Health of Things: IoT optimizes management processes

Internet of Things is a very broad concept. It covers applications, devices, equipment and already presents solutions that are optimizing management processes in the healthcare sector. Despite being under development in several countries, Brazil is still taking its first steps.

In the healthcare sector

A number of companies operating in the Internet of Things ( IoT ) area are proliferating, in terms of platforms, equipment and applications. In the healthcare sector, abroad, the major developments are mainly in the area of monitoring equipment and patients within hospital units. Douglas Pesavento, CEO of Sensorweb , gives the example of equipment already integrated into the hospital’s management system, but states that this is something that is still being engaged in in Brazil. There are hospital communication standards, such as the HL7 protocol, which allows systems in the healthcare area to interoperate — equipment, software, database — and integrate all information. This is well developed abroad, in the USA, Europe, Japan, and the equipment has already left the factory with onboard communication and allows integration into the hospital management system.

In Brazil

Some reference hospitals — Albert Einstein, Rede D’Or, Icesp — are now starting to make this a purchase requirement. It is something very recent, in a very embryonic phase. The traceability of medicines is also standardized abroad. In other words, we have a tag associated with the medicine that gives me all of its movement, such as mail and that allows the asset to know its location. This is an IoT area that has grown the most in Brazil, but is still little used, especially in a public environment, which has a lot of manual control of medicines. This causes losses to increase, whether due to expiration or storage in unsuitable conditions. Some research indicates that we have 15 to 20% of counterfeit medicines, so the traceability of medicines helps with this type of control as well.

Around the world

One area that already has solutions abroad is the monitoring of inputs such as liquids and gases. Monitoring helium cylinders and special gases for the healthcare sector is still very manual. People have to periodically go to the locations to see if it is necessary to change them. Abroad, this already has solutions, it is already integrated into the management system. When the gas level is critical, it automatically triggers a purchase process. It’s something we read about here, but we still don’t see it in practice.

Controlling wearable devices for monitoring patients brings a lot of benefit to hospitals, which is widely used abroad. Pharmaceutical companies themselves use this for drug testing, monitoring a patient who is using a drug in the testing phase, before approval. But this is in the development phase, especially in Brazil, as it is necessary to evaluate which solutions have a good cost-benefit ratio. The population that is dependent on someone, that needs care, has a tendency to grow and there is an expectation that this dependent population will surpass the so-called productive population, a target set for 2025, which opens up a very wide range of opportunities for wearable ones. Once you monitor the patient, you can work proactively , checking if they are doing the exercises regularly, if they are taking the necessary care, supporting the indication of medications. It is still very incipient today.

Investment

The efficiency of patient monitoring is being proven and there are real advantages over internationalization. In the USA and China there is public financing for wearables, the State is helping people to acquire this type of equipment with a view to improving quality of life and reducing the costs of the system itself. In Brazil, we see an increase in health plans — it reached almost 30% in 2015 -, compared to other countries such as the United States, where coverage covers almost 90% of the population. Within health plans, there is interest in investing in monitoring patients, especially elderly people or patients with critical problems. We are already proving the benefits of this, avoiding hospitalized patients, reducing costs and being able to monitor the patient daily and proactively .

In Brazil we should have several fronts: health plans that will make this available to certain patient profiles, such as the elderly, the government itself promoting it, but not in the short term, and there will even be the case of families with purchasing power hiring monitoring services directly with companies that offer this type of service. There is still the possibility that certain doctors or private clinics may offer this type of solution. It is not clear how this will arise, but it certainly will not arise in just one way.

Data security

According to Scottish doctor Des Spence’s article in the British Medical Journal , wearable devices and health apps are merely adornments comparable to earrings and necklaces. For the Glasgow doctor, “These devices and applications are unreliable, the data collected is unreliable and many of these instruments are untested and unscientific. Humanity is wasting time monitoring life instead of living it.” Data security and privacy are other flaws highlighted by Spence.

Douglas Pesavento says this is something critical around the world, with cases of data from health plans and hospitals that were stolen or lost, recovered after paying thousands of dollars. There is no record of cases of data loss in Brazil, at least in the health area. But it is true that there are gaps that are being corrected in the information and telecommunications infrastructure and data transmission. These are things that delay the evolution of IoT , but that require improvement, taking into account where and how the information is stored, and who has access to that information. These are critical points, require a secure structure and require work to improve the security of data and information.

2016 is too soon

Nowadays the IoT for the healthcare area is still in its infancy. We have solutions, we have companies starting in this area, we have investment funds, the first fund was born recently, in 2015, in São Paulo. There is time for this to mature and Brazil’s outlook is complicated. Much of the investment in the health sector comes from the public sector and it is known that there is a recession. The Ministry of Health itself admitted that the situation is bad, but it could get worse, which leads to difficulties in evolution. On the private side, with the opening to foreign investment, there is a lot of movement of foreign funds wanting to invest in hospitals and structures, mainly, which could bring some evolution in the private area. The year 2016 will not be the boom of IoT in Brazilian health, but it will be a year of validation, it is the year in which we will be able to validate financial forecasts and it will allow us to test these technologies and have more contact with it, to become familiar with this type of , create security when investing in IdC ‘s technological solution . This is something that Sensorweb understands intimately , a process it has gone through and continues to go through when demonstrating to the client how effective the solution is, what is the return on the investment they make . In the health area, it is necessary to prove by A+B that there will be gains from investing in IoT . Nowadays, this is something possible to do based on existing customers, presenting histories, what was managed to avoid losses, how it was possible to make processes more efficient, which added value in terms of quality and patient safety.

A second opinion

Roberto Cruz, CEO of Pixeon , recently spoke about how the internet of things could be one of the new pillars of healthcare. Internet of Things ( IoT ) or Internet of Things ( IoT ) is a communication between “everyday products” and the internet in order to provide the user with greater comfort and practicality when carrying out planned activities that depend on some technology. Devices that launch alerts, equipment programmed to perform a certain action at a certain time and with a certain frequency, or the now famous monitoring devices and wearable devices. But there are more complex applications of IoT , something that would be more futuristic, such as subdermal devices placed on the patient to monitor sugar levels or ingestible sensors, which control the effects of a medication. The internet of things can provide a set of advantages, ranging from the clinical to the financial area, reducing costs and increasing the quality of care, avoiding losses and errors and increasing the effectiveness of treatments.

Success stories ( Sensorweb )

Brazil is still in its infancy when it comes to the internet of things, however, there are practical cases of small advances that are already being recorded. Sensorweb presented some of these cases that are already a reality in the Brazilian healthcare sector.

São Paulo – ICESP

Icesp has more than 100 monitored pieces of equipment, spread over 27 floors. Before Sensorweb , records mainly outside business hours (nights, holidays, weekends) were made by technicians every four hours, that is, they didn’t even finish writing down the information that they already had to start over to cover. In other words, these schedules allocated practically one person dedicated to this. In addition to the issue of time and people, the process manual does not guarantee the need for reliability, that is, after implementing Sensorweb , historical monitoring data and alerts at the exact moment will allow the maintenance team to work proactively on these problems and manage to avoid losses. The alerts and graphic information also made it possible to carry out predictive maintenance of equipment, which did not happen previously, as the records were punctual every four hours, not allowing problems or failures in the equipment to be identified.

Santa Catarina Hemornet – HEMOSC

More than 400 pieces of equipment are monitored in 23 Hemosc units . Before Sensorweb , it was necessary to move people during weekends, holidays and at night to the units in order to record their temperature every four hours, according to legislation. People were also allocated for 24 hours in some more critical units, to carry out this registration. In addition to reducing these costs, the monitored system monitors the system constantly in real time and not just every four hours, bringing considerable benefits, such as checking equipment problems, triggering alerts at the time of the problem and greater reliability with system automation. recording equipment. It also contributed to achieving international certification from AABB (American Association of Blood Banks).

Research Institutes

In research institutions, where materials are stored with several years of study or years of storage, the monitored equipment is often invaluable, due to the great effort of the team, study time and materials used. In two cases, Sensorweb was effective in monitoring, sending alarms at critical moments when the storage ultrafreezers were inoperative, allowing those responsible to take appropriate actions and not lose the material from these equipment. In two other records of events, which took place at the Carlos Chagas Institute of Fiocruz in Curitiba and also at the Scientific Development Center (CDCT) linked to the Government of RS, the loss avoided was greater than the investment in the IoT solution .

Summing up the gains

  • Reduction in the frequency of equipment failures, as acting on alarms allows you to anticipate some breakdowns;
  • Reduction of the risk of product loss, with real cases in which these losses were avoided;
  • Checking freezer problems through the graphs and alerts that the system allows;
  • Improvement in maintenance logistics, allowing equipment with problems to be identified and maintenance to be better planned;
  • Reduction in time spent on manual registration and verification activities;
  • Register in real time, which allows immediate correction of any anomalies.

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