Opinion studies show that many people are enthusiastic about these types of medical devices and services. In fact, a survey of 12,000 adults in eight countries revealed that “70 percent are willing to see a doctor via video conference for non-urgent appointments” and “70 percent are willing to use a toilet sensor, prescription bottle sensor, or swallow.” “are receptive to using health monitors.”
Additionally, the use of 5G technologies has the potential to protect quality and reduce overall medical costs. Some examples of this are:
• Use of sensors and remote monitoring devices that help patients living in isolated areas access top-notch medical care. The use of video conferencing facilities or telemedicine can reduce geographic divisions and provide higher quality care to underserved communities.
• Newly emerging point-of-care testing (POCT) can save money by avoiding costly hospital visits. Instead of going to a large medical facility, patients can take advantage of mHealth technologies, digital platforms, or remote monitoring tools. The POCT market is estimated to be worth $27.5 billion by 2018.36 These devices increase patient access by providing technology at the bedside or in the home.
Home health treatment offers a way to provide quality care to patients without having to travel long distances to hospitals or medical facilities. They can transmit medical information electronically and remote doctors can advise on diagnosis and treatment.
• Research from the Veterans Administration (VA) found significant advances in chronic condition management through telemedicine. Its study of more than 17,000 VA patients showed “a 25% reduction in the number of bed days of care, a 19% reduction in the number of hospital admissions, and an average satisfaction score rating of 86% after enrollment in the program.” ” Its researchers concluded that telehealth is “a cost-effective way of managing chronic care patients in both urban and rural settings.”
• A study conducted by the University of Virginia Health System found a 37 percent improvement in hospital readmissions after home visits and acute care support. Monitoring vital signs and medical needs in real time helped the system reduce readmissions for a variety of different diseases, from heart failure and stroke to pulmonary disorders. This saved Medicare millions of dollars.
• An analysis of congestive heart failure patients in Indiana showed that remote patient monitoring reduced hospitalizations. Among those whose biometrics were tracked daily and who had weekly video conferences with health providers, only three percent were readmitted, compared with only 15 percent of those who received such attention. Nationally, the readmission rate for people with congestive heart failure is 21 percent. This helped those individuals and the participating hospitals save a considerable amount of money on treatment without compromising the quality of medical care.
• Diabetes is a big problem in many communities. The state of Mississippi found that 13 percent of its adults have diabetes and 54 percent of those individuals are located in rural areas, where there is limited access to quality care. However, after creating a diabetes telehealth network with remote care management, Medicare officials saw cost savings of $339,184 for 100 patients enrolled in that project and estimated Medicaid savings of $189 million annually.
• By keeping people away from hospitals, health IoT has the potential to keep costs down and save money without compromising quality care. Not every medical problem requires a visit to a doctor’s office or hospital. Routine problems can be diagnosed remotely and patients can be offered better alternatives to traditional care.
• Voice recognition software can streamline administrative tasks. A study of this technology in hospitals found that it helped health professionals “provide care without being interrupted by data entry and query tasks.” The software enables people to record medical information without stopping to enter data.
• Advances in intervention management are happening online. Medical facilities can better manage care resources – highly valuable assets such as operating theaters, electrocardiogram monitors and other equipment. The ability to monitor the use and status of large amounts of equipment helps facilities ensure patient safety and efficiency. Capabilities such as real-time tracking of value assets enable better management along the supply chain.
Examples of such impact have also attracted the attention of private sector innovators. For example, AT&T is working on technology solutions that can help improve health quality of life. Through the AT&T Foundry for Connected Health, the company focuses on digital health innovations that benefit people inside and outside the clinical care environment and provides patients and their caregivers with solutions to bridge the gap between the clinical setting and home.
Looking at the industry opportunity as a whole, “cost savings through e-health are expected to account for between 10% and 20% of total health care costs,” reports Paul Budd Communications. Digital medical services allow consumers to shop from different health care providers. Patients go online for health information and use it to refine their questions before medical professionals.
And advanced data analytics will help businesses keep costs in check. A study by McKinsey found that “the adoption of big data could save between $300-$450 billion in healthcare costs in the US alone.”
In short, 5G solutions connect devices for smart and timely decisions. These data provide real-time visibility of people, diseases, and symptoms, which in turn makes it possible for caregivers and policymakers to develop new insights. Interoperable devices work together with intelligent notification systems to ensure appropriate treatment for each patient.
5G networks offer great opportunities to enhance healthcare with their faster speeds and smart design. These systems are enabling new devices and applications that could revolutionize diagnosis and treatment. However, a McKinsey study highlights that significant changes are required in the healthcare sector to fully benefit from these advances.
The main challenge going forward is to expand technological opportunities and make 5G and the Health Internet of Things not just a hope, but a reality. Several steps are needed to advance the vision of 5G health care. These include infrastructure development; spectrum harmonization; adequate technical standards; effective regulation; and changes to reimbursement policy, privacy protections, and research data.
5G networks require superfast broadband and private companies are investing billions to develop the infrastructure needed for a connected society. This is paving the way for faster systems and more intelligent networks in all over the world. Having access 90 percent of the time is insufficient for mission-critical tasks. Some 5G applications require constant access without interruption, such as maintaining the Internet of Things.
Many government agencies are devoting resources to training professionals and developing new treatments that take advantage of 5G networks. For example, the National Institutes of Health is spending $130 million to train millions of volunteers to encourage “a new way of conducting research through participants and open, responsible data sharing.” The National Cancer Institute is studying genetic markers that could lead to cancer treatments that are better targeted than those available today. The Food and Drug Administration is investing $10 million on changes to the “regulatory structure needed to advance innovation in precision medicine.”
Many companies are launching testing programs. For example, both Verizon and AT&T are launching pilot projects this summer and many other companies are experimenting as well. In addition, both the 2018 Winter Olympics in South Korea and the 2020 Summer Olympics in Japan will be testing grounds for 5G-based television coverage and digital programming. These expenditures are significant because they are a critical first step in building out the digital networks and facilitating the workforce development needed in a 5G world.
An important thing to understand about 5G spectrum is that a variety of frequency ranges are needed to support different applications and use cases, each of which has its own, sometimes competing, requirements. We need a combination of licensed, licensed shared, and unlicensed spectrum in the low-, mid-, and high-frequency bands. None of these frequencies will be sufficient for emerging applications.
Frequencies that are close or adjacent to each other can be leveraged for inclusion in a single product design, even if they are not all available in the same geography. Finding frequency ranges that are available in major markets, or where available frequency bands are close enough to be supported within a single radio signal, is critical to achieving the economies of scale needed to support the business case for both manufacturers and operators. Harmonization of major markets creates commonalities in regulatory requirements and technical specifications that will help reduce the cost and complexity of implementing and enabling 5G globally.
Different types of applications require different types of spectrum. For example, signals that must penetrate through and around obstacles to reach devices in obstructed areas require low-range spectrum below 1 GHz. Autonomous vehicles and industrial applications may require less mid-range spectrum below 6 GHz than other types of spectrum because of the necessary balance between connection speed and radio link reliability. Virtual reality, 3-D video, and gaming applications require high-range spectrum, perhaps above 24 GHz where larger chunks of spectrum can be made available. Leaders need to marshal spectrum in many different ways to take full advantage of 5G-enabled applications.
The 28, 37-40, and 64-71 GHz ranges are a key part of the emerging landscape in the high-range bands. The US is conducting an incentive auction of the 600 MHz band, and the Federal Communications Commission will soon issue an order that will allocate new spectrum for 5G use and provide more flexibility to existing licensees in this range. The hope is that this will free up new resources and allow different companies to try new products. This new administrative action could bring spectrum together in ways that are likely to boost health IoT opportunities and many others.
With the complexity of interconnected devices, it is important to work through standard-setting bodies to ensure security and interoperability. Maintaining data sharing networks and the easy exchange of reliable information is vital for 5G and the Internet of Things. With billions of connected devices, it is a complex undertaking to ensure that devices work correctly and data flows smoothly and securely. According to Bridget Carlin, managing director of the IoT group at Intel, mutually agreed upon open standards are crucial because “without them, we will not be able to see the scale of IoT connected things and realize the $4 to $6 trillion economic opportunity we envision.”
Organizations such as the National Institute of Standards and Technology and various technical societies such as the 3rd Generation Partnership Project (3GPP), the Open Connectivity Foundation, the Industrial Internet Consortium (IIC), and the Institute of Electrical and Electronics Engineers are working to make this happen. Harmonizing system specifications between companies and countries.48 One of the advantages of the Internet is the free flow of data and its trade across borders, which is facilitated by international agreements and multistakeholder bodies of experts. These agreements and experts aim to identify the most promising technologies and promote their adoption on a broad basis.
It is important to understand that the best way to work through technical barriers, definitions, coexistence and certification is through a transparent and open standards process. For example, much of the work to enable 5G is being established through 3GPP-supported standards-based technologies that are designed for fair coexistence in licensed and unlicensed bands.
In the healthcare sector, widely accepted standards exist for vital signs devices, wearables, heart rate monitors, motion sensors, weight monitors and blood pressure cuffs. This has led to the proliferation of wearable devices and remote monitoring equipment that enable health providers to obtain data in real time on a range of consumer information.
International interoperability requires application developers to use open standards and clear computational architectures. These types of systems provide the basis for scalable solutions that can transform health care delivery.
Finally, secure and efficient connections over 5G networks are critical. Users must be confident that security will be maintained and intruders will not harm the high-speed network. Having a means to ensure interoperability is critical for the evolving ecosystem.
Policymakers must be careful about how they regulate technology innovation. They need to balance innovation on the one hand with societal values designed to protect consumers, safeguard privacy, and protect security on the other. In the United States, regulatory agencies such as the Federal Communications Commission and the Food and Drug Administration play a key role in setting the agenda for 5G markets in other countries. The decisions they make set the framework in which commercial companies operate.
As an example, the Food and Drug Administration is moving toward new ways to assess next-generation sequencing technologies. It wants to encourage new approaches to gene sequencing that enhance the physician’s ability to improve therapy targeting. They want to ensure that sequencing is accurate and reliable, and provides the latest information for health care providers. Devices with the potential to harm patients require careful oversight, but some new applications based on information measurement or fitness tracking are consumer devices that do not require regulation. Having clear rules on where medical sensors and remote monitoring devices fall on this regulatory continuum is important for the digital ecosystem.
When thinking about new approaches like clinical decision support, government agencies should encourage innovation and regulate software when there is a high risk to patients. Industry tools based on best practices and peer-reviewed recommendations are designed to help physicians and nurses ensure they have the most comprehensive information available. They should not be placed in the same regulatory category as medical devices that monitor patients or remote surgeries in which people are actively involved.
Government officials need to update reimbursement policy in light of new advances in digital medicine. Currently, it is difficult for health care providers to obtain reimbursement for telemedicine, video conferencing, or home health treatments. Reflecting a “brick and mortar” perspective, most official regulations favor in-person over digital approaches to health care. In many cases, doctors must be physically with the patient to qualify for reimbursement.
This ignores the many instances of imaging, diagnosis, and treatment described in this research. Treating patients via phone or video conference is often not reimbursable. Neither is the use of home therapies such as dialysis. For example, Medicare stipulates that “beneficiaries receiving home dialysis treatment may receive a clinical evaluation via telehealth if the telehealth visit is consistent with existing Medicare requirements for telehealth reimbursement.”
Experts involved in the agency’s working group recommend that “geographical limitations on Medicare reimbursement be removed so that free-standing dialysis facilities outside of HPSAs could constitute acceptable initial sites, and second, that the dialysis patient’s home could also be considered an initial site.”50 These changes would allow patients and doctors to take advantage of recent developments in home health care delivery. They would accelerate the pace toward a 5G world.
All total types of Medicare Programs also need a more nuanced and dynamic approach to reimbursement. Currently, a wide range of diagnosis and treatment codes exist based on specific diseases. Yet because of its static nature, it is difficult to aggregate this information to link treatment to health outcomes. We need a reimbursement system that includes information about patient well-being.
Value-based reimbursement represents a way to reward providers whose patients get healthier, rather than those who are covered on a “fee-for-service” basis. Linking health outcomes to diagnosis and treatment records makes it possible to evaluate outcomes. Both providers and patients will be able to see which treatments had the most positive impact and whether the cost of the treatment was worth the expense.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) established strong privacy protections for health care information around the world. Lawmakers understood that medical data is quite sensitive and patients needed assurances that medical providers and health payers did not compromise the basic privacy and security of health data.
Individuals participating in clinical trials must provide “informed consent” and stringent security measures must be taken to protect their medical information. According to the so-called “common rule”, researchers must de-identify (or anonymize) personal information. They can combine data from large numbers of individuals and analyze the collected content, and gain insights into what works and what doesn’t.
Ensuring that researchers have access to quality data is critical to moving forward. With a massive increase in the quantity and quality of data analytics in the 5G world, researchers are ready to assess medical treatments in real-time and deliver the benefits of their knowledge to patients with quick turnaround.
Additionally, people who wish to donate their medical information in exchange for access to insights from holistic research studies should be encouraged to do so. This will promote “accelerated learning” in medicine by helping everyone gain access to the insights of clinical researchers. Adoption of new consent processes beyond specific projects will help analysts provide benefits to the community as a whole.
There is tremendous opportunity through 5G across a variety of sectors to connect the healthcare world in creative ways. The use of mobile devices, sensors, and remote monitoring devices is set to increase and will lead to dramatic advances in patients receiving imaging, diagnosis, or treatment through digital technology.
However, to ensure that all this becomes reality, work needs to be done to facilitate an end-to-end system. Devices must connect from those type to networks and the cloud in ways that are interoperable and secure. This will help health providers and patients leverage digital innovation for wellness and healthcare. If we can overcome these barriers, both health care consumers and providers will see substantial advances in medical treatments.
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