Towards Futuristic Smart Intelligent Healthcare System

Enhancing the quality of health care while maintaining reasonable costs is challenging for healthcare sectors globally. In order to provide better-quality health care, it is very important that high standards of healthcare management are achieved by making timely decisions based on rapid diagnostics, artificial intelligence, the internet of things, smart data analysis, and informatics analysis. The concept of smart and intelligent health care involves a health service system that uses technologies such as wearable and implantable devices, artificial intelligence (AI), the Internet of Things (IoT), and mobile internet to dynamically access information, connect people, materials and institutions related to healthcare, and then actively manages and responds to medical ecosystem needs in an intelligent manner. Smart healthcare can promote interactions between all parties in the healthcare fields, ensure that participants get the services they need, help the parties make informed decisions, and facilitate the rational allocations of resources.?

Recently, due to the unmet need to address the grand challenges in preventive medicine and the advances in information and computer technologies, artificial intelligence, automation, medical and health care are making a paradigm shift from hospital-centered to patient-centered and from disease-focus to health-focus. Remote healthcare monitoring has exponentially grown over the past decade together with the increasing penetration of nanosensor technology, wireless communication, robotics and automation, artificial intelligence, IoT platforms.?

In order to provide better-quality healthcare, it is very important that high standards of health care management are achieved by making timely decisions based on rapid diagnostics, smart data analysis, and informatics analysis. Smart nanosensors are emerging as efficient and affordable analytical diagnostics tools for early-stage disease detection. Nanosensors can detect analytes or biomarkers in a small quantity of samples such as blood, saliva, tears, sweat. A biological marker or biomarker is a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes or pharmacologic responses to a therapeutic intervention. Emerging nanomaterial science and flexible electronics have led to wearable biophysical nanosensors that are capable of monitoring human activities, body motions, and electrophysiological signals such as electroencephalogram and electrocardiogram. Wearable biochemical nanosensors are emerging for the noninvasive detection of molecular-level indicators such as electrolytes and metabolites from biofluids. Nanosensors are widely used to detect antibodies, antigens, or nucleic acids in crude samples such as saliva, sputum, and blood-based upon colorimetric, fluorescent, or electrochemical detection approaches. Nanosensor offers many advantages such as being affordable, sensitive, specific, user-friendly, rapid and robust, equipment-free, and deliverable to end-users. Wearable devices such as activity trackers and smart watches can provide unique insights into our health and well-being. During the recent pandemic coronavirus disease 2019 (COVID-19), the potential of wearable health devices has become increasingly apparent. With the advances in point-of-care testing, chip-based and paper-based nanobiosensors have been developed for the rapid diagnosis of infectious diseases. Point-of-care testing ensures fast detection of analytes near to the patients facilitating a better disease diagnosis, monitoring, and management. Wearable nanosensors have the potential to provide continuous real-time physiological information via dynamic, noninvasive measurements of biochemical markers in biofluids, such as sweat, tears, saliva, and interstitial fluids. Wearable sensors have received much attention since the arrival of smartphones and other mobile devices. Wearable monitoring platforms can lead insights into dynamic biochemical processes in biofluids by enabling continuous, real-time monitoring of biomarkers. Such real-time monitoring can provide information on wellness and health. As the disease can be diagnosed at an early stage, a quick medical decision can be taken to start early treatment. Numerous potential point-of-care devices have been developed in recent years which are paving the way to next-generation point-of-care testing. Significant advances in wireless communication and networking technologies have paved the way to envisage and design innovative healthcare services. A combination of multiplexed biosensing, microfluidic sampling, and transport systems have been integrated, miniaturized and combined with flexible materials for improved wearability and ease of operation.

Internet of Things includes a series of technological revolutions allowing people and technology to be better connected to one another and leading to the development of a network of connected, smart, wearable devices and objects, can communicate with each other and automate key tasks. These revolutions began with the invention of the internet and have shaped technology and society for the past 30 years as we see today. The large volume of data created along with the medical devices themselves, IT systems and software, connectivity technology and servicing are combining to create the Internet of Medical Things (IoMT), which bridges both the digital and physical world and can monitor and modify patient behavior in real-time to manage chronic conditions such as high blood pressure, diabetes and asthma. This technology can streamline various clinical processes and information flows, and can also bring together people, data, processes and enablers including medical devices and mobile applications to improve healthcare delivery. The upsurge of IoMT is being fueled by an increase in the number of connected medical devices that are able to generate, collect, analyse or transmit health data as images and connect to health care provider networks, transmitting data to either a cloud repository or internal servers. It also enables remote clinical monitoring, chronic disease and medication management and preventive care and it supports people who require assistance with daily living such as the disabled and elderly people to live independent lives. It has the potential to improve efficiency, lower costs and deliver better patient outcomes.

High capital cost and high-tech devices such as CT and MRI scanners, X-ray and mammography devices, ultrasound machines and nuclear imaging devices that measure physiological parameters, transmit images wirelessly to clinicians deployed by hospitals, clinics and diagnostic centers, who incorporates into the patients’ health record along with data from in vitro diagnostic devices.???These patients’ diagnostic data and imaging can facilitate faster and more precise decision-making using artificial intelligence.??Implanted medical devices including pacemakers and defibrillators that monitor and treat cardiac conditions, nerve stimulators, bladder stimulants, diaphragm stimulators and a variety of biosensors to process different signals can be used by patients who require continuous monitoring. These medical devices are intended to remain in the human body and are implanted following the surgical or medical intervention or clinically inserted into a natural orifice. Wearable external medical devices include insulin pumps for diabetes monitoring, skin patches, cardioverter defibrillators and other devices including smart watches and activity trackers that produce data to be monitored by clinicians. Wearable external medical devices are used to monitor patients while in hospital and post-discharge as well as ongoing monitoring of patients with chronic conditions or frailty.

Artificial intelligence has been developing rapidly in recent years in terms of software algorithms, hardware implementation, and applications in a vast number of areas. The thousands of data points collected from wearable devices coupled with artificial intelligence may help in informing diagnosis, predicting a patient’s outcomes and helping health care professionals to select the best possible treatment for their patients. Artificial intelligence can outperform medical professionals in the analysis of electrocardiograms, medical imaging data, skin lesions or pathogen slides. Real-time monitoring of glucose levels coupled with a closed-loop insulin delivery system can improve type 2 diabetes mellitus control. IoMT generates intelligent and measurable information to help improving the speed and accuracy of diagnostics and target treatments more efficiently and effectively. The increasing incidence of chronic disease, sudden heart failures and degrading healthcare services in remote areas generate a need for a system of monitoring health status in real-time. Wearable biometric monitoring devices such as nanosensors embedded in smartphones or wearable medical devices coupled with artificial intelligence and IoMT are enabling the remote management and analysis of patient data in real-time. The development of these medical devices allows for remote, high-frequency and high-resolution monitoring of patients’ health status outside the hospital.

The IoMT market is expanding to grow at a compound annual growth rate of 30.8 % from $41.2 billion in 2017 to $158.1 billion by 2022. This growth is due to the rapid diagnostics of healthcare systems to help efficient patient care, the rise in the demand of mobile health care technologies and an increase in demand from an aging population and people suffering from chronic diseases. Advances in computing power and artificial intelligence, nanosensors and smart biosensors, wearable and flexible devices, lab-on-chip integration, big data collection and analytics, mining and fusion, robotics and automation, wireless communication, IoMT devices and miniaturization in medical devices will certainly be going to transform healthcare sector into the smart and intelligent healthcare system.