The Internet of Things (IoT) is being propelled by the dramatic reduction in size, power consumption, and cost of networking and computing capability. Many of the devices listed in the Wolfram Connected Devices Project are health related. “Things” like weight scales and thermometers can make measurements from many objects, but when that object is a human body, they effectively become medical devices. The sensors that come standard on smart phones also fit into this category. All of these network-connected devices that record data from humans make up the Internet of Medical Devices (IoMD).
In most ways the invasion of technology in Healthcare is no different than how mobile digital capability is changing that way we all live. For Healthcare though, the potential benefits of applying these technologies to solve both the cost problem and to improve patient safety and outcomes are tremendous.
The number of technologies and innovations (health tracking apps and devices, home monitoring, medication management, etc.) that are contributing to these goals are too numerous to count. From a medical device perspective there are four primary areas of concern that need to be addressed as the IoMD grows.
As I’ve written about many times (e.g. Interoperability: Arrested Progress), health data interoperability is a key factor in realizing both cost reductions and improved patient outcomes. Unfortunately, medical data is notoriously complex, which makes effective communication between systems very difficult.
Another significant barrier to interoperability are EHR interfaces. The issue is that each EMR vendor has a propitiatory interface for consuming device data and associating it with a patient record. Without a direct device interface, data has to be manually transcribed into the record which is expensive and error prone.
This is a particular problem in the ambulatory EMR market because there are literally hundreds of vendors. Even if they all used a standard like HL7 there is still interfacing work that has to be done for each one. It is prohibitively expensive for any device company to develop and maintain that many interfaces.
2. Patient Safety
Because proper handling and presentation of medical data pose a safety risk the FDA has recently stepped in:
Most medical software applications, like the ones you might download to your Apple or Android phone, will not be affected by these regulations.
Even though PHI (Protected Health Information) is protected by Health Information Privacy (HIPAA) laws most people consider their health a very private issue. Privacy concerns are a significant psychological barrier that must be overcome before sharing of medical data becomes commonplace.
Reports like the one described in The Internet Of Things Has Been Hacked, And It’s Turning Nasty are not encouraging:
Pinging one device brought up a login screen that said: Welcome To Your Fridge. She typed in a default password—something like “admin” or “adminadmin,” Knight said—and suddenly had access to the heart of someone’s kitchen.
The IoMD is not immune from this. Hacking Insulin Pumps And Other Medical Devices From Black Hat was big news last year. <TongueInCheek>If we’re not careful search engines like Shodan will soon be discovering pace makers near real hearts!</TongueInCheek>
UPDATE (1/25/14): Also see: Digital Health In 2014: The Imperative Of Connectivity
I agree with Udi Dahan’s Thoughts on a career in software development premise that developers will eventually be faced with a management “opportunity” at some point in their career.
It’s too bad that this is usually a “fork in the road” decision. I don’t think companies are necessarily trying to pigeonhole developers, but they certainly have specific roles (with associated job descriptions) they are trying to fill. It makes sense though. For large software projects, being a manager (and probably a scrum master) is a full time job. Put another way, if you try to split your time between being a contributor and a manager, you’ll probably do both jobs poorly.
My advise is to make this type of decision with your eyes open. If you have a management opportunity and it’s something you’re interested in, take it. Treat it like the career change that it is. Get the additional training and improve your skills just like you would be doing if you were learning a new technology. Management isn’t easy. It takes time and work get good at it.
Also, good companies do not pigeonhole technical managers. You will probably have the ability to switch back to a development or architect role as business needs and priorities change in the future. This could mean moving to a different company, but both you and your current employer know this. Switching from management back to a technical track will require yet another skills learning curve and a mindset change.
The way to create a Zigzag career is to go with the flow.
Whether you experience success, failure, or somewhere in between, each one of these transformations involves significant personal and professional growth. Also, no matter what you do always stay at the top of your game: Continuous Learning: 14 Ways to Stay at the Top of Your Profession.
Bringing artificial intelligence to mobile computing is a significant challenge. That’s the goal of Qualcomm’s new Zeroth Processors.
Mimicking the human nervous system and brain to allow computers to learn about their environment and modify their behavior based on this information has long been the goal of artificial neural networks. Whatever computing model is used to achieve this capability the real problem is one of scale. The human brain is estimated to have 100 billion neurons — with 100 trillion connections. That is at least 1,000 times the number of stars in our galaxy.
These computational models can be implemented in software (e.g. Grok), but the ability to scale to the levels required for even simple human-like interactions is severely limited by conventional computing platforms. The Zeroth Neural Processing Unit (NPU) is a hardware implementation of the brain’s spiking neural networks (SNN) method of information transmission. Integrating the NPU into computing platforms at the chip level would begin to address the computational and power requirements for these types of applications.
The goals of the Zeroth* platform are:
Achieving ”human-like interaction and behavior” is an ambitious goal, but it seems like this is a good first step.
UPDATE (25-Oct-13): Good overview here: Chips ‘Inspired’ By The Brain Could Be Computing’s Next Big Thing.
UPDATE (1-Jan-14): CES 2014: Intel launches RealSense brand, aims to interface with your brain in the long run
* The name Zeroth comes from the science fiction Three Laws of Robotics. The First law was that “A robot may not harm a human being.”
Asimov once added a “Zeroth Law”—so named to continue the pattern where lower-numbered laws supersede the higher-numbered laws—stating that a robot must not harm humanity.
We’ll have to wait and see, but let’s hope so!
The FDA has issued their final guidance on mobile medical applications: Keeping Up with Progress in Mobile Medical Apps. The guidance document (PDF) will “give mobile app creators a clear and predictable roadmap to help them determine whether or not their products will be the focus of FDA’s oversight. ”
The regulatory approach is as you would expect (my highlight):
FDA intends to apply its regulatory oversight to only those mobile apps that are medical devices and whose functionality could pose a risk to a patient’s safety if the mobile app were to not function as intended.
There are six categories of mobile applications listed that the FDA intends to exercise enforcement discretion:
If a mobile application is considered a medical device it will be classified as such – class I (general controls), class II (special controls in addition to general controls), or class III (premarket approval) — and the manufacturer will be required to follow Quality System regulations (which includes good manufacturing practices, §820.30) in the design and development of that application.
For any organization that is not already under FDA regulatory control, this is a big deal. Given that there are 1000′s of medical applications already out there, even this limited scope approach will likely affect many companies. More information is here: Mobile Medical Applications.
The guidance includes many examples (including mobile apps that are not medical devices) and an FAQ.