The pressure on the U.S. hospital system amid the COVID-19 response is expected to heighten the role of the internet of things, or IoT, for increased efficiencies and reduced costs. While the medical response is only now playing out in the U.S., the ramifications will likely add urgency to the network of sensors required to enhance hospital automation and remote patient monitoring.
According to Kagan’s latest forecast, medical IoT revenue in U.S. hospitals is poised to grow at a CAGR of 18.6%, from $136 million in 2019 to $319.3 million in 2024. Price pressure from governments, insurance companies and patients is driving the growth of IoT revenue in U.S. hospitals that will better keep expensive machines running, automate the communication of patient vital signs, and track hospital equipment and personnel.
Medical IoT refers to sensors, electronics and communications technologies that enable network connectivity in the device, and IoT revenue refers only to the revenue generated by this technology, not the value of the underlying devices. While this results in revenue numbers that are not particularly large, the capability of the device itself is significantly changed. Medical IoT is key to the future of healthcare delivery in the hospital, where it might assist with uploading the heart rate from a patient awaiting surgery, tracking the need for maintenance in a CT scanner, or notifying staff of the location of wheelchairs within a ward via radio tags. Note that, due to medical security issues such as the dangers of hacked equipment and the need to maintain patient privacy, medical IoT does not necessarily mean transmission of data to the cloud. However, it does require at least automating and tracking certain hospital functions via the use of an internal hospital network.
The worldwide COVID-19 pandemic in 2020 is affecting every aspect of the health care system and should accelerate the adoption of medical IoT in hospitals. Medical IoT will help by automating the recording of patient vital signs, such as pulse, respiration and blood pressure, allowing closer, more frequent monitoring of this data than is possible manually by hospital staffs. This will help better track patients in distress, as well as allowing hospital personnel to spend more time on those patients.
The market for IoT in the hospital includes the following three segments:
The first market for hospital-based IoT is the use of predictive maintenance to avoid downtime on major medical equipment, such as magnetic resonance imagers (MRI), CAT scanners, x-ray machines and other types of high-end imaging devices. The cost of these machines can range from several thousand to millions of dollars, and keeping them running is key to the efficient performance of the hospital. And because of their cost, guaranteeing uptime via IoT can save hospitals significant money by reducing the need to outsource scans or even the need to purchase additional machines to cover for out-of-service units.
Through IoT, these high-end imagers are monitored via the cloud using the same predictive maintenance principles that are utilized for industrial equipment. The machine can be equipped with sensors, electronics and communications technology to monitor out-of-spec performance in terms of machine vibration, temperature, voltage, current or other parameters. If the performance is out of specification in a key way, the hospital and manufacturer can be notified, and a technician can be called to initiate repairs before the machine is taken out of commission.
For example, Philips Healthcare’s e-Alert system actively monitors the company’s advanced imaging systems. It employs IoT sensors to monitor MRI machine parameters, which are checked remotely by Philips Healthcare personnel, allowing service technicians to be notified to make repairs in person, or remotely via software, before the problem becomes more serious. In addition, the sensor data generated by one machine’s problem can be shared with technicians of all machines of that type anywhere in the world, helping to guarantee uptime for other devices.
Vital Sign Monitoring
Vital sign monitors encompass many of the most common tech devices in a hospital. Basic devices measure body temperature, pulse rate, respiration rate and blood pressure. More advanced devices might measure oxygen or other gas levels, heart and brain activity, or the quantity of fluids entering a patient. Typically, a nurse must record a patient’s basic vital signs multiple times per day. There is a move toward integrating network capability into devices, through options such as Ethernet, Wi-Fi or Bluetooth, to automatically record these measurements. This information then is uploaded to the patient’s electronic medical record in the hospital network.
During shift changes, it is very important that vital sign data be recorded and passed to the next nurse on duty. If the information or documents are misinterpreted, the patient might be endangered by issues such as medication dosage errors. Because of this, vital sign monitoring based on IoT can both reduce the nurse’s workload and improve patient interactions by avoiding communication errors.
This transition to automated vital sign monitoring via IoT may be accelerated by the recent COVID-19 worldwide pandemic. IoT offers several advantages in hospital care. First, vital signs can be read more frequently, allowing patients to be monitored more closely than by hospital staff checking them on their rounds. It also limits routine interactions between staff and sick patients, limiting the potential for staff to become ill. And by limiting the routine duties of hospital staff, it allows them to focus more on patient care.
Form factors of vital sign monitors are evolving. Some vital signs monitors are becoming portable, and attached to the patient’s hand or wrist, making for more of a wearable device. These devices by necessity must have some type of wireless technology to transmit this information. Another example is wireless, disposable sensors on the patient’s body to measure heart rate, respiration, and other vital signs. In addition, sensors in the bed can track patient’s basic vital signs, such as heart and respiration, as well as tracking the level of patient movement in bed.
Asset tracking refers to the use of RFID tags and readers to track people and equipment within a hospital. Though originally designed for tracking goods within a supply chain in an industrial environment, it has emerged over the past 10 - 15 years as a primary method of asset and human tracking within the hospital. A system of RF tags can be attached to patient wristbands, staff name tags and many types of hospital equipment. These tags connect to readers installed on walls and ceilings around the hospital, allowing for tracking of people and goods throughout the hospital. Tags can be attached to large devices, including portable medical equipment and beds, as well as patient samples that are sent for testing. RFID can save money and time by tracking the movements of goods, patients and staff throughout the hospital in real time, allowing staff more time to focus on patient care.
In addition to higher-cost items, supplies that require periodic replenishment can also be monitored so that the hospital does not run out of supplies. Tracking offers the additional bonus of allowing the hospital to lower its inventory levels on supplies, thus lowering overall costs. For example, supplies such as chemicals and gases can be monitored through the use of tags and sensors. In addition, more low-cost, disposable items, such as syringes, gloves, and masks can be monitored.
The revenue forecast for IoT in all three segments can be seen in the chart below. Predictive maintenance is promising, increasing at a CAGR of 15.0% from 2019 to 2024. The primary limiting factor in this segment is the relatively small number of devices compared to other medical IoT segments. Predictive maintenance is necessarily limited to the high-cost machines that benefit from closely monitoring internal performance via sensors and electronics to track the machine’s condition.
IoT revenue for vital signs monitoring is expected to increase at a CAGR of 13.7%, with the assumption that the COVID-19 virus pandemic will help drive IoT adoption in the segment. Adding IoT to these devices can be a significant portion of overall device cost, so the need must be justified. The ability to transmit this data regularly via network can reduce hospital workload while also increasing patient safety, by instantly informing hospital staff when patients’ vital signs are abnormal. Taking some routine work from nurses allows them to focus more on patient care.
The revenue forecast for IoT in asset tracking in hospitals is quite promising, at just over 26% annually from 2019 to 2024. This revenue growth exceeds that for the two other primary hospital IoT segments due to the total available market size. RFID tags can potentially be used on every single individual, piece of equipment, sample and box of supplies in an entire hospital, making the potential market enormous. And asset tracking can save money and increase efficiency in several ways. By better tracking equipment, losses can be reduced. And by tracking employees and patients, hospital personnel can be directed to where they are needed, increasing staff efficiency.