Internet of Things (IoT) deployment in Wearable Healthcare: A Socio-Techno Evaluation.

The concept of “Things” in the IoT is generally used to reflect ordinary objects like televisions, watches, air conditioners etc. The IoT results into an immensely distributed network of devices which communicate with people as well as other devices. Internet of Things (IoT) enabled devices are widespread in the modern social media, mobility, analytics, and cloud computing (SMAC) world. The convergence of sensor and network technologies provide us the ability to measure, infer, understand and communicate various critical indicators on a real-time basis. Technologies such as Wireless Sensor Networks (WSNs), cloud platform, communication standards and protocols, Radio Frequency Identification (RFID) etc. serve as the building blocks of this ecology.

Any business wants to have competitive advantage to survive in the competitive and dynamic market. The IoT can play a significant role in providing necessary and relevant data to businesses for better decision making. Adoption of the IoT is rapidly gaining momentum in industry as technological, societal, and competitive pressures are driving them to innovate and transform. Real time data and its processing has immense application in manufacturing organizations where the overall status of the machineries can be easily monitored using the IoT. Through the IoT, predictive maintenance is possible. Management will be in position to decide on replacement, repair and pre-emptively follow maintenance of machineries before any major breakdown occurs. Companies can know the status of oil, brakes, engine etc. along with the location of the fleet of vehicles used in logistics. In addition, information sharing and collaboration become efficient through the IoT. Companies may use the location data of the customers to provide specialized services such as alerting about the nearest retail store available to him/her.

In healthcare, the IoT offers enormous benefits for various stakeholders. The IoT can have one of the most promising applications in healthcare domain. Markets and Markets estimate that the IoT healthcare market is projected to grow from to USD 158.07 Billion in 2022 from USD 41.22 Billion in 2017, at a Compound Annual Growth Rate (CAGR) of 30.8%. In addition, they estimate that the market for global wearable medical devices will be USD 12.1 Billion by 2021 from USD 5.3 Billion in 2016, at a CAGR of 18.0%. Major growth drivers of the IoT healthcare market are evolution of artificial intelligence technology, rise in investments for the implementation of the IoT healthcare solutions, and the increasing penetration of connected devices in healthcare.

One of its applications is remote monitoring of patients’ health through healthcare wearable devices. Hence, a thorough understanding of the current trends in this segment is desirable for everyone interested in the IoT deployment. However, the IoT remains in its introduction stage of product life cycle in the healthcare field, especially in the developing countries like India. Given the amount and sensitivity of health-related data, security and privacy need utmost attention especially if it is being exchanged with other devices, people and organizations. The IoT deployment in healthcare raises numerous challenges such as identity management, interoperability, authentication, authorization and management of several wearable connected devices.

Wearable devices are those devices that can be worn or mated with human skin to continuously and closely monitor an individual's activities, without obstructing the users’ motions. Wearable devices are useful in unobtrusive monitoring of health-related parameters. Wearable devices may be embedded into textiles, in fashionable clothes or worn as mask to move voluntary muscles that have degraded due to medical ailments. Based on our literature review, healthcare wearable devices can be broadly categorized into ‘over-the-body’ and ‘in-the-body’ devices.

Data and privacy challenges are at the forefront given the sensitivity of information associated with the medical data. In developing countries like India, the economic impact of the IoT can be materialized if there is a comprehensive strategy towards adoption of the IoT technologies. Given that social and technological challenges do not come under the purview of a single stakeholder, a coordinated effort is required by all the stakeholders of the IoT community. To address security and privacy aspects, public and private players have to come under one roof. Governments may address the privacy and security issues of the IoT related data by formulating stringent data governance rules. In India, the honourable Supreme Court has regarded privacy as the Fundamental Right of a citizen. The court establishes that the private zone privacy, which relates to the personal data shared during the use of credit cards, social networking platforms, income tax declarations etc., should be used for the purpose for which it is shared by an individual. Given this context, and especially in relation to healthcare data, it is imperative for the Government of India (GOI) to frame privacy laws so that there is accountability and liability for leakage and misuse of data by any person or organization. In addition, the healthcare wearable devices should come under strict regulations for approval and use. The approval process should focus on whether the medical wearable device is safe for use by common people. For this, health and IT department of government have to function in sync to frame such monitoring and evaluation processes. In addition, emphasis should be there to monitor the data protection and security aspects of the device. The process should ensure that the technical standards used for data communication between devices are safe and secure.

Medical wearable devices manufacturing organizations also have a responsibility towards data protection. These organization should ensure that the components used in the medical wearable devices are safe to use and reliable. In addition, the organization should adhere to existing privacy laws and act in accordance with them. Research and development should be an ongoing process to consistently improve data protection technology. Service providers also play a significant role in reduction of privacy and security challenges. They are the true custodians of users’ data. Effective quality measures are required by service providers with respect to data management in accordance to the privacy and security laws of a country. At an individual level, we should be aware of how our data will be used by the service provider.

Social stigma associated with the medical wearable devices may be overcome by the government, hospitals, non-government organizations (NGOs), doctors and individuals. Through everyone’s effort, an enabling environment can be created for the adoption of the medical IoT devices. In addition, to reduce the impact of digital divide, the IoT community may create mechanisms for creating awareness on the use of wearable devices to reduce resistance in the use of technology. Doctors, NGOs and wearable device users may socially influence others to allay fears of using medical wearables. Though the cost of such devices is reducing, however, even the present cost is beyond the reach of people in developing countries like India. Hence, developing countries should engage in government-industry partnerships for social and medical research/ social research for cost-reduction of wearable devices. As we are aware that these devices are early in their life cycle, the above said steps will be important in creating trust of users in medical wearables and thereby foster their smoother adoption.

Extended abstract from

Mishra, G., Unny, R. B., & Bhatt, N. (2019). Internet of Things (IoT) deployment in Wearable Healthcare: A Socio-Techno Evaluation. In B. K. Mishra, R. Kumar, N. Zaman, M. Khari, & T. JoSo Manuel R.S (Eds.), Handbook of E-Business Security (pp. 311–340). Auerbach Publications.