Internet of Medical Things and changing Healthcare IP dynamics

Dr. Yogesh Shelke
Medical Professional,
Assistant Manager-Technology Research & Advisory
Aranca

Arpit Sharma
Manager - Technology Research & Advisory
Aranca

The Pharma IoT concept involves digitalization of medical products and related care processes using smart connected medical devices and IT services (web, mobile, apps, etc.) during drug development, clinical trials and patient care. The outcomes of Pharma IoT in development and clinical trials can employ combinations of advanced technologies and services to create totally new kinds of disease treatment possibilities.

What is IoMT? The Internet of Things (IoT) ecosystem provides a platform for bidirectional communication between enabling technologies such as sensor, actuator, and communication protocol networks. The feasibility of this technology trend appears to be successful in applications such as smart grids, smart homes, intelligent logistics, and smart towns along with healthcare.

The Internet of Medical Things (IoMT), a healthcare application of the IoT technology, would essentially comprise a network of connected components that monitor physiological data in real time and enables intervention. Figure 1 illustrates the architecture of patient and physician components of this technology.



The implementation framework would potentially transform the clinical practice areas in patient evaluation, clinical decision making and treatment follow-ups. The communication and storage component of system would enable efficient patient information storage, real-time data acquisition, wearable connectivity, and data transfers to control end user applications. Data analytics components enables data-driven decision processes for cyber physical systems, which remotely connects patients with computer-based systems and facilities at tertiary care centers.

Clinical technologies in IoMT environment would be realized in the form of multiple wellness and health monitoring devices, hospital care devices, wound monitoring swabs, drug delivery and pacing systems which will interact with other machines.

Table 1 lists the key benefits and limitations of IoT implementation in healthcare domain. The foreseen impacts of machineto- machine interaction, data flow and real time intervention solutions will radically transform the healthcare delivery, affordability and reliability in near future. Additionally, increased patient engagement in decision making, personalization of treatment plans, and device performance optimization will boost compliance and overall service satisfaction. As a result of this, technology adoption rate will increase in coming years to grow this market to reach $156 Billion by 2020; a primarily growth driver for recent research in sensor, networks, cloud, mobility and big data domains.

'

Apart from their utility in managing regular health statuses, IoMT have also been used for disease prevention, fitness promotion, and remote intervention in emergency situations. Some IoMT end application areas are discussed as follows:
  • Building family history at patient and community level
  • Chronic disease management
  • Remote assisted living (Tele health)
  • Wellness and preventive care (Lifestyle assessment)
  • Remote intervention in emergency
  • Improved drug management
Shift in innovation focus due to IoMT implementation
The existing medical devices can be transformed into IoMT connected devices to monitor real-time data for patients through enhancements such as bio -sensors, signal convertors, and communication modems. IoMT devices have been conceptualized in various forms of smart wearable devices, homeuse medical devices, point-of-care kits, and mobile healthcare applications, and are able to communicate with medical experts in remote locations. The macrolevel architecture of such devices comprises three layers: local devices, connectivity, and data analytics and solutions as follows:
Local systems and control layer
Localized intelligence is among the key technological shift in IoMT devices. In localized intelligence, the prime objective is to build a medical device with intelligent sensing, predicting the next course of action, provides secured transmission and failsafe control capabilities. Current R & D efforts by hardware manufacturers are streamlined to develop innovative biosensors to measure operational parameters, converters to generate digital inputs, smart controllers to make realtime decisions based on physiological readings and network interfaces to share data with other machines/central servers. Innovations in this domain mainly covers devices in the form of wearable monitors, monitoring implants, and physician handheld diagnostic devices.

Device connectivity and data layer
The layer primarily focuses on transmitting data from the networked device and storing it in pre-defined data stores in secured manner. Criticality and sensitivity of the healthcare information demands mitigation of cyber risks, hence driving research in encryption technologies, block chain applications and new networking protocols. Networking firms such as Cisco and Qualcomm are quite active in providing advanced technologies at this level along with new entrants.

Analytic solutions layer
Irrespective of the types of healthcare solutions enabled, the remote server collects data from multiple devices over the networks. The key innovations at solutions layer are observed in built-in algorithms to analyze real-time operational data, and electronic health records to provide data driven suggestions to treating physicians. This data-driven diligence helps with diagnostic ability, disease prediction, and implementing preventive measures on mass scale.

The IP filed in this domain covers the softwares, and embedded systems for comprehensive evaluation of data from different sources such as implants and smart devices and teach machines to provide differential diagnosis and treatment options based on patient condition.

Changing Intellectual Property Landscape
Major IP related to IoMT comprises the equipment, materials, design and software, as well as services and/or processes enabling remote monitoring and intervention capabilities.

Software IP related to IoMT includes the algorithms covering data acquisition, transmission and processing to support telemetry applications. Such control algorithms with embedded software are protectable by patents or copyrights. Copyright protection covers source code from proprietary applications and programming, but provides competitors the freedom to develop equivalent software by using independently formulated coding techniques.

The functional components of physical layers include hardware and embedded controls that perform sequential tasks in order to sense, convert and transmit vital information. Hardware patent primarily comprises of sensors, signal convertors, controllers and communication modems.

IP evolution
The IP in IoMT technologies were conceptualized in 1970 with a patent filed by both Warner–Lambert and Pacemakers Diagnostics clinic of America to disclose the telemetry and telephone transmission link system, to transmit healthcare data to remote locations. However, actual patent filing activities grew robustly after 1989, with the milestone improvements in biosensing and integration capabilities.

The bio-sensing and integration technologies in connectivity and solution layer captures dynamic physiological data and transmit it through wireless networks. The IP filings after 1989 marks evolution of telemedicine and IoT devices, which comprise a closed interdependent system of networked sensors, protocols, and cloud computing inventions.

The Internet-based medical device and remote healthcare assistance segments first flourished in the US due to the country's major market share in conventional medical devices. Remote location-enabled technologies were rapidly adapted in the market due to their widespread clinical acceptance and healthcare policies. Due to this, major corporations opted to protect their inventions in North America, followed by Europe which constitutes 90% and 30% of IP jurisdictional coverage. Key players also adopted to protect their invention in Japan, Australia, and China market pertaining to growing demand and increasing reliance on tele-health services.

Key players
Philips, GE Healthcare, and Medtronic are among leading players in IoMT technology. Philips offers IoMT products that enable cardiac monitoring, remote patient communication devices, and sensors to detect physiological parameters. GE and Medtronic provide comprehensive integrated products that support cloud-based technologies in existing monitoring devices, implants, and cardiac pacemakers.



Figure 2 shows the key players at various architectural level and their patent publication trend in last five years. Other players such as Siemens and IBM extend solutions in upper layers, which enable data analytics and cloud-based services to biometric data obtained from physical devices and sensors. Roche and Cerner focus on the integration of smart communication technologies that have the ability to connect diagnostic devices to remote locations.



Milestone innovations
Key technological innovations are classified under the medical data handling (US5924074A), remote networking technologies in medical devices(US5867821A), and data capturing sensor technologies (US6024699A) categories. The following key patents cover the landmark IoMT patents and have been cited frequentl. The Figure 4 shows total number of citing patents for each key patent family.



Recent IP fi ling focus
Analysis of IP filed in last five years reveals that applications in the areas of network connectivity, sensor integration, cloud based data solutions, artificial intelligence enabled diagnostics are on the rise. Synergistic technologies such as 3D imaging, augmented reality enabled patient education tools, encrypted patient record management, point-of-care devices and wearables are also witnessing the spurt in patent filing due to development of dependent technologies.

Aranca Perspective
The IoT implementation in healthcare domain is currently in a nascent stage of development. Although implementation of this technology is likely to provide a number of advantages; device security, interrupted communication and reliability pose main concerns in mass adoption. The foreseen clinical practices advantages would drive the emergence of new innovations and IP players in this opportunity.

Currently explored areas such datadriven decision making algorithms, disease prediction capabilities, faster and secure data transmission, autonomous healthcare logistics, robot enabled interventions, deep-learning based professional assistance, large capacity storages and integration of device would be key focus in future IP filings. The connected systems are forecast to reduce cost for patients, increase treatment adherence, and offer the advantage of locally smart devices that can control health automatically, would be incremental solution offerings.

As long distance connectivity, secure transmission, uninterrupted storage and processing of high volume of data would be major factors governing successful implementation of IoMT; Hence companies providing these services (such as Telecom front end back-haul providers, Cloud storage service providers/datacenter owners and security solution providers) would be major beneficiary of this trend and likely to emerge as leading IP filers in coming years.

On the other side, tier 2 supplier companies such as Vodafone, Verizon, AT & T, NTT, Sprint would also play a significant role in implementing IoMT. These companies could-
1. Collaborate with Implantable/Wearable device manufacturers or doctors; or
2. Develop service business models such as:
  • One time fees for implantable device, per person
  • Monthly recharge for few devices, per person
  • Family based fitness plans to develop new IP and play a pivotal role .
Considering the above benefits and challenges, IoMT seems a promising solution to improve healthcare monitoring and treatment outcomes. By leveraging core capabilities in data acquisition, transmission and processing, we believe that telecom front end back-haul providers, Cloud storage service providers/ datacenter owners and security solution providers are set to promote personalized care and improve living standards.