Will IoT, Blockchain, & Bots Come to Healthcare? (Written For Healthcare Execs)

When Will IoT, Blockchain, & Bots Really Come to Healthcare?

For the first time ever, people are using messenger apps more than they are using social networks; these platforms will evolve and many already use consumer-oriented bots. The purpose of this post is to demystify tech buzzwords and shine light on when they will apply to becoming useful in healthcare. The three terms we’re covering: IoT, Blockchain, and Bots are just representations of such terms simply conceptualized as: data collection (IoT), database/data management (Blockchain), and automation (Bots) respectively.

IoT is just a term for connecting data sources and what’s important is what you do with that collected data. Blockchain is just a kind of distributed database made famous by Bitcoin. Lastly, Bots consist of a few lines of code programmed into the console in the programming language suitable for the task i.e. hardware control, platform independent program, or web based bot etc.

How Do I Explain The Difference Between Marketing and Retail Applications From the Potential Clinical Application of Future Bots?

You can use bots today for customer service queries. Bots are simple if X then Y programs; I said simple in actuality, not simple to build. There are many good customer service and retail oriented use cases for Bots that Forbes outlines here. To build a truly useful enterprise-grade bot applicable to the clinical environment will require the use of NLP on enough data. We believe that the majority of the healthcare sector will take some years to aggregate disparate data sources (if only from a technical perspective) to provide the data needed to develop truly useful decision support bots. You can read our answer here on the state of data liquidity in healthcare. Machine learning and analytics inform Bots. You can visualize a bot below in the “cognitive automation section” of the infographic below, at the top and to the right.

image credit: CIO.com

How Do I Describe the Background and Context For My IoT Plan With My Peers and Board of Directors?

According to the Brookings institution, “by the end of the decade, the fifth-generation (5G) network is expected to support 50 billion connected devices with speeds of more than 100 megabits per second. 5G’s connectivity, computing power, and virtual system architecture will soon expand the mobile internet of things (IoT). The connection of billions of digital devices through IoT will pave the way for innovation across industries and markets; in particular, connected medicine has the potential to transform health care through imaging, diagnostics, and treatment improvements, among other groundbreaking new possibilities.” Streaming sensor data would have machine learning applied to it as depicted in the cycle below. However, the value isn’t in the collection of the data, it’s in the insights derived from the analysis of that data through machine learning.

A Microservices approach to your future architecture requires isolating data persistence models to maintain its state. Despite what your legacy vendors are selling, this is uniquely facilitated by NoSQL databases.

If your peers are new to Big Data or IoT, here is a backgrounder on next gen data strategy here.

David Chou, CIO/Chief Digital Officer at Children’s Mercy describes here in this post the conceptual implications for prognosis, treatment planning, preventive health, and population health management with IoT.

One challenge in IoT is new security threats. CIO.com describes the problem of IoT security beautifully in this article. The article explains how a successful IoT strategy will require a multi-layer approach to securing the IoT network that involves providing the proper policy enforcement for existing devices and those that will come onto the network in the future.

image credit: security ledger.com

What Do I Tell My CEO About How Blockchain Applies to Our Business?

Blockchain is just a kind of distributed database whereas every node has a ledger of transactions history . Some companies like to tout it as a buzzword. There are even some products that are really like accounting systems grafted to this kind of database. Maybe that can be sold as innovation to your stakeholders?

Blockchain adds multi-signatures and cryptography to any database. The data is hashed onto the blockchain and then, using multi-signatures, people can gain access only if there is approval from the appropriate number of people. Using this technology, there could be a rule that for patient records to be accessed, the physician, nurse, and patient must all approve; or, perhaps, 2 out of 3 have to approve to grant access.

The use of Blockchain authorization in a hospital environment would lead to more delays and time to access any piece of information for a mobile messaging solution, further exacerbating a delay in care which remains the leading cause of preventable death. We believe that designing with encryption and a secure architecture produces the same results without the delays inherent in the blockchain process. In our use case, you would be adding operational complexity without added security benefit. At Medigram, we encrypt every password, every username, and hash every piece of content part of a message without the additional operations that would be required by Blockchain.

There will be good uses for Blockchain as a top healthcare CIO explains here how medication management is like financial transactions.

Further security context is provided by Mitch Parker, Executive Director for Information Security and Compliance at IU Health, “Right now, Blockchain is mostly non-production datasets that are in research and years away. When Blockchain comes into production for life sciences, it will need to have a strong identity proofing and management program behind it to ensure that people are who they claim to be, as the certificates used to sign information appended to the blockchain should be strongly bound to the individual. DEA regs also require NIST 800–63 Level III or higher for ePrescribe of Controlled Substances, and ideally, the end user applications also need to have two-factor authentication (or better) for further proofing and verification. If we’re going to use Blockchain technology to store sensitive information about people, even if it is encrypted, we need to ensure people are who they claim to be.”

Three things have happened to pique CIO’s interest in Blockchain technology application in healthcare:

1) The American Enterprise Institute testified to Congress about the benefits of Blockchain to health plans.

2) The Office of the National Coordinator for Health Information Technology selected proposals such as this winner of their Blockchain Challenge.

3) The CEO of Humana touted the potential for Blockchain here in his blog whereas he makes some good points about the potential application of blockchain for managing contractual relationships in the future as depicted below by Booz Allen Hamilton. Other observers such as Nishan Kulatilaka of Merck tout its future potential in contributing to interoperability of patient records and facilitating patient registries for clinical trials.

image credit: Booz Allen Hamilton

We hope this is a helpful talking point as you assess how your technology plans fit within the buzzword landscape (or vice versa ;-).

Sherri Douville is CEO & Board Member at Medigram and is a sought after expert in mobile technology and the medical industries. Ms. Douville currently helps to lead technical trust and safety standards for the industry through IEEE and has been published and quoted in both mainstream and industry media such as CIO.com, the Mercury News, NBC, Becker’s Hospital Review, and HITInfrastructure.com. She is also a member of the MIT Technology Review Global Panel, helping advance digital literacy in the boardroom as a lifetime member of the Digital Directors Network, and has served on the board of the NorCal HIMSS. She is currently a co-author for a Springer engineering textbook chapter and is the lead author and editor for a mobile computing in medicine book. Prior to her current work in the mobile privacy, security, health IT and AI industry, Sherri worked in the medical device industry consulting on the areas of physician acceptance and economic feasibility for medical devices. Prior to that, she worked for over a decade with products addressing over a dozen disease states at Johnson & Johnson and was recognized for thought leadership by McGraw-Hill. Sherri has a B.S. in Combined Sciences from Santa Clara University and has completed certificates in electrical engineering, computer science, AI and ML through MIT. Ms. Douville advises and serves various startups, boards, and NonProfits including as a member of the Board of Fellows for Santa Clara University and as an advisor to their Leavey School of Business Women on Corporate Boards program.

CEO @Medigram Mobile Intelligence For Healthcare http://www.linkedin.com/in/sdouville/CE