eHealth and the Internet of Things

To respond to an ageing population, eHealth strategies offer significant opportunities in achieving a balanced and sustainable healthcare infrastructure. Advances in technology both at the sensor and device levels and in respect of information technology have opened up other possibilities and options. Of significance among these is what is increasingly referred to as the Internet of Things, the interconnection of physical devices to an information infrastructure. The paper therefore sets out to position the Internet of Things at the core of future developments in eHealt

Study protocol for the Anesthesiology Control Tower—Feedback Alerts to Supplement Treatments (ACTFAST-3) trial: A pilot randomized controlled trial in intraoperative telemedicine [version 1; referees: 2 approved]

Background: Each year, over 300 million people undergo surgical procedures worldwide. Despite efforts to improve outcomes, postoperative morbidity and mortality are common. Many patients experience complications as a result of either medical error or failure to adhere to established clinical practice guidelines. This protocol describes a clinical trial comparing a telemedicine-based decision support system, the Anesthesiology Control Tower (ACT), with enhanced standard intraoperative care. Methods: This study is a pragmatic, comparative effectiveness trial that will randomize approximately 12,000 adult surgical patients on an operating room (OR) level to a control or to an intervention group. All OR clinicians will have access to decision support software within the OR as a part of enhanced standard intraoperative care. The ACT will monitor patients in both groups and will provide additional support to the clinicians assigned to intervention ORs. Primary outcomes include blood glucose management and temperature management. Secondary outcomes will include surrogate, clinical, and economic outcomes, such as incidence of intraoperative hypotension, postoperative respiratory compromise, acute kidney injury, delirium, and volatile anesthetic utilization. Ethics and dissemination: The ACTFAST-3 study has been approved by the Human Resource Protection Office (HRPO) at Washington University in St. Louis and is registered at clinicaltrials.gov (NCT02830126). Recruitment for this protocol began in April 2017 and will end in December 2018. Dissemination of the findings of this study will occur via presentations at academic conferences, journal publications, and educational materials

Breaking the Barriers to Specialty Care: Practical Ideas to Improve Health Equity and Reduce Cost - Striving for Equity in Specialty Care Full Report

Tremendous health outcome inequities remain in the U.S. across race and ethnicity, gender and sexual orientation, socio-economic status, and geography—particularly for those with serious conditions such as lung or skin cancer, HIV/AIDS, or cardiovascular disease.These inequities are driven by a complex set of factors—including distance to a specialist, insurance coverage, provider bias, and a patient's housing and healthy food access. These inequities not only harm patients, resulting in avoidable illness and death, they also drive unnecessary health systems costs.This 5-part series highlights the urgent need to address these issues, providing resources such as case studies, data, and recommendations to help the health care sector make meaningful strides toward achieving equity in specialty care.Top TakeawaysThere are vast inequalities in access to and outcomes from specialty health care in the U.S. These inequalities are worst for minority patients, low-income patients, patients with limited English language proficiency, and patients in rural areas.A number of solutions have emerged to improve health outcomes for minority and medically underserved patients. These solutions fall into three main categories: increasing specialty care availability, ensuring high-quality care, and helping patients engage in care.As these inequities are also significant drivers of health costs, payers, health care provider organizations, and policy makers have a strong incentive to invest in solutions that will both improve outcomes and reduce unnecessary costs. These actors play a critical role in ensuring that equity is embedded into core care delivery at scale.

An IoT-Based Framework of Webvr Visualization for Medical Big Data in Connected Health

Recently, telemedicine has been widely applied in remote diagnosis, treatment and counseling, where the Internet of Things (IoT) technology plays an important role. In the process of telemedicine, data are collected from remote medical equipment, such as CT machine and MRI machine, and then transmitted and reconstructed locally in three-dimensions. Due to the large amount of data to be transmitted in the reconstructed model and the small storage capacity, data need to be compressed progressively before transmission. On this basis, we proposed a lightweight progressive transmission algorithm based on large data visualization in telemedicine to improve transmission efficiency and achieve lossless transmission of original data. Moreover, a novel four-layer system architecture based on IoT has been introduced, including the sensing layer, analysis layer, network layer and application layer. In this way, the three-dimensional reconstructed data at the local end is compressed and transmitted to the remote end, and then visualized at the remote end to show reconstructed 3D models. Thus, it is conducive to doctors in remote real-time diagnosis and treatment, and then realize the data processing and transmission between doctors, patients and medical equipment

Towards fog-driven IoT eHealth:Promises and challenges of IoT in medicine and healthcare

Internet of Things (IoT) offers a seamless platform to connect people and objects to one another for enriching and making our lives easier. This vision carries us from compute-based centralized schemes to a more distributed environment offering a vast amount of applications such as smart wearables, smart home, smart mobility, and smart cities. In this paper we discuss applicability of IoT in healthcare and medicine by presenting a holistic architecture of IoT eHealth ecosystem. Healthcare is becoming increasingly difficult to manage due to insufficient and less effective healthcare services to meet the increasing demands of rising aging population with chronic diseases. We propose that this requires a transition from the clinic-centric treatment to patient-centric healthcare where each agent such as hospital, patient, and services are seamlessly connected to each other. This patient-centric IoT eHealth ecosystem needs a multi-layer architecture: (1) device, (2) fog computing and (3) cloud to empower handling of complex data in terms of its variety, speed, and latency. This fog-driven IoT architecture is followed by various case examples of services and applications that are implemented on those layers. Those examples range from mobile health, assisted living, e-medicine, implants, early warning systems, to population monitoring in smart cities. We then finally address the challenges of IoT eHealth such as data management, scalability, regulations, interoperability, device–network–human interfaces, security, and privacy