IoT technology can lead the way in helping to prevent and manage current and future pandemics.
One of the United Nations’ sustainable development goals is preparedness to combat the spread of infectious diseases. This goal has never been as relevant as it is now during the Covid-19 pandemic. Technology plays a major role in beating infectious diseases, and the IoT is an important part of our technology arsenal. Cost reduction, autonomous and remote caregiving and diagnosis, as well as newly available patient data are just a few of the ways that the IoT is transforming healthcare. And when it comes to disease control, wireless and IoT technologies offer powerful solutions.
We often think of IoT as a network of sensors and wireless microcontrollers, yet this is only the physical layer of IoT. Holistically, the IoT is distributed computing on a massive scale. The estimated 24 billion smart connected devices of the IoT can collect and perform computations on unprecedented amounts of data. In a pandemic response, more data simply means better decision making and better response plans. Both are vital in preventing and controlling the spread of a disease.
At the rise of a pandemic, the most urgent task is to trace and isolate those who possibly made contacts with the infected. This is one way of putting the disease under control. The traditional contact tracing techniques rely on interviewing subjects and asking them questions. This method is costly and time consuming and prone to human error. Traveling populations between densely populated cities exacerbate the problem and emphasize the weaknesses of the traditional method.
Alternatives to the traditional contract tracing rely on wireless technology (RFID, Bluetooth Low Energy, GPS, Wi-Fi and magnetic field signature) for detailed location tracking. Unlike the traditional method, wireless technology offers information on duration and proximity of the interaction with confirmed cases. Bluetooth Low Energy (LE), one of the most highly adopted IoT standards, can provide location tracking to a relatively high degree of precision. Compared to Wi-Fi and cellular location, Bluetooth LE can provide an order of magnitude greater precision than proximity detection. This improved accuracy is paramount in classifying the traced contacts and prioritizing the response to the closer contact cases. Bluetooth LE offers a multitude of location tracking schemes, such as RSSI and angle of arrival (AoA). The Bluetooth LE standard is also widely available on our smartphones and most connected wearables.
During the rise of a pandemic, deploying Bluetooth tags is yet another solutionto improve the response plan. To put things into perspective, this means deploying hundreds or even thousands of Bluetooth tags and smart devices communicating in densely populated urban areas. Systemwide optimization of this mesh of Bluetooth devices is needed to overcome message collisions, which could potentially mean missing a highly susceptible contact because their device did not register the interaction they had with a confirmed subject.
Biosensors and point-of-care Ttesting
Another critical task in pandemic response is point-of-care testing. The lack of widely available test kits for Covid-19 has put us under the tip-of-the-iceberg impression whenever we examine Covid-19 data. The unconstrained spread of the Covid-19 virus in New York City could have been minimized if test kits were more widely available. Cost effective and quickly deployable diagnostic devices are also a fundamental need in remote and developing parts of the world, where lack of trained personnel and equipped healthcare centers can result in uncontrollable spread.
Besides being cost effective, diagnostic devices must be reliable, sensitive, portable, and user-friendly. Additionally, it is preferable if they can be fully or partially disposable, easily reproducible and have a small form factor. Cloud-connected biosensors fit this bill perfectly. Imperial College London researchers have demonstrated a lab-on-chip capable of early detection of diseases. The patient experience is fairly simple. A sample is extracted from the patient into a disposable cartridge. Within 30 minutes, the testing is complete.
From a technical standpoint, here is what happens: The cartridge is loaded into the lab-on-chip device containing an array of ISFET sensors mounted on a CMOS chip, which is connected to a microcontroller transferring the data via Bluetooth to the cloud or a smartphone app. The biosensor in use, ISFET, is very similar to a MOSFET transistor except that the metal gate is replaced with an ion-sensitive structure. The ISFET biosensor can measure ion concentrations in solution. The sensors perform ion imaging of the reaction at the surface of the chip, thus enabling DNA amplification to be monitored in real time. Monitoring this biological process is equivalent to detecting the viral infection. This demonstration shows how IoT can power trivial technologies to enable ubiquitous and pervasive computing and allow unprecedented point-of-care testing capabilities. And to put things in perspective, this Lab-on-Chip technology, even though a lot cheaper, is similar to Abbott Labs Lab in a box test kits that got expedited FDA approval and are being deployed in the past few weeks.
Internet of medical things
The CDC estimates health-acquired infections (the number of people getting infected during a health-related visit) in American hospitals alone to be 1.7 million annually. During pandemics, this number doesn’t only increase, it also causes shortages in health professionals when we need them the most. How do we reduce the risk of hospital infections during a pandemic?
One attractive solution is the Internet of medical things (IoMT). IDC estimated that more than 70% of healthcare providers are already deploying IoMT, which is good news for future pandemic prevention. The fundamental genius of IoT is it turns any object into a source of data. In the case of IoMT, the “object” is medical, be it a heart rate monitor, a wheelchair, or a wearable device. A continuous stream of patient-generated health data (PGHD) can be used to analyze the health status of the patient. On a greater scheme, the collection of data from patient populations can be used to accelerate medical studies and development.
Deploying more automation and technology in hospitals such as IoMT bedside devices means fewer interactions with infectious patients and more staff protection. Readily available patient data will reduce the need and duration of hospital visits. This goes hand in hand with evolving technologies of remote doctor visits, remote diagnosis and monitoring. Although it’s important to note as IoMT and automation rise, with the exception of pandemics, the technology doesn’t replace the human-to-human connection, which is a crucial part of patient care. If anything, IoMT provides doctors with more time to focus on the human aspect of their jobs, such as patient and family consultations.
IoMT also enhances remote care for the elderly or those with chronic conditions, which in a scenario like the current Covid-19 pandemic, could mean a dramatic reduction of exposure to the most vulnerable populations. During a pandemic, caring for elderly with the least amount of interaction is vital to avoid risking their lives. With virtual assistants, medical sensors, and smart homes, we can keep our vulnerable populations physically safe and mentally well.
The discussion of IoMT and IoT in general is never complete without addressing security and privacy concerns. While IoT technology has evolved enough to carry data back and forth from objects to the cloud, device and data security remain an issue. This explains why healthcare providers have been deploying IoT in their back-end systems and are cautious with how much customer interfacing is mobilized by the new frontier of IoMT. Patients are rightfully nervous about a smart wearable medical sensor constantly broadcasting sensitive information about their health status. In addition, in the case of a pandemic and especially when it comes to contact tracing, data privacy becomes a sensitive issue. If we deploy Bluetooth tags in the population to enable contact tracing at the rise of a pandemic, who owns the collected data? And to what extent can this sensitive data be accessed and manipulated?
IoT privacy and security vulnerabilities must be addressed before the technology reaches the hands of healthcare consumers. Addressing such concerns begs for the collective work of legislative, economical, medical, and technical players in the field. From a technical standpoint, a tremendous amount of innovations already exist to protect hardware and software devices against hacks. For example, Silicon Labs’ Secure Vault technology generates a unique signature, like a birth certificate, for each wireless chip. This means the computations performed on the chip become only available to IoT service providers of the IoT service and not to nearby hackers. However, establishing consumer trust in how their personal data is handled by the providers remains an open issue.
IoT technology can lead the way in helping to prevent and manage current and future pandemics. The IoT, deployed at mass scale, offers humanity an unprecedented body of data and analytics in the face of pandemics. Controlling the spread of a disease becomes more efficient and can help us can track, test, and treat entire populations with IoT technology.
— Asem Elshimi is an RFIC design engineer for IoT wireless solutions at Silicon Labs.