There are big expectations for the potential of Smart Health Technologies to support healthcare. This type of technology is still in its infancy, but Smart Health Technologies are expected to be commonplace in the future. However, further research and development is needed, e.g. to ensure the accuracy of data.
There are many opportunities for companies to develop Smart Health Technology solutions that will support the healthcare sector, e.g. within telemedicine and early detection. However, there are also definite barriers, e.g. the infrastructure and competencies needed to incorporate Smart Health Technologies in daily operations. Advice for companies includes ensuring data security and using global open standards, and much more.
Potentials of Smart Health Technology
How will the emerging potential of Smart Health Technology evolve in the near future? What is the current state, what are the potential values and possible risks?
The term ‘Smart Health Technology’ combines the term ‘Smart Technology’ with health, i.e. smart technologies used for health purposes. Smart Health Technologies is capable of recording health information from increasingly advanced sensors, storing and computing this information automatically and deliver either personalised advice or automated actions from the collected data. As such, Smart Health Technologies are at least in part physical, and can include the means to interact and engage with data by way of e.g. Virtual or Augmented Reality as well as other forms of data representation.
Smart Technology is an umbrella term covering all forms of technologies which have
Smart Health Technology adheres to the above definition, with the clause that it is used with the purpose of, or within the domain of health.
Smart Health Technologies are believed to cause drastic changes over a short period of time as well as provide an opportunity of incorporating both health data from private citizens through wearable technologies and smart health data from within the hospitals. This latter aspect will give rise to intelligent operations and maintenance. Hal Wolf argues that not only wearables, but also sensors and robotics will be available for remote monitoring by 2025.
According to Niall McDonagh, Smart Health Technologies cover a variety of solution types. In hospitals they can be e.g.:
Beyond the hospital sphere they can be e.g.:
While Data Analytics enable IT-systems to deliver tailored advice based on advanced analysis, the analysis will only ever be as good as the collected data. With recent advances in the development of health technology, we are seeing pervasive technology within healthcare which empowers citizens, patients and healthcare personnel as well as the operations of the healthcare system in general. Smart Health Technologies are able to obtain and engage with various kinds of data related to personal health and wellbeing.
The trend of recording especially personal health information has been steadily growing for several years with the notion of the Quantified Self. This movement has seen a steep increase in recent years as the rising abilities of IT and decreasing costs has made a wide variety of Health Technology available at an ever lower cost. The current state of Smart Health Technologies is advanced but still in its relative infancy. It will combine and grow alongside Data Analytics.
The care-o-bot 3 from Fraunhofer IPA is a robot which takes care of service related tasks in peoples home. The care-o-bot is in early stage of development, but the vision is that the robot in time should be able to bring the owner different things, help them come out of bed, helping with training.
“Care-O-Bot 3 is already able to independently move around the home while it performs simple service tasks. In Patient@home, these properties are continuously expanded through the project’s research and innovation performance and the robot will therefore continuously be able to engage in scenarios of increasing complexity” (Care-O-Bot, 2012)Care-O-Bot. (2012). Care-O-Bot 3 as a Test Platform and Inspiration. Retrieved from http://www.en.patientathome.dk/projects/care-o-bot-3-as-a-test-platform-and-inspiration.aspx.
Smart Health Technologies are influenced by the megatrends of democratisation, increased health focus and the paradigm shift in patient groups, while the trends of acceleration and digitalisation enable Smart Health Technology solutions, along with Data Analytics.
In relation to the burning platform created by the demographic change, the advances of technology have already been adopted to assist in providing care and wellbeing for persons in need for several decades. The demographic change is expected to be a driver for the development of Smart Health Technologies. The types of Smart Health solutions will depend on the needs presented by this change.
The true relevance of Smart Health Technologies also depends on the future capabilities of the technologies. Kevin Dean gives an example:
“SENS Innovation ApS was founded in 2014 with the aim of revolutionising the way our healthcare system uses daily physical activity in the treatment and prevention of a number of diseases. SENS motion® is a tool for health professionals to efficiently follow up and motivate larger patient groups and provide support for especially physically weak patients. The SENS motion® technology uses small and flexible disposable smart patches. The system has been developed with doctors, patients and health trainers to fit the rehabilitation process both at home and within a hospital setting. The SENS motion® smart-patch platform had to be significantly matured to be usable within the area of home rehabilitation. This product development process have been driven by the user inputs gained from Patient@home” (Sens Motion, 2012)Sens Motion. (2012). Efficient home rehabilitation tool SENS motion®. Retrieved from http://www.en.patientathome.dk/projects/efficient-home-rehabilitation-tool-sens-motion%c2%ae.aspx.
The use of sensors in self-monitoring has long been the cornerstone of the notion of Quantified Self. The combination of recording personal health and the possibilities within Data Analytics enable Smart Health Technologies to provide engaging and personalised output. In the future, machine learning may enable Smart Health solutions to provide users with predictive recommendations based on their lifestyle recorded through different data sources.
Smart Health Technologies make both real time and historic health data available to the citizens and healthcare personnel. The reliability of the collected data, however, is often discussed. Smart Health Technologies are still in their infancy and the reliability of the data is still not high enough for healthcare providers or end-users to rely on the precision and accuracy of the data. Jonas Moll sees a great future for Smart Health Technology data when the reliability is better:
More advanced solutions will be developed in the near future, as the advances in mobile data-sharing rise with the advances of 5G data transfer. This will enable data transfer rates faster than 1Gbps, allowing for virtually instantaneously responses to citizens (DNV GL, 2017)DNV GL. (2017). Technology Outlook 2025. Retrieved from https://to2025.dnvgl.com/p: . .
According to the Danish Institute for Local and Regional Government Research, previously KORA now VIVE, “the expectations for biotech and AI are enormous. It is however essential that this potential is demonstrated in a reliable fashion” (KORA, Højgaard & Kjellberg, 2017)KORA. , Højgaard, B. & Kjellberg, J. (2017). Fem megatrends der udfordrer fremtidens sundhedsvæsen. Retrieved from https://www.kora.dk/aktuelt/nyheder/2017/fem-megatrends-vil-forandre-fremtidens-sundhedsvaesen/p: . . However, it is important to remember that “it is a common trend to underestimate the time of implementation for megatrends, and undervalue the value in the long term” (KORA et al., 2017, p. 53)(KORA, Højgaard & Kjellberg, 2017)KORA. , Højgaard, B. & Kjellberg, J. (2017). Fem megatrends der udfordrer fremtidens sundhedsvæsen. Retrieved from https://www.kora.dk/aktuelt/nyheder/2017/fem-megatrends-vil-forandre-fremtidens-sundhedsvaesen/p: . . This applies to Smart Health Technology as well.
The expectations for the potential of Smart Health technologies are high but there is still a way to go before the full potential is realised. Jonas Moll argues that:
The present state of Smart Health Technologies is characterised by an enormous promise of future abilities, but for now the examples are few. While we see mostly smartphone apps and a few stand-alone products today, the prevalence of Smart Health Technology in health is still limited. The current ability to analyse and provide actionable advice to users based on their health data is still limited. Jonas Moll explains:
Smart Health Technologies and their ability to analyse and provide actionable results still need to be developed further before the true potential can be realised. Steffen Lerche believes that like Healthcare personnel have their clinical decision support systems, patients will soon have their own decision support systems too:
Among our interviewed experts there is an agreement that Smart Health Technologies will increase and become pervasive in the near future. For example, Hal Wolf argues that Smart Health Technologies will be commonplace in 2025:
Our experts also agree that making claims about what specific technologies will be worth focusing on is speculative, and that the best practice is to adhere to industry standards. New technologies will emerge in accordance with purposes or needs. As with the development and adaptation of smartphones, it is likely that we will see a rapid deployment of a singular good Smart Health Technology-related idea.
Sensor technology is expected to be perfected in the near future. This will enable Smart Health Technologies to incorporate precision technologies and internet connection in wearable devices. This means significant opportunities for monitoring and treatment. It will take time and require several steps of research and development, not least to ensure adequate precision for use. Kevin Dean explains:
On the one hand the challenges for Smart Health Technologies are related to the technical capabilities of the technologies, e.g. whether adequate precision and data security can be ensured. This will be necessary to ensure that Smart Health Technologies can be incorporated in healthcare. On the other hand incorporating Smart Health Technologies in healthcare will affect the healthcare personnel and the way that they work. A cultural change is in the cards.
The introduction of Smart Health Technologies will no doubt foster a change in the healthcare system. Not only will the healthcare sector need to adopt a new way of managing citizens with illnesses and special needs, the healthcare personnel will also need to be more agile in relation to integrating and working with new technological devices. For example, the advances in especially Smart Health Technologies is expected to speed up the process of using telemedicine to monitor and treat patients remotely. Peder Jest underlines:
In general more healthcare will take place in the homes of the citizens or in their local environment. Telemedicine is often used to the benefit of chronically ill patients today, however in the future, treatment in the local environment of the citizens will expand to other patient types. This means that the healthcare personnel will be delivering healthcare in a different way. Peder Jest explains:
Peder Jest argues that for providing healthcare in the local environment, Smart Health Technologies will have a significant role, and the healthcare personnel will need to learn how to work differently (Jest, 2018)Jest, P. (2018, January 2). Peder Jest. Interview performed by Health Innovation Centre of Southern Denmark.
The expectations for Smart Health Technologies are significant when it comes to reach, effect and time. Niall McDonagh underlines this expectation:
Kevin Dean argues that the pervasive technologies which we see today will become even more so in the coming years, and that familiar technologies such as the smart phone or smart watch will be developed further to include more detailed and reliable health technology sensors and abilities (Dean, 2018)Dean, K. (2018, January 4). Kevin Dean. Interview performed by Health Innovation Centre of Southern Denmark.
The opportunities for companies developing Smart Health Technology solutions are expected to be significant, particularly when it comes to:
There are, however also some barriers for Smart Health Technology solutions to overcome:
When developing solutions for healthcare, particularly solutions that handle personal data, the following aspects will be relevant to consider.
In May 2018 the General Data Protection Directive from EU (GDPR) will enter into force in the EU (European Council, 2016)European Council. (2016). The General Data Protection Regulation. Retrieved from http://www.consilium.europa.eu/da/policies/data-protection-reform/data-protection-regulation/. The purpose of the directive is to strengthen citizens’ fundamental rights when it comes to data, privacy and digitalisation – but also to simplify rules for companies and thereby facilitate growth. Some of the more noteworthy changes enforced by the directive are the possibilities of issuing fines amounting to up to 4% of a company’s annual turnover.
In order to adhere to the GDPR, companies may look at the Guidelines for Cybersecurity (ISO 27032).
The regulation regarding data subject consent has been further strengthened and clarified. Consent must be explicit and the citizen must be clearly informed of the precise and defined purpose of data collection. Furthermore the citizen has the right to revoke consent. If consent is revoked the data must be deleted and proof that it has taken place presented to the citizen. This will affect all companies handling data pertaining to the citizen’s health.
Data portability is a new topic introduced by the GDPR. With GDPR the citizen will have the right to data portability. This means that if you collect personal data the citizen has the right to receive the personal data concerning him or her in a structured, commonly used and machine-readable format. They also have the right to transmit those data to another organisation that collects data about the citizen. The purpose of this obligation is to limit the number of times citizens have to answer questions about the same subject matter, e.g. age, height, gender etc.
This is particularly interesting from a healthcare perspective because data might be required to be shared across different organisations in the healthcare sector to a much greater extent than they are today. This might also prove a new business opportunity for companies, since there may be a whole new market emerging for solutions to support data portability, e.g. by providing system integration or sharing information between different IT systems.
In addition to the more general GDPR directive, an updated directive on Medical Devices will enter into force in the spring of 2020 and 2022. The two directives (EU) 2017/745 “MDR” & EU 2017/746 “IVDR” – (European Parliament & European Council, 2017a)European Parliament. & European Council. (2017a). (EU) 2017/745. Retrieved from http://data.europa.eu/eli/reg/2017/745/oj/eng and (European Parliament & European Council, 2017b)European Parliament. & European Council. (2017b). (EU) 2017/746. Retrieved from http://data.europa.eu/eli/reg/2017/746/oj/eng heavily regulate what is defined as medical devices, and how such devices can be tested and used within the boundaries of the EU. This is central for especially Data Analytics and Smart Health Technologies. ‘Medical purpose’ is defined as any type of diagnosis, prevention, monitoring or treatment or alleviation of disease or disability. The vast majority of devices which collect health information are likely to be considered medical devices, even if they do not process or analyse the data. Companies operating within the domain of health should proactively investigate compliance with these regulations and adjust development processes accordingly.
Bringing technology into the sphere of healthcare services brings with it relevant ethical considerations. The Health Innovation Centre of Southern Denmark has developed two videos that illustrate the expectations and challenges that may arise when new technology meets the healthcare sector. The videos focus on the perspectives of the patients at home and the clinicians working across sectors, respectively. Companies may consider these ethical aspects in their development process.
Companies developing Smart Health Solutions for the Danish Healthcare Sector of 2025 should particularly consider the following:
With access to easily understood information citizens are empowered to take charge of their own health. While this is not a necessity, it is an ability with which great results have been seen earlier. The key point is a clear and transparent link between action and data which help to illustrate and thus either create or shorten the feedback loop between action and consequence. Deloitte suggest incorporating gamification to ensure the motivation and engagement of citizens:
“Gamified applications have significant, positive effects on health by developing resilience and patient empowerment while activating optimistic emotions … Gamification has the ability to activate patients, make them accountable for their health choices, and turn them into consumers” (Deloitte, 2016)Deloitte. (2016). Boosting patient empowerment and motivational pull. Retrieved from https://www2.deloitte.com/de/de/pages/strategy/articles/boosting-patient-empowerment-and-motivational-pull.htmlp: . .
Steffen Lerche advises companies to:
With several companies offering Smart Health Technologies to both private and institutional use, there is a need to use both Global Open Standards and a platform which incorporates data into one coherent view. There are markets for solutions that record specific data, analyse data or offer a platform for aggregating data from several Smart Health Technology providers.
Due to the sensitive nature of the data collected, there is a need to ensure long-term access and quality of data. Combined with other factors, such as Global Reach, companies should use and adhere to Global Open Standards as well as allow integration of competing products onto platforms and exportation of data. Using globally recognised Open Standards will allow companies to offer services globally and reduce the cost of services. In addition, this will ensure that citizens and hospitals using Smart Health Technology services are ensured access to their data in the event of companies going out of business. It will also ease migration from older systems to new.
Steffen Lerche advises companies to:
Erik Jylling underlines the need to integrated solutions into existing systems:
When entrusted with the personal information of citizens, there is an expectation to keep this information secure and encrypted. When the information is personal health information there is an added critical element to keeping this information safe due to the sensitivity of the information. Jonas Moll explains:
Smart Health Technologes may add value for the citizens, healthcare personnel, healthcare sector and society as a whole in relation to:
However there are also potential risks to consider: