How IoT will disrupt healthcare

There are hundreds of proposals for the IoT in the health services. Half of them could be terrible. If only we knew which half! I’m not sure about other countries but whenever I hear about ‘disruptive technology’ and the British National Health Service (NHS), I always feel nervous.

We’ve already wasted £11 billion (€12.31 billion) and rising on a ‘fit for purpose’ programme for IT that wasn’t fit for anything. It would be a brave NHS purchaser that would sign off on any more ‘disruption’. Surely, if they are going to sell the idea, they need a new catchphrase, says Nick Booth, freelance IT and communications writer.

For now, in this sector at least, IoT needs to be a bit less brash and ambitious. We don’t want to see any more flash IT salesmen flaunting their wealth. Acqueon claims its IoT could save the NHS £500 million (€559.72 million) a year. Well, OK, prove it, by taking your payment as a commission on the savings you create.

The savings they are so confident about will come from solving the problem of medication noncompliance – that situation where patients don’t keep taking the pills. This will get worse as our population ages. IoT connected pill boxes don’t miss their doses.

Failing to take medication correctly leads to 200,000 premature deaths in Europe a year. Partly it’s because the old are bamboozled with complicated drug taking regimes. This polypharmacy involves a smorgasboard of pills which have to be taken in varying intervals.

A smart pill box knows when they’ve not been opened and sends automated reminders to the patient. If these messages go answered and the pill box still not opened, the device snitches on you to the clinician who then phones you directly.

Robots are getting old now too. The first robot assistant, the Arthrobot, made its debut in an operating theatre in 1984. Since then, robots have performed surgery on everything in degrees of complexity ranging from eyes and knees to neurosurgery.

Imperial College London created the PROBOT, which first performed prostate surgery at Guy’s & St Thomas’s Hospital in 1992. The robots are starting to take on human characteristics.

They’re starting to leave pieces of equipment in the patients, just like their human counterparts. This is all documented in Adverse Events in Robotic Surgery: A Retrospective Study of 14 Years of FDA Data. The authors from University of Illinois, Michigan Institute of Technology and Rush Medical Center compiled the report from MAUDE data (as in Manufacturer and User Facility Device Experience).

In a study of 1.74 million robotic surgical procedures – mostly urological or gynaecological – the data recorded 8,061 device malfunctions, 1,391 patient injuries and 144 patient deaths. Adverse incidents included electrical arcing, sparking or charring of instruments and the falling of broken or burnt pieces into the patient’s body. Such incidents were said to have contributed to 119 injuries and one patient death.

Clearly, operations utilising robotics are not without their risk, says Greg McEwen, partner at insurance law specialist BLM. As he points out, incidents relating to broken or left behind instruments aren’t exclusive to robotic surgery. Therein lies one of the difficulties in interpreting the data,” says McEwen. “It cannot tell us whether a complication is solely or partly attributable to the use of a robot, whether it is patient-related, or whether it represents a complication of the surgery itself.”

So, the debate about robotic surgery and whether the advantages outweigh the costs is likely to rumble on. Some studies have suggested that surgical outcomes for robotic procedures are as good as the non-robotic alternative, but is as good as” good enough?

There’s been a decline in the sale of surgical robots in recent years. Maybe the robots have got fed up with putting so much effort in with so little appreciation and they are thinking about new careers.

Robots need longer set-up times and changing instruments during surgery takes longer, so patients spend longer under anaesthetic.

Robots also lack the sensation or ‘feedback’ that experienced surgical hands may rely on to apply just the right level of traction or force, and can lead to inadvertent trauma and resultant injury. There have already been court cases in America where robotic surgery, sometimes involving death, was the bone of contention.

However, investment is pouring into robotics, particularly in China and the tech stronghold that is Sao Paolo in Brazil. So IoT is in a healthy condition, in several senses.

Remote surgery over 5G was demonstrated at Mobile World Congress Barcelona in March. However, slicing – of both networks and human flesh – is not a reality just yet.

The author of this blog is Nick Booth, freelance IT and communications writer

Comment on this article below or via Twitter: @IoTNow_OR @jcIoTnow

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