Introduction: improve how physicians deliver care as well.

Introduction:
IOMT (Internet of Medical Things) or healthcare IoT:
Healthcare has numerous applications fall under the internet of things, from remote monitoring to smart sensors and medical device integration. It has the potential to not only keep patients safe and healthy, but to improve how physicians deliver care as well. Healthcare IoT can also boost patient engagement and satisfaction by allowing patients to spend more time interacting with their doctors.
Some examples:
1- Medical apparatus and devices like wheelchairs, scales, defibrillators, nebulizers, pumps or monitoring equipment can be tagged with sensors and located easily with IoT. Apart from real time location services, there are IoT devices that help in environmental monitoring as well (checking the refrigerator temperature, for example).
2- With the intervention of Internet of Things, clinicians can predict the arrival of patients who are recuperating in the Post-Anesthesia Care Unit (PACU). They can also monitor the status of patients in real time.
3- Hand hygiene monitoring systems which measure the degree of cleanliness in a healthcare worker.
4- Hospitals can provide good care to patients at affordable rates. IoT aims to provide better patient journey by:
ï Room lighting through personal control
ï Communicate to family and friends through email services
ï Immediate attention to patient needs
IoT Architecture and Structure:
For the implementation of  IoT to be undertaken successfully in the healthcare industry, devices need to be structured around specific network architecture to ensure that every piece of technology is introduced and maintained to a high standard, which should theoretically lead to zero breakdowns in communication between the network and devices. Regarding IoT structure, there are two main aspects, one is device management. Normally falls under the remit of a member of the Security and IT team, who are responsible of ensuring security protocols are followed during the introduction process of new devices and maintained during their lifespan. The second aspect is infrastructure management. Frequently overlapping with device management processes, how effective they are implemented is depending on the speed in which devices are connected. Owing to their computational limits reducing their speed and memory, numerous IoT devices are modified, with a boosted connection to the Cloud to increase their productivity. 
Detailed overview of the Technology:
The proliferation of the Internet of Things (IoT) in the healthcare market, which comprises systems and software, medical devices, and services, has had a significant impact on the overall healthcare sector and been immensely beneficial in remote clinical monitoring, chronic disease management, preventive care, assisted living, and personal fitness monitoring. Termed as a true game-changer for the healthcare industry, the Internet of Things has transformed the sector by lowering costs, improving efficiency, and bringing the focus back to quality patient care.
From clinicians that need to identify patients, collect specimens, administer medication and monitor vital signs to pharmacists that need an accurate inventory count, with the Internet of Things, healthcare organizations can benefit from next level Intelligence.
I. Operational Efficiency
There are many challenges that faced the industry of healthcare from mostly every aspect of operation. From managing equipment, inventory and time to tracking patients, the level of accountability is high. A good example is medical inventories. Many hospitals overstock certain inventories to prevent “running out” during an emergency. 

Implementing solutions such as RFID and mobile scanners connected with cloud technology, organizations can gain visibility into these assets, providing real-time information to the people and transactions that require them ensuring hospitals have what they need, where they need it, when they need it.
II. Improved Patient Care
In order to provide the best quality patient care, clinicians and staff need access to the right equipment at the right time. Moreover, hospital staff need to better allocate their time to patient care rather than manual documentation, and tracking down the right supplies. With mobile devices, wearable technologies and comprehensive electronic medical records stored on these devices, clinicians can spend less time doing needless testing or asking redundant questions, eliminating errors, and have more time to focus on the patient’s current problem.
With IoT solutions, healthcare organizations can now gain access to the information they need in real-time to improve patient experiences and outcomes. In addition, IoT also makes it easier to integrate data from consumer devices such as fitness band into hospital systems, which help organizations gather more data and deliver better care.
III. Leadership and Innovation
For healthcare organizations to stay ahead of the curve, rather than always fighting to catch up, implementing solutions that capture and analyze their data enables them to find common patterns and anticipate what’s coming.
With IoT technologies maturing at a rapid rate, the healthcare industry stands to benefit from this intelligence to improve performance and innovation.
When it’s said and done, by spending less time manually managing processes and tracking down resources, healthcare professionals can spend more time dedicated to patient care and building strategies that improve how they operate.
Algorithms/protocols used:
Today, algorithms are everywhere and much more important absolutely in Healthcare Technology. The algorithms that used:  
Fourier Transform: enhancing our Senses. 
The flourier transform has been dubbed one of most important algorithms of our time. It’s a mathematical technique for breaking complex signals into basic components. It allows technicians, for example, to see voltage fluctuations in a wire connecting a microphone to a loud speaker. Because it reduces a signal to a short list of numbers, it’s also used to squeeze audio and image files into portable packages (MP3’s and JPEG’s). Without it, medical imaging wouldn’t exist. Magnetic resonance and ultrasound machines couldn’t turn raw data into pictures that enable doctors to see inside our bodies to diagnose and treat bleeds and broken bones, tears, tumors and more.
RSA: The Encryption Algorithm
This algorithm allows for the secure transmission of digital data. It was one of the first practicable encryption algorithms. The function of this algorithm to secure sharing of electronic health records and be locked in filing cabinets, mailed and faxed.

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MUMPS: Health Care’s Operating System
 It’s a computer programming language made for the health care industry, and still used today by many hospitals and banks. It was one of the first languages to enable computers to run multiple programs simultaneously. Today it powers the entire Veterans Health Administration’s clinical records management system and Epic, America’ largest electronic health record software company.
Probabilistic Data Matching: The Clinician-Scientist’s best friend
Probabilistic algorithms look for diverse bits of information in medical records, and then rank them according to their possibility of belonging to patient. Used to retrieve clinical data and assist in research. The probabilistic algorithm, Niave Bayes Classifier, for example, is used to update the probability estimate or provide additional evidence for a research hypothesis. Paired with genetic sequencing it allows biologists to better understand the evolutionary relationships among species or populations to trace the phylogenetic relationships within major branches of Darwin’s tree of life.

BLAST: Basic Local Alignment Search Tool
High-throughout sequencing has ushered in a new age of genetic discovery, making it possible to cheaply and quickly find mutations among the 3 billion base pairs of the human genome. Identifying mutations is just the first step, though. It falls to biologists, aided by computer algorithms, to make sense of the growing body of data, to work out which genes and proteins confer disease and how. Chief among those algorithms is the search tool. BLAST, a search algorithm, accomplishes this by analyzing gene & comparing protein sequences to a library or database of sequences and relevant scientific papers. Publications about BLAST hold the 12th and 14th spots in a list of the 100 top-cited science papers of all time, according to the journal, Nature. BLAST is being surpassed, though, by Clustal, a similar program for aligning multiple sequences at once, according to Nature.
NEIGHBOR-JOINING: Phylogenetics
A study illustrated “neighbor-joining” algorithm, when paired with genetic sequencing, allows biologists to better understand the evolutionary relationships among species or populations to trace the phylogenetic relationships within major branches of the tree of life. Phylogenetic trees are used in drug development to, for example, identify closely related, naturally occurring chemical compounds suspected to have medicinal value. Phylogenetic trees of pathogens help scientists understand the adaptive evolution of bacteria, viruses and parasites how they infect hosts, subvert immune systems and resist treatment. No. 20 on Nature’s list of top-cited science papers.
Google Search: Page Ranking
We do a lot of Internet searches every day using Google or Yahoo. Whatever the search engine, it’s a complex algorithm known as “page rank” that first, source the Internet for pages that have the key word you ender and then rank them based on factors, such as their location or their frequency of use. “Googling” answers our burning questions, or at least gives us a start. But has it helped or hurt health care? It’s certainly democratized it and put more information within easy reach of patients.

How it works to provide the expected service.

Recently, the healthcare can be categorized in multiple ways based on the perspective of the technology, functionality and the benefits. There is a trend happening with the convergence of consumer devices and medical devices.  Most recent smartphones are being launched with health sensors in the accessories like wrist gear. This enables the Health, which refers to the use of mobile and wireless technologies in the practice of medicine and the monitoring of public health. This reduces medical errors based on continual monitoring practices. IoT applications in healthcare can be grouped in to following categories based on the functionality.
ï Tracking of objects and people.
ï Identification and authentication
ï Automatic data collection and sensing
Health trends can be analyzed with respect to the application areas in medical practice. Some of the applications areas are listed below along with the usage of IoT concept and their benefits.
1- Wireless patient monitoring: This application is for remote surveillance of patient vital functions through the use of internally and externally located patient devices. As opposed to discrete interactions, the provision of healthcare is moving to a model where information is being transmitted and shared in real time between individuals and caregivers. This is especially relevant for chronic disease management such as hypertension, diabetes, coronary heart disease, asthma.
2- Mobile system access: This application is based on the mobile technologies that enable remote/virtual access to current clinical systems (electronic health records EHRs, picture archiving and communication systems PACS, etc.). All the medical system can be automated with easy to use mobile app interface. This application of technology in healthcare is referred as e-Health. If the mobile is used as monitoring and delivery of healthcare, the application area is termed as m-Health. Examples: Websites, portals, mobile apps.
3- Medical devices: This application is used to capture and track key care compliance and disease management data.  Mainly these are used as fitness solutions for tracking of patient activities and smart diagnostic devices used for capturing the data from the sensors for further analysis by doctor. Google glass is also under research for possible medical devices as this can used to perform assisted surgeries and recording, etc.

Its applications in real-life :
•Medication Dispensing Device by Philips: remind patients of their doses; good for elderly patients.
•Niox Mino by Aerocrine: for routine measurements of Intric Oxide in a patient’s breath.
•UroSense by Future Path Medical: for catheterized patients to check their core body temperature and urine output.
•GPS SmartSole: this is a shoe-tracking wearable device for dementia patients who have the habit of forgetting things.
IoT Healthcare Security:
The IoT is growing rapidly. In the coming years, the medical sector is expected to witness the widespread adoption of the IoT and flourish through new eHealth IoT devices and applications, they are expected to deal with vital private information such as personal healthcare data. Moreover, such smart devices may be connected to global information networks for their access anytime, anywhere. thus, the IoT healthcare domain may be a target of attackers. To facilitate the full adoption of the IoT in the healthcare domain, it is critical to identify and analyze distinct features of IoT security and privacy, including security requirements, vulnerabilities, threat models, and countermeasures, from the healthcare perspective.
Security requirements for IoT-based healthcare solutions are similar to those in standard communications scenarios. Therefore, to achieve secure services, there is a need to focus on the following security requirements.
1) Confidentiality
Confidentiality ensures the inaccessibility of medical information for unauthorized users. In addition, confidential messages resist revealing their content to eavesdroppers.
2) Integrity
Integrity ensures that no adversary can alter the received medical data in transition. Furthermore, the integrity of stored data and content should not be compromised.
3) Authentication
Authentication ensures the identity of the communicated peer in IoT health device.
4) Availability
Availability ensures the survivability of IoT healthcare services (either local or global/cloud services) to authorized parties when needed even under denial-of-service attacks.
5) Data Freshness
Data freshness includes data freshness and key freshness. Because each IoT healthcare network provides some time-varying measurements, there is a need to ensure that each message is fresh. Data freshness basically implies that each data set is recent and ensures that no adversary replays old messages.
6) Non-Repudiation
Non-repudiation indicates that a node cannot deny sending a message sent earlier.
The strengths of IoT in healthcare:
1. Decreased Costs: When healthcare providers take advantage of the connectivity of the healthcare solutions, patient monitoring can be done on a real time basis, thus significantly cutting down on unnecessary visits by doctors. In particular, home care facilities that are advanced are guaranteed to cut down on hospital stays and re-admissions.
2.Improved Outcomes of Treatment: Connectivity of health care solutions through cloud computing or other virtual infrastructure gives caregivers the ability to access real time information that enables them to make informed decisions as well as offer treatment that is evidence based. This ensures health care provision is timely and treatment outcomes are improved.
3.Improved Disease Management: If patients have been monitored on a continuous basis and health care providers are able to access real-time data, diseases are treated before they get out of control.
4.Reduced Errors: Accurate collection of data, automated workflows combined with data driven decisions are an excellent way of cutting down on waste, reducing system costs and most importantly minimizing on errors.
5.Enhanced Patient Experience: The connectivity of the health care system through the internet of things, places emphasis on the needs of the patient. That is, proactive treatments, improved accuracy when it comes to diagnosis, timely intervention by physicians and enhanced treatment outcomes result in accountable care that is highly trusted among patients.

The weaknesses of IoT in healthcare:
Although the Internet of Things is transformational in the health care sector, it also presents a number of challenges given that health data is sensitive. As such, when shared inappropriately, health information may damage reputations or destroy careers amongst other things.
Security of data is also another risk factor that is likely to increase with an increase in the level of data being shared. The volume of data is bound to increase significantly hence the need to shield this information from cyber attacks.
What’s next for IoT technology in the health sector?
Internet of Things technology holds the potential to revolutionize the healthcare industry, but not before overcoming barriers of security and data ownership.
¬ telepresence prove a big win for remote healthcare – whether that’s before or after a visit to the doctor’s office or the hospital. Health tech’s biggest advocates believe efficient remote health could dramatically cut down on the necessity for routine reviews and checkups. Patients would also be allowed to leave hospitals and clinics earlier, as professionals are enabled to monitor them from home rather than keeping them in hospitals for observation.
¬ Ideally, the objective data that could be taken from a network of IoT devices will also be able to significantly lower margins of error. And in the predictive realm, it could, for example, be able to detect the onset of a wide range of health issues, from high blood pressure to early signs of delirium. Emergency admissions could then, in theory, be reduced – with proactive health systems in place to address the problems before they become more serious or irreversible.
¬ Some businesses want to make it possible to attend a full healthcare appointment from the comfort of your home, so health specialists from around the world can provide a consultation or even diagnosis from hundreds of miles away.

Conclusion:
As discussed in this report, all the physical objects will work seamlessly with machineto-machine and human-to-machine interfaces. This level of interconnection is a boon for the healthcare, where health influencing factors both internal & external to the human body can be analyzed based on the model. These factors along with the genomic inputs shall make it possible to predict the health trends and allergies of the person; thereby the technology can provide customized recommendations on suitable physical activities, diets, etc. This mobile doctor buddy apps are not meant to be the replacement for experience of the doctors. They should work collaboratively with the doctor. In this approach of complementing the doctor with the technology based inputs, the new trends in IoT has the capability to transform the way the primary healthcare is delivered to the patients.
Finally, healthcare institutions should enter into agreements with vendors that require the connected devices to be updated with improved security over time and that the updates are tested and verified before being put into use. Given the nature of healthcare data and potential legal liability for resulting data breaches, the “Internet of Things” at healthcare institutions and the contracts that cover them need to constitute a “Security of Things.”

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