that we as a country need to make some decisions about. This chapter elucidates the second leg of IoMT devices: the data that they produce. It is ultimately why the IoMT ecosystem needs to be protected.
The Volume of Health Data
The United States has one of the largest per-capita expenditures on healthcare of any modern nation. We have been looking for solutions to reduce those overall costs. The causes of the expenditures are up for debate, but some of the prevailing issues cited include everything from administrative overhead to heavy use of both emergency room visits and acute care utilization. Obviously for the latter, IoMT has the ability to play a part in reducing the overall cost. One study cited by T-Mobile stated that the end result of combining wireless and IoMT devices created a 40% reduction in acute care utilization and a 65% reduction in emergency room utilization. To top things off, IoMT also resulted in a 30% increase in workflow efficiency.1
Think about this from both a hospital and a patient perspective. Trends could indicate a worsening of conditions early on and allow the hospital and patients to respond more quickly. This is a tremendous win across the board. IoMT technology can help in many other ways. Remember the NFC communications in the previous chapter? Just putting an NFC bracelet on a patient and an NFC tag on medicines has resulted in faster validation, fewer incidents of people getting the wrong medicine, and an overall improvement in the system.2 To get this to work, simply check the tag on the patient, and when they need medicine, the medicine is matched against the NFC tag to validate that the patient is receiving the correct medicine. It is a very effective method to reduce problems related to medication errors. Some estimates are between 55% and 86% reduction in errors.3 All of these small changes help to improve many aspects of today's medical treatments.
With so many success stories occurring as a result of improvements, it is no wonder that all the devices that support Medicine 2.0 are proliferating so quickly. COVID-19 is only accelerating the pace of change. This is all part of the beginning stages of Medicine 2.0,which stands on the proverbial back of Web 2.0 technology—basically technology that includes more audio and video content than Web 1.0. We now have more hard drives and more ways of connecting to the internet than ever before. I would also argue that the cloud principle of elasticity has been a huge boon to collecting and storing information. In the past, companies had to spend a tremendous amount of money to continuously expand their infrastructure. The cloud allows companies to get out of the hardware business and focus on the technology that is truly important to them.
If you recall, we stated the average hospital has between 10 and 15 medical devices per patient. While not all of them are producing continuous information, they are providing more and more detailed information at often close to real-time speeds. All that data begins to add up to volumes of information. A December 2019 report by the World Economic Forum said the average amount of data a hospital produces is 50 petabytes (PB) per year.4 While data was collected prior to Medicine 2.0, the volume of data has exploded exponentially—mostly due to the advent of IoMT. Lifewire put together some fantastic statistics to help understand the sheer volume of information. One petabyte is equal to roughly 1.5 million CD-ROM discs, which is equal to 4,000 digital photos taken per day over the course of your entire life.5
Also, to help put things in perspective, since 2016, there has been an 878% growth in the amount of data that has been collected electronically. Some of this is due to the Affordable Care Act, but a large amount of it is due to the proliferation of IoMT devices. Health data is here to stay and is not going away anytime soon.
Projecting into the future, the proverbial holy grail of medicine would be to get a full 360-degree view of a person—to understand what is going on with them on a constant basis. The more data you have, the better and stronger recommendations that may be given. We have a long way to go before we get there, but the technological seeds are in place to cause data to grow exponentially—far more than the amount of data we collect now.
Data Is That Important
No matter your perspective on the Affordable Care Act (ACA), it has hastened the push toward Electronic Health Records (EHRs) that both technology and the HITECH Act began. It represents another step toward a more paperless office. The overarching goals are about transforming the medical care through the sharing and analysis of information. There are several benefits to doing so, but the outcome is more data in more locations.
Providing insurance to millions of Americans who did not have it before is a tremendous help—especially during a pandemic. Aggregating the information from insurance companies, hospitals, doctor's offices, and so on, can help leaders identify key neighborhoods where the problem is worse and provide appropriate responses. New York City, for example, is starting to experiment with closing areas that are harder hit from COVID.6 Whether or not that plan is successful, it demonstrates the power of what data can be used for. It also aids in community outreach so we can respond more locally to local problems. This would not be possible without solid actionable data being at least semi-centralized.
From a hospital perspective, that information is very valuable. Thirty years ago, if a patient came into a hospital unconscious, there was no information about that patient. Today, depending on the sharing capabilities of a region, doctors have the ability to look up the medical history of a patient or even lab tests they have had in the past. This prevents the waste of performing the tests again and provides healthcare professionals with invaluable information on how to treat patients more quickly based on their background. That extra information can help save both lives and money.
But from a pandemic perspective, it can help hospitals predict where the influx of patients will be coming from so they can better plan to handle those patients. Information is absolutely critical. Without it, hospitals can be overwhelmed. Even with that information, hospitals can be overwhelmed, but at least they are better prepared to save lives.
The ACA also has provisions for fighting fraud from potentially dishonest providers. Being specifically focused on the data, participating organizations can have their data accessed to search for fraudulent activity. Centralized data does have specific value as part of an overall fraud reduction strategy.7
The ACA also has provisions for Accountable Care Organizations (ACOs). The primary function of ACOs is to create cost savings by encouraging doctors, hospitals, and other health providers to coordinate patient care more efficiently. In order to do that, they need data from the members who are part of the network of services that the ACO is part of. So again, the drivers are there to have data in more locations.
In the final analysis we certainly have improvements to make, but we are making very larges strides as a society to cut back on individual medical expenses through the use of IoMT and better communication networks. Our care is becoming more personalized as we gather data on patients on a regular basis. We are responding to medical issues before they become major problems. The access we have to medical records is saving us from having to redo the same tests time and again. We are reducing our error rates, which is a boon for hospitals and patients alike.
This Is Data Aggregation?
Almost ironically, the need to aggregate data is also a cause of some of the dispersion of data. Every company needs data in order to operate effectively. The more centralized that information, the better. Years ago, the information was by hand
