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The era of the Internet of Things (IoT) is coming. Are you ready?

We are slowly moving away from the Internet being solely the realm of mobile devices and computers; soon it will permeate every facet of our life. Our cities will be filled with infrastructure that updates from the net and reports to it, big data about how people live their lives will become commonplace as information collection becomes easier. Our homes, our cars, our schedules will grow more interdependent. Imagine your home automatically unlocking as it senses your driverless car pulling into the driveway or your kitchen suggesting recipes and giving you weights and measures without you having to pull out a cookbook.

Alternatively, as some writers have suggested – all this integration could lead to an IT apocalypse (a piece I highly recommend if you want a fun read).

Love or hate that thought, it's where we're trending and it has massive implications both for Canada and the health industry. As information technology permeates our day-to-day lives, so too will it in healthcare. People will come to expect the same accessibility out of the healthcare system that they get in their lives. We are already seeing the rise of that phenomenon in younger generations who try to self-diagnose through sites such as WebMD and do pharmacological research in places like drugs.com. While the medical information provided by these sites can be helpful, it is also dubious as to their efficacy as a real public health tool. 

Demographic change is pushing the need for IoT-based healthcare. Younger generations are coming to expect more out of their medical service, in fact – they expect the same level of convenience they get from everything else. As part of the IoT, telehealth is beginning to come into its own and the range of medical duties it encompasses are near boundless.

As the Institute for Critical Infrastructure Technology puts it,

Telehealth is the practice of delivering healthcare through a remote telecommunication platform, such as mobile phone, video conferencing, or email. Telehealth covers a broad range of fields and applications such as: dentistry, counselling and mental health, physical and occupational therapy, healthcare for homebound patients, monitoring and management of chronic diseases, disaster management, and consumer and professional management to name a few. Telehealth could be as simple as a WebMD style platform that is actually supported by practicing doctors. It could take the form of video conferencing between a patient and their doctor or specialist. Telehealth could just be a platform for securely transferring ePHI in the form of X-rays, videos, or documents between patients and medical professionals over secure email, over a secure mobile application, or securely over a cloud network.

Each of these applications can have seriously beneficial consequences for the state of healthcare in Canada, such as:

  • easy access to up-to-date records,
  • the ability to better track illness as it moves through a community,
  • better access of specialist information and consultation to rural communities, and
  • dealing with mental health crises.

The list is endless. Speaking about mental health, the government of Ontario has implemented a way to webchat with helpline workers – removing some of the treatment load from hospitals and mental health facilities province wide. In terms of general health, Healthlink BC has its own version of WebMD, a government-sanctioned way of recommending whether symptoms need immediate treatment or not.

The benefits of telehealth

Telehealth and IoT-based healthcare solutions can save a healthcare facility money in the long run through preventative care, information sharing and remote biometric monitoring. Preventative care could be something as simple as a wearable that reminds outpatients what pills to take when, or to do their physical rehabilitation exercises at certain points of the day. Even to go so far as to recognize that somebody is eating a meal and should take medicine that requires a full stomach for maximum efficacy. These solutions exist so many people do not comply once they become outpatients; general compliance rates range from 40-50% for long term care and 20-30% for lifestyle affecting treatments. This lack of compliance leads to patients coming back to the health facility, costing more and taxing the system – “33%-69% of drug-related adverse events that result in hospital admissions".

The usage of telehealth can also somewhat alleviate the pains created by our shortage of physicians. Not only can preventative care be employed to reduce the average amount of visits required by individual patients, telehealth and IoT tools can help shave the amount of time it takes to treat or diagnose a patient. By reducing the amount of time needed per patient, you can begin to bridge the work gap between existing and needed physicians. Telehealth solutions can also work in areas that don't have great access to medical care, such as in rural areas. According to CIHI, only 15% of physicians in Canada serve the rural population, which makes up 18% of our population. Servicing rural areas is made more difficult by people needing specialized medical care (2% of our specialists work in our rural areas). Telehealth can make it easier for doctors to refer rural patients to specialists, and for specialists to consult with people who otherwise might not be able to reach them.

The global market for IoT healthcare is forecasted to be 117 billion as of 2020 and will only go up from there as innovators figure out better ways to make healthcare the best it can be. With IT's role in healthcare growing tremendously, the risks associated will grow as well – in both legal and technical senses. Mobile, bring your own device (BYOD), or IoT healthcare can lead to serious security breaches of some highly sensitive personal information. If your IoT infrastructure isn't synced and facility staff aren't properly trained, massive privacy violations can occur. You need consistent and solid architecture in order to manage your IoT solution for your practice. Lack of those two things can lead to miscommunications between providers, system outages and general reporting confusion.

Healthy IT, healthy communities

One the core roles of healthcare IT is going to be securing devices and your network. We believe that hospitals and health facilities are among the most tantalizing and vulnerable of all Canadian institutions, subject to ransomware, DDoS attacks, spear phishing – you name it. As your profile of IoT devices grows over the future, an IT professional will have to worry about how the devices are connected to the net, how they interact with one another, and what can happen when they go down. Questions must be asked, “Do I have backups?”, “Are there systems in place that can take over in case of emergency”, “Is there a robust enough failover system for my implementation?” Once you merge one of your functions with the IoT, you create a far wider area for hackers and script kiddies alike to attack.

To combat these IT woes, you need to have a comprehensive and solid security plan that is baked into your IoT planning. That begins with knowing what devices you will have connected, what your intention to do with them is, and how each of their configurations works. From there, you need to build out your security system in a manner that comprehensively covers attacks as best as possible. There are currently networks in Canada taking great steps to have a secure and robust network. eHealth Ontario's ONE Network is a strong example of a network that is allowing physicians greater peace of mind for electronic health records (EHRs). In other jurisdictions projects like Cristal-Net in Quebec and BC's e-health initiatives are working to connect health records and information between institutions and practitioners on more secure backbones. It is a bit of a patchwork quilt, but all aimed at the same goal of safer, more secure, and faster medical communications.

Here at CIRA we believe that one of the biggest threats to any network is the DDoS – low cost, easy to use and absolutely crippling when pointed at the right target. Say a DDoS hits a hospital with a robust use of IoT technology, what happens? Emails and records don't get sent; doctors and patients don't get to enter medical portals to access information and diagnosing tools. Secure video conferencing with patients goes out the window. It would be a major pain for an institution where consistency and uptime are absolutely critical. There are some provincial health networks building out dedicated health networks for inter-hospital communication, for telehealth we must still rely on the Internet at large.

How D-Zone Anycast DNS can help

As a not-for-profit company dedicated to strengthening the Canadian Internet, its reasons like these that we developed D-Zone Anycast DNS. While you implement IoT solutions that help push the future of healthcare forward – we want to make sure that your efforts are safe and protected.