The Internet of Things: Modernising Healthcare
This article is taken from Innovations in Pharmaceutical Technology December 2016, pages 31 – 33. © Samedan Ltd
Imagine a truly modern digital healthcare system, powered and shaped by the latest electronic and wireless technology. Doctors monitor the condition of their patients remotely via printed electronic biosensors worn on or inside the body, dramatically reducing the strain on GP practice and hospital service levels. Pharmaceutical packaging changes colour when the contents are no longer consumable, and communicates with the consumer by streaming dosage and usage instructions to their smart phone. Elderly patients can remain independent within their homes for years longer, their health tracked by nurses remotely and sensor embedded flooring triggering an emergency home visit if a fall is detected, saving the NHS millions of pounds in care costs. Utilising the ‘internet of things’ has the potential to turn this vision into a reality.
Awareness of the internet of things is continuing to grow across mainstream media, trade press, and even as a feature of national innovation strategy. The term refers to a world in which everyday physical objects are embedded with electronic functionality, enabling them to communicate with users and exchange data with other smart objects wirelessly over the internet. In the home alone, there are potentially hundreds of applications for the internet of things. From smart outlets like the WeMo, which enables users to turn off electrical appliances from the other side of the world (or room) using their smartphone, to the wearable Mimo baby monitor, which streams real-time information about a baby’s breathing, skin temperature, body position, and activity level to their parents.
Ultimately the internet of things offers product developers endless opportunities to embed intelligent functionality into any surface or object. The main advantages of this are:
- Increased control for users, particularly remote control;
- Non-intrusive data collection; and
- Supply chain monitoring, opening up streamlining and cost saving opportunities.
The internet of things is made possible by printable electronics. Ultra low-cost, flexible electronic circuits that are thinner than a human hair, printed sensors, and near field communication (NFC) and radio frequency identification (RFID) antennas, are the components required to bring this technology to life.
There are significant opportunities within the healthcare and pharmaceutical market for printed electronics to provide transformative innovative solutions.
For instance, printed bio-sensor and NFC embedded devices worn on or inside a patient’s body that monitor their physical condition can provide healthcare professionals with remote, real-time information about the physical state of their patients, streamed over the cloud. The sensors will raise an alarm in the event of any deterioration, potentially enabling an intervention before the patient’s condition becomes critical. Widespread adoption of this technology could free up hospital beds for critical care and operations. It could also play a key role in facilitating the anticipated shift towards a more home based, community healthcare system, which focuses on prevention rather than cure.
Printed bio-sensors can also be utilised in in-vitro diagnostic devices to test samples from the human body for infection and to diagnose medical conditions. Again, this could be carried out away from a hospital environment, reducing delivery costs and providing much needed breathing space for already overburdened health service providers.
One of the most exciting opportunities for the pharmaceuticals born out of the internet of things is the so called “chip in a pill”. This is a special ingestible pill-shaped micro camera which passes through the human digestive tract, recording the patient’s health status and the effects on key organs of any drugs in the patient’s system. The gathered data is transmitted to a wearable device and/or sent as a report over the cloud to health care personnel for diagnosis.
The information obtained can enable medical professionals to prescribe personalised or precision medicines. These biopharmaceutical medicines work by breaking complex conditions down into smaller subtypes based specifically on their underlying causes. Those causes are then targeted and treated at a molecular level, potentially offering significant improvements in treatment efficacy. The dosage and type or combination of precision drugs required will be specific to individual patients or sub-types, so the highly precise chip in a pill method of data collection will be a useful tool for enabling accurate treatment planning and prescription.
Chip in a pill, and ‘organ on a chip’, which is a multi-channel 3‑D microfluidic cell culture chip that simulates the activities, mechanics and physiological response of entire organs and organ systems, could streamline drug development and make it more cost effective. Rapid research and development trials running multi-stage diagnostics offer improved productivity, with smart reporting and advanced analytical tools generating data in real-time without the need for continual feedback from subjects. Resultantly, data reporting costs and research time will be reduced.
Overall reductions in time-to-market can be realised by applying internet of things technology to the whole supply chain for new drug development. Using data obtained from smart systems integrated across the whole pharmaceutical value chain, pharma companies will be able to plan more efficiently, and make faster, better informed decisions about which drugs to pursue.
A further key area of application is the pharmaceutical packaging market. Interest in the incorporation of embedded smart components has been keenly felt in the pharmaceutical packaging industry. The umbrella term “smart packaging” is regularly used to describe packaging embedded with smart components, however there are different sub-classifications of electronically enabled packaging. These are:
- Smart packaging: Any packaging that serves a purpose other than containment and protection.
- Active packaging: Packaging that actively improves the product or its potential use.
- Intelligent packaging: A packaging system that transmits or gathers data or information about the product.
Smart packaging can provide consumers with a better understanding of their product and how to interact with it safely. For instance, by communicating with technology in smartphones, tablets, and other Wi-Fi-enabled devices, packaging could remind a patient to take their medication, and supply a dosage schedule for ensuring that they attain optimum results. This data could be shared with the patient’s doctor, enabling them to monitor patient treatment plans remotely to reduce the time and cost burden of repeated face to face meetings. Repeat prescriptions could be processed automatically without the patient having to formally request them.
Smart pharmaceutical packaging can provide important information about, and monitor the environmental conditions, such as temperature, shock, and humidity, that a product has been exposed to during its journey through the supply chain. This data can be utilised to provide unequivocal evidence of quality, a great advantage within an industry where consumers and brands face the risk of genuine harm from improperly packaged goods, expired products, and improper use. It will also provide suppliers with the opportunity to optimise logistics operations and monitor stock control down to individual units. This will afford suppliers greater control over return on investment, acting as an opportunity to identify ways of making the supply chain more efficient, streamlined and effective.
It is also possible to use printed sensors to identify and guard against counterfeiting and third party interference. For example packaging that changes colour upon the happening of shock or certain temperatures is already in production. This is particularly advantageous in the developing world, where there are known problems with drugs being tampered with, or swapped for cheaper, less effective drugs, and subjected to non-compliant storage and handling. As with food packaging, smart packaging can monitor the oxygen and moisture levels of its contents in order to communicate when a drug is no longer fit for consumption.
Despite the clearly outstanding potential for the internet of things to herald a significantly improved system of healthcare, there are a number of barriers that must be overcome before the technology becomes truly mainstream. The primary issue is the current lack of an established supply chain for NFC technology. Cost is a particularly prohibitive barrier within the commercial drugs market, where profit margins are often low. Manufacturers have traditionally focused on creating the cheapest solutions so they can inject as much capital as possible into product development. Mass market adoption will only be possible once there is a cost effective production supply chain in place that enables printable electronics to be incorporated for roughly the same prices in current production.
High profile research and development projects, such as SCOPE and Remedies, are underway to address this issue. These projects aim to identify new processes, equipment, and applications which will enable high-volume manufacturing of billions or even trillions of printed electronic components incorporating NFC technology. For the supply chain to be genuinely viable, highly automated and high speed integration techniques that use generic equipment will need to be used, and production costs of <1 cent per NFC tag achieved.
Perhaps the most controversial potential barrier to a fully internet of things embracing healthcare system is also the most economically valuable opportunity that the technology presents. The data gathered by smart objects and pharmaceuticals could provide a wealth of information about users’ habits and the way that they interact with and consume their medication, gathered in a non-obtrusive, highly streamlined manner. However as precision medicines become more mainstream, and the data that is handled and gathered becomes more and more personal, patients may not be comfortable with their information being collected and shared. Issues as to ownership of data may also arise: do healthcare professionals own the information about their patients’ treatment schedule, or does the drug manufacturer?
In relation to smart packaging specifically, thought leadership is required to inspire a shift towards consideration of how packaging can improve and compliment the product it accommodates at the outset. A process for disposing of smart packaging will also need to be developed. Sensors and other printable electronics have value that should be reused if the components are to achieve their full and useful life span. Disposal practices and procedures will need to be planned, implemented, and overseen, to ensure that a cost-effective, sustainable solution can be realised. In many cases, the task of developing effective recycling programmes for these electronics will fall to regulatory officials, but this is unlikely to happen until internet of things technology becomes more prevalent in the marketplace.
In the current economic climate of limited resources and funding, and with the NHS under increasing strain to streamline and achieve more with less, the internet of things offers the healthcare and pharmaceutical markets a real chance to transform both production and delivery into something more effective and more efficient. If manufacturers, healthcare providers, and scientists are to develop solutions which capitalise upon this technology to its full potential, collaborative cross sector R&D projects will give them their best chance of success. Open access innovation centres, which offer technical know-how, specialist facilities, and broad networks of contacts, can be the enabling catalyst for making this happen.
Turning innovative ideas into a commercially viable offering needs lots of different entities with complimentary offerings to join forces if smart pharmaceutical and healthcare solutions are to be utilised to the full benefit of producers, providers, patients, and the wider community.