not require special drivers.
Mobile carts are applicable in all hospital environments like the patient’s rooms, emergency rooms, and lab environments. They are used by health practitioners in conducting the necessary tests with typical devices including portable heart monitors and glucose monitors among others. One characteristic of the devices is that they are mainly on the move hence they call for wireless connection. Power connection is at times a vital consideration because some of the devices are battery-powered. The devices should also be network-enabled to facilitate asset tracking so that they can be easily located within the health care facility.
The use of mobile carts has been improvised across health care facilities environment right from the rooms where patients stay, the labs where they are tested, as well as the emergency rooms where they receive treatment. Typically, the devices may entail those that help monitor glucose levels as well as those that monitor the heart but can be moved around. The devices have to be connected through a wireless means to the network because the patients have to move with them. There are cases where batteries are used to power them. Through the devices, the network can also help track assets as a way of helping in locating them within the health care facility.
Home monitoring is also referred to as remote patient monitoring. It has a subset of applications that require the varied frequency of data delivery and it is regarded as one of the fastest-growing applications of medical device connectivity. Home monitoring is regarded as a segment that is fastest in growth in the networking sector. The devices that are used for home monitoring should be of low cost and easy to connect so that patients can easily connect them without the need for special skills. There is an increasing interest in home monitoring due to the need to free hospital space by allowing relatively stable patients to use home monitoring devices to monitor their improvements at home while sending information to their clinicians either by means of a cellular connection or via the patient’s home network connection.
With the use of the devices, patients play a vital role in their health care as they are responsible for monitoring their own progress while at home. In case any worrying signs are noticed, the patients can be invited for a consultative session with a doctor or they can be readmitted for closer attention. Home monitoring devices are highly helpful in responding to the increase in the number of patients. It helps to free hospital space to accommodate patients that need close monitoring as those that are on their way to recovery are given room to recover from home. It is also believed that overstaying in hospital beds has the risk of making patients acquire other ailments hence there is a belief that patients who are on their way to recovery should be allowed to recover from home.
Key Benefits of Applications of Medical Device Connectivity
There are a number of benefits that are associated with the application of medical device connectivity. The benefits are as discussed below.
Greater Efficiency and Accuracy
There is a lot of concern about the frequency of occurrence of medication errors. The number of patients that nurses have to handle on any given day is increasing hence pilling a lot of pressure on nurses. It is because of the increased pressure that nurses often make errors when attending to patients (Gibbs, 2007). With the adoption of medical device connectivity, cases of medication errors are limited because the connectivity eliminates the need for nurses to manually log in to patients information in paper chart records before having them transferred into a computer. Medical device connectivity enables an automatic entry of patients’ medical records as such records are automatically uploaded to the patient’s electronic records hence eliminating human error. This advancement is important since accuracy is an issue of great interest in healthcare since a single mistake can have dire consequences on a patient. As such, the move to implement medical device connectivity is highly uploaded as a viable initiative that seeks to ensure accuracy and efficiency of health care processes (Lazakidou, 2016).
Clinicians are highly concerned about measures that can be taken to control costs. However, cost controlling measures should not be taken at the expense of the need to deliver quality health care. Virtually all stakeholders in the health care industry, employers, and governments are keen to ensure that the costs of health care are reduced because of the growing number of patients and the need to have all of them attended to satisfactorily. Similarly, health care is among the essential government services in which large amounts of government money is spent. It is because of the perception that having a healthy population is vital to any country’s development (Lazakidou, 2016).
The Centers for Medicare and Medicaid Services gave an estimate of the annual health expenditures of the United States as of May 2006 to be around $1.9 trillion and the cost is said to have risen to more than $2.4 trillion by 2015. As of 1965, the cost of health care accounted for 7.2 percent of the gross domestic product (GDP) and the figure rose steadily to 20 percent of the GDP with expectations that it will continue rising based on the observed trends due to increasing in the number of patients (Lazakidou, 2016).
There is a worldwide concern about the rise in health care costs and such increases are observed in the countries in the European Union and Canada. The Centers for Disease Control and Prevention suggests that the Unites States spends approximately 75 percent of its health care costs to attend to chronic conditions (Lazakidou, 2016).
. The United States has a high population of underinsured and uninsured patients. When such patients suffer acute conditions, they are unable to access quality health care on their own without the intervention of the government. The government has to put measures in place to provide routine preventive care to the low-class members of the society so that their exposure to acute condition is curbed. The cost of health care is also hiked by cases of unnecessary spending as evidenced by reports from the Annals of International Medicine that stated that about 30 percent of health care expenditures are unnecessary hence considered wasteful. The wasteful expenditures results from redundant testing, application of manual paperwork and unnecessary hospital admissions (Lazakidou, 2016).
Taking initiatives to eliminate the time that is spent on administrative duties is one way by which staff productivity can be improved. Therefore, medical device connectivity is one of the ways by which the health care industry can minimize cost of health care. It is because such connectivity helps to prevent unnecessary medical costs besides eliminating errors that result from manual entry of patients’ health records. When medical device connectivity is fully adopted by health facilities, governments are able to reduce their expenditure on health care and use the money to cater for other developmental needs as taxpayers also feel relieved from the burden of financing unnecessary health care costs. Medical device connectivity makes it possible for all patient’s records to be stored in a single electronic record. It makes billing be automated and highly streamlined so as to reduce medical costs and chances of occurrence of medical errors (Lazakidou, 2016).
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Effective Response to Rising Number of Patients
The increase in the number of patients in comparison to the number of health care providers is alarming. The U.S Census Bureau announced in 2006 that the U.S had released a population increase of more than 5 percent within five years and that the US population had gone above 300 million. The bureau gave a prediction that the population will continue growing and that by 2050; the U.S population is likely to reach 392 million that will be more than 50percent higher than the population in 1995 (Lazakidou, 2016).
A particular concern is raised by the report from the Journal of the American Medical Association that points to a steady decline in the number of medical school graduates from the US who chooses primary care as their preferred area of operation. The trends point to the actual strain that is experienced with regards to a shortage in the number of skilled staff that is worsened by the increase in the aging population.
The figures show that there is a great need for creation of innovative means by which health care providers can offer quality services to the growing number of patients. It is through medical device connectivity that the dream can be achieved. The application of medical connectivity enables health facilities to have a clear track record of all patients as they are stored in a database to facilitate the provision of quality care (Lazakidou, 2016).
Better Quality of Care by Use of a New Care Model
There is a lot of emphasis on outpatient and preventive care with an aim of improving the outcomes of health care. The application of collaborative technologies can help facilitate the new model as it is effective in creation of new synergies and boosting the efficiency of the new treatment modalities. The new model has patients empowered so that they can take a lot of responsibility in their health care. Patients need a network system that can facilitate dissemination of information and communication between them and their health care providers. The system can allow them to get a lot of information about their own health. The internet and other information sources provide patients with an opportunity to access a lot of information concerning available treatment protocols and the available alternatives. Information technology has also boosted transparency in communication between clinicians and patients. Improved transparency in patient-clinician interaction gives particular health care facilities a competitive advantage over other facilities (Lazakidou, 2016). It is because patients like associating with and getting medical care from providers with whom they can freely interact. Increased applicability of information technology in health care facilities has given patients an opportunity to demand for quality care as they can raise complaints or seek clarification through the internet and other available information sources.
Information sharing in the new care model is facilitated by the MGN. The network is applicable in health care as it facilitates sharing of accurate and reliable information across the healthcare delivery system. As such, the MGN network helps in boosting connectivity of the health ecosystem. Networking is also helpful in that it relieves the staff in health facilities from the need to input data manually in their computers. Automated patients data allows for timely response to alarms besides giving finer details of patients’ health records that make it easy for health care providers to provide quality care to patients (Lazakidou, 2016).
Networking and medical device connectivity also helps to secure patients’ records so that they are not accessed by unauthorized people. Networking provides an opportunity for medical records to be sent through encrypted connection where challenges associated with paper loss and access by unauthorized persons are curbed.
Challenges Faced in Medical Device Connectivity Integration
Despite the advantages that are associated with networking and medical device connectivity, there are a number of challenges that are experienced in the adoption of such innovations. As seen with the benefits of device integration, the challenges that are encountered in the attempt to integrate the products are similar across different applications. With respect to the respective health care environments, the high acute areas have more complex challenges compared to the low acuity areas.
The first challenge is associated with difficulties in connecting medical devices. Some of the medical devices call for professionalism in connection despite the fact that virtually all electronic medical devices have a port for data output. It is possible to find that each of the physical ports is different from the common connectors hence causing a lot of challenges in connections. The most commonly found ports are 9-pin male, 9-pin female, and 25-pin male among others. There are also some proprietary connections that are given by specific manufacturers. Apart from the challenges that are associated with the physical connection of the devices, there are at times other communication protocols and vital setting requirements like the recommended rate of data transmission, parity setting for checking errors, and baud rate among others. The recommendations must be adhered to so as to ensure effective functionality of the devices. The settings and characteristics may differ from one manufacturer to another but most of them share the same pin-out standards. The challenges seem daunting but they can easily be solved by following the step-by-step approach. In the categorical connection, one needs to start by selecting the connector type before determining the pinout. Manufacturers also facilitate connection through provision of a manual to guide in the connection process. After completing the laid down procedures as per the manuals, connectivity shall have been attained and it is possible to start conducting basic communication with the device.
The IEC 60601 Standard
In comparison to other equipment that is available in the market, medical devices have a lot of safety requirements attached to them and they are highly regulated. It is because the devices are used on human patients and there is a lot of value that is attached to human life. There is also a lot of interest in the essence of ensuring IEC 20601 compliance in the process of integrating medical devices (Aral & Alstyne, n.d). The IEC 60601 refers to an internationally harmonized safety standard that facilitates evaluation and designation of medical products to ensure compliance under one standard. The standard is applicable in many countries and it is used in the protection of the manufacturer’s declaration of conformity. The IEC 60601 serves to ensure that patients security is guaranteed. Compliance with the standard requires efforts to ensure that medical equipment are safe for use under normal and single fault conditions. The IEC standard has four different parts. The first two are the IEC 60601-1 which looks at all general requirements for electrical medical products and the IEC 60601-1-x collateral that addresses horizontal issues like EMC testing for a variety of medical devices. The other two are IEC 60601-2-x which looks at the requirements for a given type of medical device and IEC 60601-3-x which looks at the performance requirements for a particular type of device (Aral & Alstyne, n.d). International approval can be difficult to achieve and most countries have chosen to adopt the IEC 60601-1 as their national standard. However, it is important to note that every country has its own safety and regulatory agencies while some countries also have national standards (Aral & Alstyne, n.d).
The application of networking and medical device connectivity faces challenges that mainly relate to security and privacy threats. The IEC 60601 requirement for approval of medical device connectivity is a big integration issue that is mainly experienced in the operation room, the intensive care unit, and the patient’s rooms. Integration issues are comparatively flexible in the lab environment because IEC 60601 is not a requirement in the lab environment as there is no patient interaction. The devices that are used in the lab environment are also less complex in comparison to those that are found in the Intensive care unit and the operation room. As such, the medical devices that are found in the lab environment do not require special skills to connect (Aral & Alstyne, n.d).
There is the challenge of the cost that is experienced with lab equipment connectivity. The lab equipment is mostly connected to a computer and it can be challenging to have the connection. Organizations have chosen to check on the cost of connecting lab devices by use of a small external device server after which they equip the main server with a piece of software that is referred to as the serial port redirector. The software makes the computer feel that it is connected to the serial port by use of a serial connection while it is connected over the network. The connection enables the computer to use the software that is meant for direct connection and to communicate with several devices (Aral & Alstyne, n.d).
There are also challenges experienced with telemonitoring. Normally, telemonitoring is intended to achieve three basic requirements. It should be easily set up by the patient, send data reliably besides being easily configurable. However, a challenge is often experienced when connecting medical device to the telemonitoring interface. When the connection is physically done, patients dock the device to telemonitoring interface to enable downloading of data. The physical connection is highly cumbersome and it hardly gives room for seamless real-time monitoring (Mahmood, 2016). Patients also have several connection options for use in the connection from the telemonitoring device to the clinical information system. Among the possible options, the simplest entails the connection of the telemonitoring device to the telephones used by or accessible to patients at home. Although the connection is easy to do, it is mostly very slow and it mostly leads to infrequent updates that are mostly done late in the night when the telephone is not in use. Besides, the connection does not allow for real-time monitoring (Aral & Alstyne, n.d).
A patient’s home internet connection can also be either wired or wireless. Wired connection is done by having the telemonitoring device directly connected to a network port on the patient’s router (Househ et al., 2014). The connection gives room for two-way communication by the use of tools that facilitate access of devices behind a firewall. Safe connection calls for a technician to be dispatched to the site so as to have the patient’s wireless network professionally connected (Mahmood, 2016).
The last option is to have the connection done via a cellular phone. The method also allows for two-way communication and real-time monitoring as observed with a home internet connection. The challenge that is associated with the connection is high airtime cost and the requirement that the patient must be within the range of a cellular tower (Househ et al., 2014).
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Improving Health Care through Mobile Medical Devices and Sensors
There is a lot of concern about the disparities in health care access worldwide. The disparities are a result of the differences in people’s levels of income and the high cost of health care that makes it almost impossible for low-income earners to get quality health care. It is clear that without health cover, many people can hardly afford the cost of health care. Governments are making efforts to expand medical cover, but such efforts have not sufficiently met the desired goal. Measures have to be taken to improve access to health care so as to promote a healthy society. Mobile technology has been identified as one of the ways by which the challenges associated with access to health care can be solved or reduced (Mahmood, 2016). Mobile technology presents mobile health applications and sensors that are applicable to medical devices and remote patient monitoring products to increase access to health care. The devices are effective in maintaining a high level of patient-clinician interaction so as to facilitate timely response to danger signs. They help to lower costs of health care through the facilitation of the delivery of care as patients and health care providers get adequate access to reference materials, laboratory tests patients medical records by use of mobile devices (Househ et al., 2014).
The complex mobile health applications are applicable in many aspects of health care including in the management of chronic diseases, provision of training for health practitioners, and monitoring the indicators of critical health. By use of the mobile applications, other medical applications like prescription reminders, calorie counters, and physician locators are enabled (West, 2013). In addition, it is by the use of the applications that health care providers are in a position to give proactive response in addressing medical conditions. The applications help to solve the problem of unlimited health care access as they enable health care providers to address patient’s medical conditions irrespective of the location of the patient through near real-time monitoring and treatment.
West (2013) observed that the applications have proved to be viable as evidenced by the success realized when using them. For example, the iWander app that is applicable with Android devices is applicable for patients who are suffering from Alzheimer’s disease or dementia. The application uses the GPS function that is available in smart phones in tracking patient’s location. Whenever the patients travel out of the home or from other locations that are known, the application sends a signal to have the patient’s family members or his or her caregivers informed of such movements. This is an illustration of how the iWanderapp helps to monitor patients’ movement hence reducing their exposure to risk (West, 2013).
Patients are also helped to cope with some particular diseases by social media platforms. The application of social media services to respond to some health complications help to decongest emergency rooms as patients are empowered to take an active role in their health care. Diabetes-related complications are reported to be accounting for the highest cases of emergency room visits. Social media presents an opportunity for people to share their experiences with given health complications and to discuss the various ways that they used to cope up with such complications. By sharing their experiences, viewers are able to see the experiences of other patients and to learn how to cope with the various complications following the success records of other social media users with similar complications. Some of the applications are developed for the cloud but there is still a problem in the health care sector with regards to having different medical devices effectively connected (Househ et al., 2014). The obstacles are referred to as interoperability challenges and they occur in different ways. In some situations, challenges occur where information systems fail to communicate with each other while in other cases incompatibilities are experienced in terms of the file-sharing protocols and semantics. The challenges are often solved by having a wireless solution placed on a cloud storage system so as to facilitate communication across different regimes (West, 2013).
An example of a cloud-based system is the Electronic Medical Information Exchange (eMix). The system facilitates the accessibility of medical reports by patients and healthcare providers irrespective of their geographic location. The connection enables health care providers to get access to patients’ health background in a safe distribution system as patients also access lab tests, imaging reports, and other essential health reports that help them to better understand their health and to take necessary initiatives in seeking health care (West, 2013).
There is another system referred to as the 2net platform that was initiated by Qualcomm Life. By use of the system, the providers of health care services find storing, transferring, converting, and displaying electronic medical device data easier than before. The cloud-based system is made in such a way that it allows interoperability with different kinds of medical applications and devices. The system is effective in the sense that it allows patients and health care providers to access information throughout hence presenting several benefits in cases of medical emergencies.
It is evident that application of mobile technologies in health care provision helps in connecting patients, their family members, friends, and their care providers. The applications enable timely health monitoring which is crucial in giving timely and effective medical intervention to some crucial health complications (West, 2013). The incorporation of mobile applications in health care also makes patients to be engaged in health care provision hence improving the outcomes of health care. The applications provide access to medical information, reducing the costs of health care, enabling the occurrence of remote care besides increasing health care efficiencies. They increase connectivity between patients and their caregivers without any time or geographical barriers. Due to the effectiveness of mobile applications in boosting health care provision, they are slowly becoming a vital tool that is applied to extend health care resources all over the world (West, 2013).
Healthcare Network Architecture and Security Considerations
There is an increasingly high need to provide security and limitation to the level of access to centralized and standardized databases that are used in the storage and dissemination of health care information. It is medical institutions that have taken the trend of implementing computer networks and hospital information systems technology (HIS) which calls for a lot of consideration with respect to the use of appropriate measures to curb security threats. The advantages that are associated with the ability of internet technology to promote access to information and to facilitate distribution of medical data cannot be of any value if appropriate measures are not taken. Measures have to be taken to safeguard health information from unauthorized access. It is for this reason that designers of health care network architecture make a lot of considerations when designing the network so as to boost security that can damage the reputation and support for such networks. The increased development of software and hardware devices helps in providing a means by which the databases that are used in health care can be controlled and effectively managed to increase the efficiency of health facilities (West, 2013).
Health institutions have shown a continued application of HIS integrated information systems for managing administrative, financial, and clinical documents. The decision to use the system was presented by the essence of effective resource management, high availability, and the essence to have adequate security for health care information. Many institutions have successfully implemented the systems with efforts made to solve the problem of incompatibility that is experienced with some structures. There is a need for some centralized and incompatible resources to be developed so as to respond to challenges like the slow retrieval and loss of vital information. The application of effective architecture also helps to prevent cases of time wastage when health care providers have to spend a lot of time trying to search for patients’ health records from the hospital’s records (West, 2013).
There are many considerations that should be made when developing the architecture. One of these considerations is to look for aspects of scalability and the possibility of having the architecture integrated with the already existing networks besides considering remote and secure resources while also looking for aspects of user-friendliness. Secondly, scalability is a vital aspect that must be considered when designing health care network architecture for ease of adaptability of the system to any health institutions. When many institutions start adopting the system, it is important to see into it that the architecture can ensure that users will not experience any downtime because it is vital to have the data available throughout to make the system reliable and user friendly. The requirement is attainable by the use of load balancing and clustering technique that is effective in enabling redundancy. It is vital to ensure that any new architecture is integrated into the existing structures due to the convergence between data networks. The integration should not pose much challenge because the architecture is modular. With the modular, integration should be possible without the need to modify the implemented communication mechanisms (West, 2013).
There are two main approaches that can be used to fulfill the objective of ensuring complete data security. First, internal security can be boosted by the use of user permissions and token-based authentication (West, 2013). There is also a need to configure VPN tunnels and traffic filters at the edge of every structural component so as to safeguard against system penetrations and data interception.
The application design that is used in health care systems is made with close consideration of the fact that some of the users may not be having a technical background in information technology hence there is a need to have the system made in such a way that they are easy to operate. User-friendliness of the health care internet architecture is a vital requirement that has to be considered with every design that seeks to improve the quality and accessibility of health care (West, 2013).
The Internet of Things Architecture
The Internet of Things (IoT) refers to a network of devices that can directly connect with each other so as to capture and share essential information or data via a secure service layer (SSL) which connects to a central command and control server in the cloud (Evans, 2011).
The power of the IoT is in its ability to innovatively connect dots. The technique has brought about a transformative possibility that is evolving across the broad spectrum of boosting the attainment of connected homes, connected health care and connected enterprises. According to Evans (2011), the IoT is used to facilitate connected health care in that the connected medical devices are effective in providing a unified view across medications, devices and patients. Through the internet of things, communication in the health care industry has been boosted in such a way that the entire ecosystem that is composed of patients, caregivers, and payers are able to freely communicate through the interactive capacity of the IoT. The interconnection that is facilitated by the IoT offers visibility and insights about exercise regimens (Evans, 2011).
There is an increase in internet use across the globe. The information age is characterized by a high dependence on online platforms for information retrieval and dissemination. The emergency of the techno-savvy generation has made the IoT to be more viable and relevant as it is used to propel the medical service industry to have the clients and care providers to fully explore the short and long-term business possibilities that are associated with the technology. From the trends that have been observed in the health care industry, it is worth noting that the network is making inroads into the medical device industry and that its application in the industry helps to improve service provision (Evans, 2011). There is a transformation by medical device companies that are shifting from a device or consumable providers to decrease or care management organizations (Zaleski, 2011). The IoT- powered medical services, like subcutaneous drug delivery units and continuous glucose monitoring equipment, have highly aided digitization in acute care. They help in ensuring that patients and those that are close to them like their relatives and friends take a vital role in boosting health care as they are able to monitor patient’s progress over time (Evans, 2011).
There are other essential changes that are compelling medical device companies to reinvent themselves. Such changes include the consolidation of group purchasing organizations (GPOs) and Accountable Care Organizations (ACOs) under the health care reforms. Other changes are the increased attention that is given to prevention and wellness management and application of value based health care. The emergence of all these changes and the increased adoption of technology has made it crucial for medical device companies to innovate from within or through deeper ecosystem collaboration. Sensors and embedded software have also become vital elements of most of the mechatronics medical devices. The medical technologies that are currently applicable are vast ranging from the use of implantable devices, the application of capital-intensive diagnostic and monitoring equipment to the application of medical apps (Evans, 2011).
As a result of the elasticity of cloud computing, Evans (2011) suggests that the IoT architecture is increasingly becoming acceptable. There are security and privacy features that are built into all the layers of the architecture hence making its susceptibility to security threats very minimal. The IoT also has a cross-disciplinary nature that is offered by its 3C model that is helpful in building the asset base and identifying the most appropriate partners. If the architecture is rightfully executed, it can help health facilities realize remarkable improvements in service delivery and gain a lot of dividends in transforming business outcomes in a cost-effective manner (Niewolny, 2013).
IoT in Action in Healthcare
The IoT is widely applicable in health care as observed in its adoption in health care applications that are used in managing chronic disease and kits used in disease prevention. As shown below, there are several illustrations of how the potential of IoT is already benefitting the health care industry (Evans, 2011).
In clinical care, IoT drove, noninvasive monitoring is used to monitor patients who are hospitalized and whose conditions call for close monitoring. With this technology, health care providers use sensors in collecting vital physiological information while gateways and the cloud is used for analyzing and storing the information before the analyzed data is sent wirelessly to care providers for further analysis and review (Cognizant, 2016). This development has helped to improve patients monitoring and seal the gaps that were experienced in cases where physical monitoring that were done at given intervals would fail to effectively determine the progress of patients. The adoption of IoT inpatient monitoring has replaced that case where health care professionals had to conduct regular checks to observe patient’s vital signs as opposed to the continuous automated flow of information that is facilitated by the application of the IoT (Cognizant, 2016). Applying the IoT has led to a great improvement in care quality through the provision of constant attention to patient needs while equally bringing down the cost that health facilities have to incur in providing quality health care. Instead of spending a lot of time conducting physical checks on patients, the IoT gives care providers easy time so that they can focus on data analysis so as to determine how best to respond to the symptoms that are observed in patients over time. This way, health care becomes more effective and the care providers are relieved from several traditional tasks that are associated with physical monitoring (Evans, 2011).
The IoT has greatly assisted in facilitating remote monitoring. Many people suffer several consequences that resulted from challenges in accessing effective health monitoring. However, the network has tried to improve the situation. Currently, there are powerful wireless solutions that are connected through the IoT that are currently helping to solve the problem of difficulties in remote monitoring. The devices make monitoring to come to the patients instead of the patients having to travel in such of monitoring services. By use of different sensors, the devices can capture patients’ health data as complex algorithms are applied in analyzing the data that are later shared via wireless connectivity with medical professionals who have the capacity to make appropriate recommendations. Therefore, there are limited chances that patients with chronic diseases will develop more complications simply because of challenges that are associated with patient monitoring (Cognizant, 2016). The application of IoT connected devices also help to facilitate diagnosis of patients with acute complications earlier than they would be diagnosed if such monitoring facilities were not available. For instance, the patients who are suffering from cardiovascular diseases and whose treatment involves the use of digitalis can be monitored throughout so as to prevent possibilities of drug intoxication (Link lab, 2016). The technology also facilitates the detection of Arrhythmias that are often seen on an EKG and the EKG data that indicate heart hypoxemia can facilitate detection of cardiac complication (Evans, 2011).
Earlier detection of complications is vital as it gives room for preventive approaches to be taken. When people realize that their conditions are slowly worsening, they can move with speed to seek appropriate medical intervention so as to bring their illnesses under control.
Freescale Home Health Hub reference platform is an example of a technology that enables remote monitoring (Niewolny, 2013). The technology is built on freescale i.MX applications technology and it facilitates tight integration of vital capabilities like wireless connectivity and power management in the telehealth gateway that facilitates physiological information collection and sharing (Cognizant, 2016). When applying the hub, patients data is captured from various sensors and securely stored in the cloud for retrieval by those who are involved in health care provision. The data aggregation device is effective in capturing patients health records and they are likely to become commonplace particularly in health care facilities (Evans, 2011).
IoT Facilitates Early Intervention
Evans (2011) noted that the IoT is also helpful to healthy people for they can use it in monitoring their daily activities and well-being. People who are living alone may want to use some device to monitor their daily activities so that in case they witness a fall in such activities, they can have the information communicated to health care providers or family members for an early intervention. In this aspect, the IoT solution is beneficial even to sportspersons as they can be used by such people for monitoring their activities and communicating feedback to emergency responders. The technology can be effective for sports people if they can be designed in such a way that they can be worn (Cognizant, 2016). Apart from these examples of IoT-based health care solutions, there are many others that are emerging and which will help to better health care provision. People will be in a position to get alerts on their health conditions then have such information communicated to their care providers in a timely manner so that timely responses are given to prevent the complications from worsening. The IoT has helped and will continue helping in managing cases of acute patient monitoring hence helping to reduce the risks that are associated with such illness as well as the cost of providing care to such patients (Evans, 2011).
Technologies Enabling IoT
There are several enabling technologies that determine the successful application of IoT in the preceding health care. Without the enabling technologies, it would not be possible to achieve the connectivity and usability of IoT particularly in arrears like health monitoring. The smart sensors that have the capacity to combine a sensor and a microcontroller provide an opportunity for harnessing the power of IoT for use in health care through monitoring and analyzing various health statuses (Evans, 2011). The device facilitates monitoring an analysis of important signs like blood pressure and glucose levels that can be used to understand a patient’s progress and which can be used to determine the appropriate measure that should be taken to respond to given danger signs. It is possible to incorporate smarty sensors in pill bottles and to connect them to them main network to be able to get an indication if patients are adhering to their dosage. Evans (2011) emphasized that the sensors can only work effectively if the microcontroller components have the required capabilities.
There is need for low-power operation that helps to extend the battery life and to keep the device foot print small. The characteristics are essential to keep the IoT device usable. For example, Freecscale has a low power processing and it works to enable bettered free devices that use energy harvesting techniques by use of ultra-low-power DC-DC converters. The application of integrated precision-analog capabilities also serves to enable sensors to achieve high accuracy at a less expensive cost (Niewolny, 2013). The enabling technology is offered by Freescale within microcontrollers that have analog components like high-resolution analog-to-digital converters. Graphic user interface is also used to deliver a lot of information in clear detail and facilitating access to the information (Cognizant, 2016). The Freescale’s I, MX applications processors that have advanced graphics-processing performance enable advanced GUI development (Biswas & Martin, 2011).
According to Cognizant (2016), wireless networking is believed to be very reliable for use health care facilities connections because the networking helps to solve the limitations that are associated with traditional wired networking like Ethernet and USB connections. Wireless connectivity is enabled by microcontrollers that are provided by Freescale for use with devices in line with wireless standards like Bluetooth and Bluetooth Low Energy (BLE) that are applicable in personal area networks (PAN) that are used with personal devices and Wi-Fi. They are also used with Bluetooth for local area networks (LAN) in clinics and hospitals (Cognizant, 2016).
Medical device IoT is complex due to the wide spectrum of medical devices that apply different data communication protocols. It is most likely that the interoperability between devices will always be improving in the same way as standardization will continue becoming stronger and stronger. The application of IoT is also expected to help solve the problem of excessive power consumption by medical devices. The communication that occurs by use of the medical devices often consume a lot of power in the devices but the IoT enabled devices that have increasingly been put in use will highly assist in terms of availability of energy harvesting technologies. It is also vital to attend to social concerns that relate to illegal invasion of privacy. There is a lot of concern about the way in which the devices can be used in tracking people’s movement. Hospitals are also increasing the challenge of data exfiltration when they enable medical devices with network connectivity capabilities. There are guidelines that have been given by the United States Federal Drug Administration (FDA) for use in managing cybersecurity in medical devices (Cognizant, 2016).
Despite the advantages that are associated with the application of the IoT, there are several challenges that are likely to slow down the development of the technology. Among the main challenges are the ones associated with agreement on standards, power for sensors and the deployment of IPv4. With respect to the deployment of IPv6, the fact that the world ran out of IPv4 in February 2010 poses a challenge in that the occurrence can slow down the progress of IoT due to the fact that the possible billions of new sensors will need unique IP address for them to function (Cognizant, 2016). Networks are also easier to manage by use of IPv6 because of the auto configuration capabilities and the IPv6 also provides improved security features (Cognizant, 2016).
Finally, with these technologies health facilities empower patients to take an active role in their care plans through issuance of small medical devices for use in monitoring various aspects of health like blood sugar levels and activity rates. Evidently, health care has also been boosted by the application of the IoT as evidenced by its use in health facilities to manage chronic diseases and in disease prevention. It is good to note that, in the hospital environment, networking can be done in all sections like the operation room, the Intensive Care Unit, the patients room and the lab. However, networking designs in the areas vary from one section to the other based on the nature of activities that are undertaken in the sections. For example, high acute areas have a lot of device connectivity while low acute areas have relatively low medical device connectivity. Besides, in selection of the nature of networking between wired and wireless connection, it is important to consider the level of movement in the hospital section where the connection is to be done. Sections with less movement can be networked using wired networking while sections with a lot of movement can be networked using wireless networking. Generally, networking and medical device connectivity has helped to revolutionize health care provision.
In conclusion, it is evident that networking and connectivity of medical devices has enabled improvement in health care provision. Health care facilities have their medical devices connected so as to facilitate data storage and dissemination of vital information that is used to boost health care provision. The facilities have also adopted the use of mobile apps that are meant to boost communication between health care providers and patients. The mobile aps have helped to solve the problem of health care accessibility by enabling patients to personally monitor their health situations through an observation of symptoms. Apart from patients, health care providers can also use the mobile apps to remotely monitor the progress of their patients. In such a way, the connectivity enables health care providers to provide timely responses to undesirable symptoms that are observed in patients through remote monitoring. Evidently, networking and medical device connectivity has also helped in boosting the quality of care that is provided to patients.