How 5G wireless (and concomitant technologies) will revolutionize healthcare?

The need to have equitable access to quality healthcare is enshrined in the United Nations (UN) Sustainable Development Goals (SDGs), which defines the developmental agenda of the UN for the next 15 years. In particular, the third SDG focuses on the need to “ensure healthy lives and promote well-being for all at all ages”. In this paper, we build the case that 5G wireless technology, along with concomitant emerging technologies (such as IoT, big data, artificial intelligence and machine learning), will transform global healthcare systems in the near future. Our optimism around 5G-enabled healthcare stems from a confluence of significant technical pushes that are already at play: apart from the availability of high-throughput low-latency wireless connectivity, other significant factors include the democratization of computing through cloud computing; the democratization of Artificial Intelligence (AI) and cognitive computing (e.g., IBM Watson); and the commoditization of data through crowdsourcing and digital exhaust. These technologies together can finally crack a dysfunctional healthcare system that has largely been impervious to technological innovations. We highlight the persistent deficiencies of the current healthcare system and then demonstrate how the 5G-enabled healthcare revolution can fix these deficiencies. We also highlight open technical research challenges, and potential pitfalls, that may hinder the development of such a 5G-enabled health revolution

M-health review: joining up healthcare in a wireless world

In recent years, there has been a huge increase in the use of information and communication technologies (ICT) to deliver health and social care. This trend is bound to continue as providers (whether public or private) strive to deliver better care to more people under conditions of severe budgetary constraint

The safe administration of medication within the electromagnetic scenarios of the Internet of Things (IoT): looking towards the future

This paper has focused on analyzing the impact of Information and Communication Technologies (ICTs) to prevent or reduce errors during therapeutic drug administration. The methodology used has included scientific literature and marketed appliances reviews and laboratory tests on radiant devices. The role of the patient has been analyzed, both in terms of compliance with the prescribed treatments and user of technical solutions designed for administering medication. In addition, it has taken into account, how a future characterized by multiple technologies designed to support our daily routines, including health care, might affect the current model of relationship between health professionals and patients. Particular attention has been given to safety risks of ICTs in environments characterized by concurrent electromagnetic emissions operating at different frequencies. Implications and new scenarios from Internet of Things or IoT, have been considered, in light of the approach taken jointly by the European Commission and the European Technology Platform on Intelligent Systems Integration – EPoSS, in their 2008 report Internet of Things in 2020: a roadmap for the future, and how the concept has evolved since then.Chapter 1. Adverse drug events. Chapter 2. ICTs in everyday life and healthcare. Chapter 3. the challenge of electromagnetic safety. Chapter 4. ICTs in health care and in the prevention of medication errors: IoT. Chapter 5. A more effective and safer alternative approach. Chapter 6. Technological proposal 7. Conclusions.N

Internet of things for medication control: service implementation and testing

RFID technology (Radio Frequency IDentification) enables putting an identification label (e.g. tag) into a certain object and, by means of a reader, get the information related to it without any physical contact. The use of these tags in medical context enables a rapid and precise identification of each patient and, by means of Internet of Things (IoT), enables a ubiquitous and quick access to medical related records. These technologies, RFID and IoT, integrated within a suitable system, promote a better physician-patient interaction. A simple IoT-enabled system can send warnings to any physician, nurse or other health caregiver. Therefore, with a simple IoT architecture one may remotely monitor and control the patient's well being. This paper presents an IoT architecture, using RFID tags, able to easily and remotely establish a medication control system, beginning from physicians prescription to pharmaceutical drug administration. This paper presents the implementation and analysis of a prototype service, with a web interface, allowing for a first evaluation of the proposed service. The prototype service - based on RFID, EPC (Electronic Product Code) and ONS (Object Name Service) - and its web interface are presented and evaluated. Some use cases are presented and evaluated using this prototype service entitled "RFID-based IoT for medication control".Fundação para a Ciência e a Tecnologia (FCT

Smart Healthcare solutions in China and Europe, an international business perspective

The thesis is part of the Marie Curie Fellowship project addressing health related challenges with IoT solutions. The author tries to address the challenge for the implementation of telehealth solutions by finding out the demand of the telehealth solution in selected European economies and in China (chapter 1), analyzing the emerging business models for telehealth solution ecosystems in China (chapter 2), how to integrate telehealth solutions with institutional stakeholders (chapter 3) and why are elderly users willing to use telehealth solutions in China. Chapter 1 and chapter 2 form the theoretical background for empirical work in chapter 3 and chapter 4. The thesis addressed four research questions, namely “Which societal and social-economics unmet needs that Internet of Healthcare Things can help to resolve?”, “What are the business model innovation for tech companies in China for the smart health industry?”, “What are the facilitators and hurdles for implementing telehealth solutions”, “Are elderly users willing to use telehealth solutions in China?”. Both qualitative study and quantitative analysis has been made based on data collected by in depth interviews with stakeholders, focus group study work with urban and rural residents in China. The digital platform framework was used in chapter 2 as the theoretical framework where as the stakeholder power mapping framework was used in chapter 3. The discretion choice experiment was used in chapter 4 to design questionnaire study while ordered logit regression was used to analyze the data. Telehealth solutions have great potential to fill in the gap for lack of community healthcare and ensuring health continuity between home care setting, community healthcare and hospitals. There is strong demand for such solutions if they can prove the medical value in managing chronic disease by raising health awareness and lowering health risks by changing the patients’ lifestyle. Analyzing how to realize the value for preventive healthcare by proving the health-economic value of digital health solutions (telehealth solutions) is the focus of research. There remain hurdles to build trust for telehealth solutions and the use of AI in healthcare. Next step of research can also be extended to addressing such challenges by analyzing how to improve the transparency of algorithms by disclosing the data source, and how the algorithms were built. Further research can be done on data interoperability between the EHR systems and telehealth solutions. The medical value of telehealth solutions can improve if doctors could interpret data collected from telehealth solutions; furthermore, if doctors could make diagnosis and provide treatment, adjust healthcare management plans based on such data, telehealth solutions then can be included in insurance packages, making them more accessible

INTEGRATION OF INTERNET OF THINGS AND HEALTH RECOMMENDER SYSTEMS

The Internet of Things (IoT) has become a part of our lives and has provided many enhancements to day-to-day living. In this project, IoT in healthcare is reviewed. IoT-based healthcare is utilized in remote health monitoring, observing chronic diseases, individual fitness programs, helping the elderly, and many other healthcare fields. There are three main architectures of smart IoT healthcare: Three-Layer Architecture, Service-Oriented Based Architecture (SoA), and The Middleware-Based IoT Architecture. Depending on the required services, different IoT architecture are being used. In addition, IoT healthcare services, IoT healthcare service enablers, IoT healthcare applications, and IoT healthcare services focusing on Smartwatch are presented in this research. Along with IoT in smart healthcare, Health Recommender Systems integration with IoT is important. Main Recommender Systems including Content-based filtering, Collaborative-based filtering, Knowledge-based filtering, and Hybrid filtering with machine learning algorithms are described for the Health Recommender Systems. In this study, a framework is presented for the IoT-based Health Recommender Systems. Also, a case is investigated on how different algorithms can be used for Recommender Systems and their accuracy levels are presented. Such a framework can help with the health issues, for example, risk of going to see the doctor during pandemic, taking quick actions in any health emergencies, affordability of healthcare services, and enhancing the personal lifestyle using recommendations in non-critical conditions. The proposed framework can necessitate further development of IoT-based Health Recommender Systems so that people can mitigate their medical emergencies and live a healthy life

The Emerging Internet of Things Marketplace From an Industrial Perspective: A Survey

The Internet of Things (IoT) is a dynamic global information network consisting of internet-connected objects, such as Radio-frequency identification (RFIDs), sensors, actuators, as well as other instruments and smart appliances that are becoming an integral component of the future internet. Over the last decade, we have seen a large number of the IoT solutions developed by start-ups, small and medium enterprises, large corporations, academic research institutes (such as universities), and private and public research organisations making their way into the market. In this paper, we survey over one hundred IoT smart solutions in the marketplace and examine them closely in order to identify the technologies used, functionalities, and applications. More importantly, we identify the trends, opportunities and open challenges in the industry-based the IoT solutions. Based on the application domain, we classify and discuss these solutions under five different categories: smart wearable, smart home, smart, city, smart environment, and smart enterprise. This survey is intended to serve as a guideline and conceptual framework for future research in the IoT and to motivate and inspire further developments. It also provides a systematic exploration of existing research and suggests a number of potentially significant research directions.Comment: IEEE Transactions on Emerging Topics in Computing 201

A Platform for Inpatient Safety Management Based on IoT Technology

There is a need to integrate advancements in biomedical, information, and communication technologies with care processes within the framework of the inpatient safety program to support effective risk management of adverse events occurring in the hospital environment and to improve inpatient safety. In this respect, this work presents the development of a software platform using the Scrum methodology and the integrated technology of the Internet of Things for monitoring and managing inpatient safety. A modular solution is developed under a hexagonal architecture, using PHP as the backend language through the Laravel framework. A MySQL database was used for the data layer, and Vue.js was used for the user interface. This work implemented an RFID-based nurse call system using Internet of Things (IoT) concepts. The system enables nurses to respond to each inpatient within a given time limit and without the inpatient or a family member having to approach the nursing station. The system also provides reports and indicators that help evaluate the quality of inpatient care and helps to take measures to improve inpatient safety during care. In addition, diet management is integrated to reduce the occurrence of adverse events. A LoRa and Wi-Fi-based IoT network was implemented using a LoRa transceiver and the ESP32 MCU, chosen for its low power consumption, low cost, and wide availability. Bidirectional communication between hardware and software is handled through an MQTT Broker. The system integrates temperature and humidity sensors and smoke sensors, among others.Colombian Ministry of Science, Technology and Innovation Francisco Jose de Caldas National Financing Fund for science, technology and innovation 80740-233-2020AUIP (Iberoamerican University Association for Postgraduate Studies

The association between pre-operative pain experience and post-operative pain in patients undergoing elective gastrointestinal surgery: a descriptive-comparative study

Aims: The purpose of the rapid review was to summarize and aggregate information for researchers and clinicians about predisposing factors for post-operative pain in laparoscopic patients and the prevalent management approaches post-operatively. The purpose of the descriptive-comparative study was to explore the associations between previous pain experiences and medication on the intensity of pain post-operatively in patients undergoing elective gastrointestinal surgery, using data collected by the Smart Pain Assessment Tool Based on Internet of Things. Methods: For the rapid review, the databases of PubMed, Web of Science and Embase were searched. ROBINS-I tool was used to evaluate the quality of non-randomized studies while ROB 2 tool was used for randomized controlled trials. For the descriptive-comparative study, 50 patients after gastrointestinal operations at Turku University hospital were included. The data collection of the study was done by a researcher belonging to Turku University staff at Turku University hospital. The data analysis was done by using descriptive and comparative methods of analysis. Descriptive statistics were used for the presentation and analysis of participants outcomes, diagnoses, procedures, and groupings based on variables related to the experience of pain (e.g., graphical measurement maximal pain levels using the numeric rating scale). Comparative statistics were used for associations and correlations regarding previous pain levels, medications, fear, and expectation of pain on maximal pain levels after gastrointestinal operations at Turku University Hospital. Results: The result of the rapid review suggest many predisposing factors for post-operative pain are influenced by the psychological profile of the patient. Among these factors are anxiety, fear, depression, expectation of pain, and other factors related to gastrointestinal surgery. Nevertheless, the results of this review also describe acute pre-operative pain, surgical factors, genetics, age, gender, obesity, and previous experiences of pain as relevant predisposing factors to pain following gastrointestinal surgery. Pain care strategies following gastrointestinal surgery include the use of pharmacological and non-pharmacological interventions. The literature suggests, non-pharmacological interventions are under-utilized and should be encouraged as an adjunct to pharmacological pain control strategies following elective gastrointestinal surgery. The results of the descriptive-comparative study somewhat contradict the results of the rapid review. Previous pain experiences or the recollection of preceding painful events were not associated with the administration of supplemental pain medication post-operatively (p = 0.741). Fear related to the upcoming pain following surgery was not associated with the level of invasiveness of the surgery (p = 0.662). In addition, the relationship between expectation of pain (p = 0.698), fear of pain related to the upcoming surgical procedure (p = 0.637) and medication post-operatively (p = .481) on the intensity of maximal post-operative pain was found to be negligible. The results of this study suggest patient expectation as a possible domain of intervention for better pain outcomes post-operatively. The administration of pain medication in the recovery room and the amount of pain medication in the recovery room were significant predictors of maximal post-operative pain (p = .001). Discussion: The results of the rapid review suggest a high to critical risk of bias in the studies included. The predisposing factors for post-operative pain differed widely across studies, but mainly included psychological factors as factors for post-operative pain. Pain management strategies should include an individualized approach and be implemented before, during and after the operation. For the descriptive-comparative study, there are substantial difficulties in discerning the effect of pain history or experience on post-operative pain using physiological or subjective reporting for conscious individuals due to risk of bias and using a unidimensional approach. Conclusion: Predisposing factors for post-operative pain should be screened in the pre-operative phase if possible, focusing on addressable factors whereas management of pain care strategies should include careful screening of participants biopsychosocial profile for elective surgery. The descriptive-comparative study suggests a possible, yet minimal benefit for managing patients’ expectation of pain related to the upcoming gastrointestinal surgery. The amount of pain medication in the recovery room is a significant predictor of maximal post-operative pain. Future research should include a larger sample, more variables related to pain and continue with a follow-up. Keywords: gastrointestinal, post-operative, pain, analgesia, anesthesiaTavoitteet: Katsauksen tarkoituksena oli tiivistää ja koota yhteen tutkijoille ja kliinikoille tietoa laparoskooppisten potilaiden postoperatiiviselle kivulle altistavista tekijöistä ja vallitsevista postoperatiivisista hoitokeinoista. Kuvailevan-vertailevan tutkimuksen tarkoituksena oli tutkia aiempien kipukokemusten ja lääkityksen välisiä yhteyksiä postoperatiivisen kivun voimakkuuteen potilailla, joille tehdään elektiivinen ruoansulatuskanavan leikkaus, käyttäen tietoja, jotka on kerätty esineiden internetiin perustuvalla älykkäällä kivunarviointityökalulla. Menetelmät: Katsausta varten tehtiin hakuja PubMed-, Web of Science- ja Embase-tietokannoista. ROBINS-I-työkalua käytettiin satunnaistamattomien tutkimusten laadun arviointiin, kun taas satunnaistettujen kontrolloitujen tutkimusten osalta käytettiin ROB 2-työkalua. Kuvailevaan-vertailevaan tutkimukseen otettiin mukaan 50 potilasta Turun yliopistollisessa sairaalassa tehtyjen ruoansulatuskanavan leikkausten jälkeen. Tutkimuksen aineistonkeruun suoritti Turun yliopiston henkilökuntaan kuuluva tutkija Turun yliopistollisessa sairaalassa. Aineiston analysoinnissa käytettiin kuvailevia ja vertailevia analyysimenetelmiä. Kuvailevia tilastoja käytettiin osallistujien tulosten, diagnoosien, toimenpiteiden ja kivun kokemiseen liittyvien muuttujien perusteella tehtyjen ryhmittelyjen esittämiseen ja analysointiin (esim. maksimaalisen kiputason graafinen mittaaminen numeerisella arviointiasteikolla). Vertailevia tilastoja käytettiin yhdistelmiin ja korrelaatioihin, jotka koskivat aiempia kiputiloja, lääkkeitä, pelkoa ja kivun odotusta maksimaalisen kiputason suhteen ruoansulatuskanavan leikkausten jälkeen Turun yliopistollisessa sairaalassa. Tulokset: Katsauksen tulokset viittaavat siihen, että potilaan psykologinen profiili vaikuttaa moniin leikkauksen jälkeiselle kivulle altistaviin tekijöihin. Näihin tekijöihin kuuluvat ahdistus, pelko, masennus, kivun odotus ja muut ruoansulatuskanavan leikkaukseen liittyvät tekijät. Tämän katsauksen tuloksissa kuvataan kuitenkin myös akuutti preoperatiivinen kipu, kirurgiset tekijät, genetiikka, ikä, sukupuoli, lihavuus ja aiemmat kokemukset kivusta merkityksellisinä altistavina tekijöinä ruoansulatuskanavan leikkauksen jälkeiselle kivulle. Ruoansulatuskanavan leikkauksen jälkeisiin kivunhoitostrategioihin kuuluu farmakologisten ja ei-farmakologisten toimenpiteiden käyttö. Kirjallisuuden mukaan ei-farmakologisia toimenpiteitä käytetään liian vähän, ja niitä olisi edistettävä farmakologisten kivunhoitostrategioiden lisänä elektiivisen ruoansulatuskanavan leikkauksen jälkeen. Kuvailevan ja vertailevan tutkimuksen tulokset ovat jossain määrin ristiriidassa nopean katsauksen tulosten kanssa. Aiemmat kipukokemukset tai aiempien kivuliaiden tapahtumien muistaminen eivät olleet yhteydessä ylimääräisen kipulääkityksen antamiseen leikkauksen jälkeen (p = 0,741). Leikkauksen jälkeiseen tulevaan kipuun liittyvä pelko ei ollut yhteydessä leikkauksen invasiivisuuteen (p = 0,662). Lisäksi kivun odotuksen (p = 0,698), tulevaan kirurgiseen toimenpiteeseen liittyvän kivun pelon (p = 0,637) ja leikkauksen jälkeisen lääkityksen (p = 0,481) välinen yhteys maksimaalisen leikkauksen jälkeisen kivun voimakkuuteen todettiin merkityksettömäksi. Tämän tutkimuksen tulokset viittaavat siihen, että potilaan odotukset ovat mahdollinen interventioalue, jolla voidaan parantaa leikkauksen jälkeistä kiputilannetta. Kipulääkityksen antaminen heräämössä ja kipulääkityksen määrä heräämössä olivat merkittäviä postoperatiivisen maksimaalisen kivun ennustajia (p = .001). Pohdinta: Katsauksen tulokset viittaavat siihen, että mukana olleissa tutkimuksissa on suuri tai kriittinen harhan riski. Postoperatiiviselle kivulle altistavat tekijät vaihtelivat suuresti eri tutkimuksissa, mutta niihin sisältyi pääasiassa psykologisia tekijöitä postoperatiivisen kivun tekijöinä. Kivunhoitostrategioihin olisi sisällyttävä yksilöllinen lähestymistapa, ja niitä olisi sovellettava ennen leikkausta, sen aikana ja sen jälkeen. Kuvailevassa ja vertailevassa tutkimuksessa on huomattavia vaikeuksia havaita kipuhistorian tai -kokemuksen vaikutusta leikkauksen jälkeiseen kipuun fysiologisen tai subjektiivisen raportoinnin avulla tietoisten yksilöiden osalta, koska on olemassa harhan riski ja koska käytetään yksiulotteista lähestymistapaa. Johtopäätökset: Kivunhoitostrategioihin olisi kuuluttava osallistujien biopsykososiaalisen profiilin huolellinen seulonta valintaleikkausta varten. Kuvaileva-vertaileva tutkimus viittaa siihen, että potilaiden tulevaan ruoansulatuskanavan leikkaukseen liittyvien kipuodotusten hallinnasta on mahdollista, joskin vähäistä hyötyä. Kipulääkkeiden määrä heräämössä on merkittävä leikkauksen jälkeisen maksimaalisen kivun ennustaja. Tulevaan tutkimukseen olisi sisällytettävä suurempi otos, enemmän kipuun liittyviä muuttujia ja jatkettava seurantaa