A few years ago, the first phones started supporting 5G, and I certainly didn’t think it would expand so quickly. In Slovenia, 5G coverage is more than 38%. But there’s more to it than just fast internet. Its biggest advantage is perhaps the internet of things (IoT), which is important for healthcare as well.

What is IoT?

Internet of things are various interconnected devices that exchange data over the internet. The emphasis is on “devices” and “data”. We can integrate sensors, cars, phones, wearables, and anything else you can think of to work like one.

But the point is not to just connect them. It has to be fast and automatic. The condition for that is having a high-speed broadband network, which is 5G.

5G are essentially high-frequency radio waves that allow for higher download speeds compared to wide-spread networks such as 4G.

Additionally, 5G can connect many devices, which is the essence of IoT.

The downsides, on the other hand, are that 5G:

  • has low range (because of its high frequency), which is why many antennas are needed
  • has some potential security threats (more about this in a minute)
  • can interfere with existing technology in weather forecasting and aviation

Both IoT and 5G are very exciting for healthcare. As you might imagine, healthcare consists of a lot of data that has to be transferred quickly from point A to point B. Additionally, it contains numerous devices. And the goal should be to make them communicate and share data with each other as efficiently as possible. All in the light of improving patient care.

Smart hospitals

The ideal scenario of the use of IoT are smart hospitals, where devices collect patient data and are connected to each other. One such example was published in Nature Medicine in May 2021.

A hospital in Guangdong, China, started integrating AI into hospital management and operations in 2018. They connected AI to “patient registration and triage, diagnosis aids, health-record organization, digital payment, and the transportation of operating-room supplies”.

The problem was that the 4G network simply wasn’t fast enough. In my opinion, 4G network speeds for daily tasks are more than enough. But it’s a different story in hospitals. Imagine uploading a CT scan (file sizes up to 1 GB) at point A and then downloading it at point B. Not fast enough.

Now they’re building the same system but with 5G, which will make all of this possible and useful.

By using 5G in combination with cloud storage and AI, the comprehensive 5G smart hospital will cover areas of healthcare, teaching and training, research, and management, with 5G technology applied both within and outside the hospital, including ambulance, outpatient and inpatient services, and the operating room.

The whole thing is pretty exciting, so I’m outlining it all here (but read the piece for more details):

  • When a patient enters an ambulance, data is sent to the hospital in real-time. This allows the hospital to organise their resources well in advance.
  • The hospital wards make use of “wearable trackers, smart touchscreens, robots for supply delivery and cleaning, infusion devices, and real-time monitoring and warning systems”.
  • Infusion devices are alerting nurses via their wearables if anything requires their attention.
  • Patients can receive remote consultations and monitor their treatment.
  • And more.
The internet hospital is a fully digital platform that provides healthcare services and has the potential to be a telehealth model for healthcare provision and consumption in China.

Real-time alerting system

Speaking of alerting hospital staff, another paper in Nature Medicine showcased a real-time alerting system for COVID-19.

This was one of “the first large-scale, real-time monitoring and alerting systems for detecting abnormal physiological events”.

The researchers used two algorithms (called RHRAD and CuSum) for detecting abnormal physiological events and even developed their own called NightSignal. This allows the algorithm to work on a wide range of fitness trackers.

They managed to detect “COVID-19 at or before symptoms in approximately 80% of the symptomatic cases and even identifies asymptomatic cases”.

The paper goes to extreme details of explaining exactly how they achieved this, which is beyond this issue. But it’s important to understand that even a simple fitness tracker could be used for monitoring COVID-19 patients in a smart hospital for timely intervention.

Extending it with blockchain

As I was in the process of collecting resources for this issue, I stumbled upon a report that explains hospital devices are severely vulnerable to hacks. It analyses over 10 million devices at over 300 hospitals and other healthcare facilities around the world.

Any device connected to the internet can be subject to hacks. But hospitals deal with sensitive data and patients that are dependent on the devices working flawlessly.

In some hospitals, infusion pumps can remotely connect to electronic medical records and pull the correct medication dosage. The report suggest 73% of these infusion pumps are severely vulnerable to hacks.

It also struck me that running outdated Windows operating systems also poses a severe risk. The problem is that many of them are used almost continuously, which gives hospital security teams very little downtime to update them.

Summary of security vulnerabilities.
Summary of security vulnerabilities.

With the adoption of 5G technologies like in the examples above, the security question is even more important. Especially because of 5G itself could be vulnerable. There will be even more devices connected with each other and even more data will be shared among them. “This can raise the attack surface for these devices to a substantial scale, and the capacity for DDoS attacks, cryptojacking, and other cyberattacks could boost proportionally” (source).

Whereas most of the above is theoretical and might be different in practice, the security risks simply have to be taken seriously.

An idea how to secure data exchange between these devices is blockchain technology.

IOTA is a type of blockchain built as the distributed ledger specifically for IoT (and Internet of Everything). It overcomes the cost and scalability limitations of blockchain. This means it uses relatively little energy, has no transaction fees, and runs quickly. Another advantage is that it’s distributed, which increases its security. There are already concrete examples of using IOTA in data transfer between devices.

Trends in Medical Research of Blockchain
With the emergence of NFTs and ideas of a Web3, cryptocurrencies - blockchain is experiencing a major boost. The hype is always there in the tech world, but few are connecting it to medicine.

I think such applications of blockchain technologies are very valuable and useful. But most importantly, they solve real problems. The challenge is always applying these solutions in real-life. But I remain optimistic that because IoT is inevitable, so are the solutions to its problems.