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IoT Cloud Network for Healthcare

Ashok Kumar Pradhan

SRM University, AP, Amaravati, India

E.Bhaskara Santhosh

SRM University, AP, Amaravati, India

Priyanka S

SRM University, AP, Amaravati, India

Due to rapid growth in information and communication technologies, the building of smart homes and cities becomes a reality. Smart homes and cities take the home and living experience to the next level. One of the major reasons for the development of smart homes and cities is to provide efficient and cost- effective healthcare facilitiesfl 00]. This chapter discusses different issues related to Internet of things (loT) in Cloud network for smart Healthcare. The usage of loT in healthcare has sharply increased across the industry and personal healthcare sectors. Remote monitoring and telemedicine are the main initiatives in loT healthcare. More integrated approaches and benefits are sought with a role for the so-called Internet of Healthcare Things (loHT) or Internet of Medical Things (loMT). Remote health monitoring (RHM) is the main loT use case in healthcare. Remote health monitoring and various other loT use cases in healthcare are the main challenges in healthcare. In a health data context some data from medical devices and monitoring systems ultimately end up in Electronic Healthcare Records (EHR) Systems or in specific applications which are connected with them and send the data to labs, doctors, nurses and other parties involved. Finally, all the EHR are securely saved in the cloud so the doctors, patients and authorized third parties can access the information based on their requirements.

Introduction to modern health computing

Health is what makes or breaks an economy, which is why good healthcare is equal to a good economy. An efficient and reliable healthcare system is an important factor in establishing a good economy. Bad or poor health leads to inefficiency in work which results in various problems in economic balance. Provision of adequate healthcare facilities to each citizen of the country is the responsibility of government and is an important process in e-governance framework. In a country like India, where there is social and economic inequality, health is a major concern. People living in rural areas are not even aware of the basic and primary healthcare services. Villages constitute a huge part of the Indian economy, and they are not even getting the primary level medical facilities. According to the 2011 census[296], 68.84% of the total population of India is living in villages, but the condition of healthcare and medical services has not met the expectations and requirements. Rural areas face the problem of primary healthcare services shortage. Out of the primary healthcare sectors available, 8% do not have doctors or any medical staff, 39% do not have lab technicians, and 18% do not even have a pharmacist. These issues make the need for new and innovative technology an urgent and dire need to provide better healthcare services to rural India.

Internet of Things (loT)[382] is an ever-growing technology that helps in connecting anything and everything over the internet. It aims at collecting data from various sources with high accuracy and less time. loT enables collection and exchange of data which can be stored and used for analysis, measurement, as a reference by experts. It helps in making the world a better place and improves the quality of life. Information and communication technology can be effectively used to improve the healthcare system in rural areas[117]. Increased health awareness has led to the emergence of "self-care" and "healthcare advisor" disciplines. The benefits of a healthy lifestyle have fueled innovation that plays a key role in moving the point of care from the hospital or the physician's office to the patient's home. Delivering on this vision with the help of enabling technologies requires regularly capturing information related to a person's health, lifestyle, and other vital parameters and sharing it with caregivers. Smart patient healthcare monitoring systems provide better healthcare service by improving the availability and transparency of health data. However, it also poses serious threats to data security and privacy. The Fig.11.1 represents the fundamental features required for a novel smart healthcare system.

Novel Healthcare System Features

Figure 11.1: Novel Healthcare System Features

According to the latest survey by KaaloT Technologies^], spending on healthcare based loT solutions will reach a strategic point of $1 trillion in the year 2025 by providing highly personalized, easily accessible and timely healthcare services for everyone. Several critical issues are considered to be important in smart healthcare, such as duration of monitoring, frequency of data collection and transmission, amount of data transmitted and nature of monitoring in terms of alerts, periodic or continuous. The following overview of requirements of patient monitoring shows the complexity, diversity, and somewhat contradictory nature of the requirements. At the same time, these healthcare systems need to improve reliability, efficiency and acceptability along with data security, privacy, and availability. As the healthcare industry has been increasingly getting more access to consumer data than ever before, health organizations are facing significant, but not insurmountable, challenges in managing, interpreting and protecting patient data. The lack of Electronic health record (EHR) integration is another barrier to overcome. The reliability and security of EHR data, interoperability, lack of proficient training in EHR management and lack of infrastructure are the hurdles among healthcare providers. The next tier of the problem lies among the populations that can benefit most from loT like poor internet access among vulnerable populations, including the elderly, those with low education levels, lower-income populations, rural residents, and minorities. Let us now get to talk about overcoming these obstacles that the industry is currently struggling with.

Overcoming the challenges

Interoperability of disparate data sources needs to be addressed with loT devices. As patient data comes in, health systems should have the infrastructure, resources, and processes in place to extract actionable insights from it that caregivers can use. Finally, as cyber-attacks are becoming a growing threat, health systems and their partners must ensure the protection of their networks by investing in viable features and capabilities. Since loT devices capture and transmit data in real-time, the infrastructure to receive and process and store this data from millions of devices should be designed and built for scale. However, most loT devices that report healthcare data suffer from a lack of data standards or protocols.

Security and privacy of patient data

Privacy and security concerns are slowing the progress for loT to take over the sector and prove its potential. Healthcare is a highly regulated industry and requires everything to be secure and safe because patient information has to remain protected at any cost. However, security breaches still run rampant in many parts of the country. It is mandatory to meet the compliance requirements under the Health Insurance Portability and Accountability Act (HIPAA)[375]. When it comes to loT based healthcare system, the compliance is also needed to focus on app developers, hosting service providers, cloud computing service providers and including subcontractors who involved in the healthcare space might have access to electronic patient health information (ePHI). Therefore, this industry is more focused on the virtualization of security right now than previously. Interestingly, many of the organizations that suffered breaches demonstrated a failure of proper controls over physical devices. Keeping physical devices under control is critical for gaining the confidence of patients in the use of loT in healthcare. Providers, their associates, and vendor partners have a responsibility to ensure protocols are in place and their employees are trained to follow them.

Lack of uniformity among connected mobile devices

The problem is that there are no common standards or communication protocols to facilitate the process of aggregating information from them. The proliferation of connected health and activity devices that many of us now use makes it easy to see why a lack of interoperability is a huge obstacle to progress. Health systems should maintain at least some common standard for the type of devices kept in their facility. It should be done to facilitate a smoother transmission of data for quicker insights.

Vulnerable data transmissions

Ensuring connectivity is an important factor for loT in healthcare. Data transmissions between devices, or between a device and the cloud, should be uninterrupted as well as speedy. Furthermore, they should have the capacity to host a great number of devices connected at the same time. Also, maintaining the quality and speed of transmissions is a key factor for loT functioning. To overcome these challenges, the development of 5G technology is already underway. The other challenge is to make loT sensors collect data even if there are troubles with the network. Also, an loT system should be able to notify the user whenever a component is disconnected, so the physicians know at ever)' moment what is going on.

Patient readiness

A non-technical, but significant factor is patient consent in adopting loT. Patients are often confused about the introduction of new technology in a sector like healthcare and may be unwilling to take it. Physicians too may have their inhibitions about the same. Therefore, to overcome this challenge, patients need to aware of the potential benefits of loT in healthcare. In a world that's slowly but steadily transitioning into a digitally-driven society, the applications of loT are immense.

Awareness about IoTs

Understanding loT from the consumer's perspective is not an easy task. As the uses for the loTs are expanding and changing, there needs to be widespread awareness about them in the entire country. Furthermore, it requires constant push and promotion by healthcare authorities, physicians, care teams and patients to become successful.

Paralysis of Data Analysis

The overflow of massive amounts of data can lead to analysis paralysis. It means that it can be mind-boggling to go over every piece of information presented in the data. Extracting insights from data for analysis is the last stage of loT implementation, and it has to be driven by cognitive technologies. Hospitals and health systems have a responsibility to ensure that the platform they opt for is capable of moulding according to their requirements. In smart cities, the loT gathers a huge quantity of data and it can be processed by using automatic assessment systems. However, the increasing use of wireless transmission of health-related data raises the concern of data protection and authenticity. The medical data of an individual may be secured such that unauthorized access to the data could be denied. Only authorized healthcare staff may access the data to ensure the privacy of an individual's identity.

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