Many of us have heard about the Internet of Things (IOT) in recent years, and more recently the Internet of Medical Things (IoMT), and perhaps even the growth estimates of this enormous industry as a whole. When we think of these devices, we may imagine sensors connected to our smartwatch or perhaps certain household items that are part of what is now becoming the “smart home.” But what about devices that may serve us in a life or death situation? Or, perhaps devices that regulate specific bodily functions to prevent a potentially deadly event? Cue medical devices.
A study conducted by Markets to Markets found that “The global connected medical devices market to grow at a CAGR of 9.24% during the period 2017–2021.” All things considered, the push towards a more connected world will certainly include the devices we are going to rely on for our healthcare. IoT and IoMT medical devices have a broad range of characteristics and functionality. For now, let’s consider devices that perform functions that require hardware, software, and connectivity.
There is clear evidence that connected medical devices will continue to proliferate and become smarter to help reduce cost and will need to become more interconnected as part of a greater information system. This trend will also open the doors to malware, viruses, and new attack vectors that could directly put people’s lives in jeopardy — whether it be for ransom, blackmail, or otherwise from hackers infiltrating the system.
For safeguarding purposes, medical devices have been locked down in an attempt to prevent malicious infiltration and also to protect the intellectual property rights of the manufacturer. However, because the devices and their counterpart systems are made with proprietary hardware/software, it is extremely difficult to make multiple devices and systems communicate in such a way that gives a holistic view of a patient’s overall well-being. For the IoMT or IoT of healthcare to really become efficient and scalable, medical devices are going to have to integrate into one coherent system which is no easy task, and certainly not by current methods. They will need to process vast amounts of data to be relevant in an age where big data can be scalable and processed effectively for optimal results and accurate recommendations to be made without conceding intellectual property of the manufacturer, or compromise security.
If we look at a common example of a critical medical device, in this case a pacemaker, there are a few systems in place and possible attack routes that could lead to serious injury or even death. Modern pacemaker implantable devices are connected in two main ways — an at home data unit connects wirelessly to the pacemaker when in range and transmits monitor data to the provider via the internet. At an office visit, the provider will also be able to access the device live via a vendor-specific wireless access mechanism to view data and/or make tuning adjustments to it. It’s possible for an attacker to access the wireless network and infiltrate the pacemaker to augment the functionality remotely or to manipulate the data unit readout so that the provider is misinformed and makes the wrong adjustments.
Anything that is connected can be infiltrated and exploited by hackers, but at the same time we need to have interoperable devices to make meaningful use of the vast amounts of data produced from them. This data is currently siloed and is analyzed individually. For the most effective analysis it would be ideal if multiple devices were able to achieve a level of interoperability whereby the full picture of patient health data is calculated together. There is a solution that is showing promise in this area and that is the healthcare blockchain, sometimes referred to as a medical blockchain, provided by Helix3.
Helix3 is a healthcare blockchain startup that uses blockchain technology to safely and securely transact information between patients, providers and payers within the healthcare ecosystem. A blockchain network called Ethereum is equipped with “smart contracts” that automatically execute when certain criteria are authenticated using a randomized network of nodes that calculate complex algorithms which are mathematically linked to one another. A series of nodes on the network need to make enough correct calculations in which consensus is reached for the transaction to be valid, then whatever criteria governs the smart contract will be automatically executed. If somehow, a bad actor infiltrates this network and attempts to tamper with the transaction the consensus will fail and the bad actor ejected. Since proof of stake is required (financial participation) to transact on this network the bad actor will lose stake and it then becomes cost prohibitive to tamper with transactions. This method of communication is specifically useful for exchanging the rights to use certain information which puts the patient in control of their sensitive healthcare data, rather than relying on the current centralized computer systems which have many security vulnerabilities and have already been exploited many times.
Meaningful Use Stage 3 encourages the use of API’s to help bridge gaps in health IT systems, this solution could satisfy that effort without compromising security. Every patient, provider and payor will have a “digital twin” of themselves on the Helix network comprising of all the necessary information and valid proof of stake needed to make transactions — this is established in the system before any transactions can be made. The same principal can be applied to medical devices, whereby each device has a digital twin which is authorized to transact with other devices and analyzed together to get the full picture quickly and securely. This can effectively resolve the issue of siloed data and make for faster decisions on proper treatment and patients will be able to view their records, treatments and recommendations in their app interface.
What this means for the future of healthcare is giving providers and patients timely insights into otherwise isolated systems of health data analysis, bringing about an era that redefines precision medicine and will likely lead to more advances in healthcare.
Leading up to being able to solve the interoperability and security problem of medical devices, Helix3 is using the concept of gamification to motivate people to sustain healthier lives by creating and accepting physical activity challenges through their interactive app. The app is able to integrate with wearable devices to track activity and give feedback. It also features a community to share progress and ranking among peers. Participants are rewarded HLX tokens that can be used to purchase goods and services through a digital marketplace.