Remote patient monitoring: medical IoT as-a-Service from Medisanté

Remote patient monitoring: medical IoT as-a-Service from Medisanté

How can providers streamline the collection of patient data remotely while protecting patients’ privacy?

Swiss innovation champion Medisanté aims to streamline the collection and collation of patient-generated health data with its direct-to-cloud medical Internet of Things (IoT) infrastructure, which has already been adopted by Marseille Public University Hospital, one of the top three university hospitals in France; as well as University Hospital Bern, one of Switzerland’s top three university hospitals. HEQ speaks with CEO Gilles Lunzenfichter about Medisanté’s origins, ethos, and plans for the future.

How did Medisanté get started?

We realised that personal health devices all operated in silos, with each device connecting via mobile app to the proprietary cloud of its manufacturer. Healthcare providers were telling us that it was an interoperability nightmare for them to connect to all these manufacturer-specific silos in order to capture patient-generated health data from personal health devices; and so we came up with a device-agnostic cloud-based platform which would provide a single interface to the IT system of the healthcare provider, thereby shielding healthcare professionals from the complexity of dealing with multiple devices.

We have created a cloud platform which provides plug and play device interoperability with any targeted clinical system through a Fast Healthcare Interoperability Resources (FHIR) interface. Where providers may want to deploy thousands or tens of thousands or someday hundreds of thousands of possible health devices into patients’ homes, we can upscale the platform to offer device-agnostic fleet management across multiple devices.

What are the clinical benefits of integrating patient-generated data into everyday healthcare?

Healthcare providers are already well equipped to capture data from patients when they are in hospital, but at a certain point, patients must be released from the hospital and they return home without the same level of clinical surroundings. If at that stage, personal health devices can generate data that can easily reach the clinical system of the hospital, they can act as a remote telemetry system for patients who have been discharged from the hospital. The data generated by these IoT devices can then act as an early warning for healthcare providers if something might be wrong; and helps to avoid costly and dramatic emergency readmissions to the hospital if the vital signs go South.

The second use case is the provision of remote patient monitoring at large for chronic patients over multiple years. Most chronic patients are aged between 70 and 85; and they can be telemonitored by healthcare providers specialising in remote patient monitoring. The first key benefit of this is convenience: it reduces costs, there is less travel involved for elderly and vulnerable patients, and it is less time consuming for doctors. In addition, long term remote patient monitoring using this system can generate better outcomes; because if there is something alarming in the data, then the patient can be called to the clinic to see a GP or a specialist, whereas if nothing is alarming, then there is no need for extraneous routine visits which can be conducted remotely.

What advantages does the use of remote patient monitoring systems offer patients?

We offer what we call ‘zero touch’ configuration, which means patients do not have to download a mobile app to automatically send their vital signs to their care team; they do not need to enter their credentials into an app; they do not have to pair a medical device – such as a blood pressure monitor or a glucose monitor – with any additional technology. All the avertible, cumbersome device configuration falls away: we make it very easy for both healthcare professionals to deploy those devices and for patients to use them at home.

The fact that patients can be monitored from the comfort of their home is a huge relief for most patients. Remote patient monitoring promotes patient comfort because it allows particularly vulnerable demographics to stay at home – during the COVID-19 pandemic, for instance, remote monitoring could have enabled hospitals to collect a great deal of data from the patients at home without putting them at risk of infection.

How has Medisanté tackled the challenge of integrating patient-generated health data into a clinical setting?

The huge strength of our cloud-based platform is its device interoperability capability: we can integrate in a matter of hours into any clinical system which is able to receive FHIR-based data. FHIR is the new standard for device interoperability; and in supporting it, we break the silos: instead of vendors producing tens or hundreds of cloud systems which are complicated to integrate, we provide a single cloud-based platform which abstracts the provider from multiple cellular device types and offers device-agnostic device management capacity. We deliver **medical IoT as-a-Service** to healthcare providers.

How does Medisanté ensure data protection when using remote patient monitoring systems?

The primary element here is that the identity of the patient never leaves the clinical system. We leverage the compliance and security capabilities of existing clinical systems: if those systems were not safe and did not respect basic data privacy and data security requirements, the organisations which rely on those systems would not be able to operate, as it is their core business to protect the data of their patients.

We assign our IoT devices directly to a patient within an existing clinical system by the swipe of a barcode. The patient’s identity is never shared with any device vendor; it never goes in any cloud other than the clinical system itself, where the device is mapped to a patient. We call this privacy by design. When devices rely on Bluetooth – which ours do not – vendors assign a Bluetooth device to a patient in their home via mobile app: this means that the patient must provide their contact details when they download the app; and it is then a complicated process to anonymise their data. The only data that we manage in our device cloud is completely void of patient identifiable information.

How has the recent spike in cyber-threats affected medical IoT infrastructures?

A lot of what is currently referred to as medical IoT is in fact consumer Bluetooth devices. These devices are not actually medical IoT: they are too exposed to risk in terms of data privacy and data security; it is extremely dangerous for healthcare providers to collect vital signs that rely on Bluetooth devices and mobile apps.

The healthcare industry is the only industry that still tries to rely on Bluetooth connectivity to collect data in the home of the patient. Within the automotive industry, for example, car manufacturers draw IoT data directly from a SIM card in the car; with utility companies, smart meters in citizens’ homes are not connected via Bluetooth, the smart meter connects directly to the utility server. They both rely on direct-to-cloud connectivity. The healthcare sector can learn from these other industries which have already conducted large scale IoT deployments: the best way is to do it exactly the same way as those industries have done it, which is by including direct-to-cloud IoT connectivity in the device. Medical IoT in this sense is extremely safe – and much safer and less prone to cyber-attacks than devices which rely on Bluetooth.

We rely on the machine-to-machine telecom network provided by Vodafone and its global partners. In terms of cyber-attacks, taking down the entire network of a carrier like Vodafone is substantially different than cracking Bluetooth connectivity in a hotel room or in a patient’s home, because the latter can be done by any first year computer science student, while the former would require a secret service level of capability – and if you try to tap into the antenna of a telecom provider, two hours later the army is asking you what you’re doing.

Has the demand for medical IoT gone up during the COVID-19 crisis, with more people working from home or being treated from home?

It has become increasingly evident that delivering remote care will be the first choice in the future. There are multiple levels of remote care: the first level, which was massively accelerated by the pandemic, is teleconsultation, where the physician and the patient can interact over telephone or video. The second level entails partnering with all those telemedicine players who have experienced astronomical growth during the crisis, to add remote patient monitoring devices that capture patient-generated health data on an ongoing basis. We see the boom in telemedicine as a promising springboard for the next wave: remote patient monitoring supported by the deployment of medical IoT devices at a massive scale, so that health authorities and healthcare providers can be prepared for the next pandemic, when millions of people will again be confined to their homes.

Gilles Lunzenfichter
Chief Executive Officer
Medisanté Group AG

This article is from issue 14 of Health Europa. Click here to get your free subscription today.

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