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Carrier services help expand healthcare, with 5G in the offing

There are connectivity options aplenty for most types of IoT deployment, but the idea of simply handing the networking part of the equation off to a national licensed wireless carrier could be the best one for certain kinds of deployments in the medical field.

Telehealth systems, for example, are still a relatively new facet of modern medicine, but they're already among the most important applications that use carrier networks to deliver care. One such system is operated by the University of Mississippi Medical Center, for the treatment and education of diabetes patients.

[More on wireless: The time of 5G is almost here]

Greg Hall is the director of IT at UMMC's center for telehealth. He said that the remote patient monitoring system is relatively simple by design - diabetes patients receive a tablet computer that they can use to input and track their blood sugar levels, alert clinicians to symptoms like nerve pain or foot sores, and even videoconference with their doctors directly. The tablet connects via Verizon, AT&T or CSpire - depending on who's got the best coverage in a given area - back to UMMC's servers.

According to Hall, there are multiple advantages to using carrier connectivity instead of unlicensed (i.e. purpose-built Wi-Fi or other technology) to connect patients - some of whom live in remote parts of the state - to their caregivers.

"We weren't expecting everyone who uses the service to have Wi-Fi," he said, "and they can take their tablet with them if they're traveling."

The system serves about 250 patients in Mississippi, up from roughly 175 in the 2015 pilot program that got the effort off the ground. Nor is it strictly limited to diabetes care - Hall said that it's already been extended to patients suffering from chronic obstructive pulmonary disease, asthma and even used for prenatal care, with further expansion in the offing.

"The goal of our program isn't just the monitoring piece, but also the education piece, teaching a person to live with their [condition] and thrive," he said.

It hasn't all been smooth sailing. One issue was caused by the natural foliage of the area, as dense areas of pine trees can cause transmission problems, thanks to their needles being a particularly troublesome length and interfering with 2.5GHz wireless signals. But Hall said that the team has been able to install signal boosters or repeaters to overcome that obstacle.

Neurologist Dr. Allen Gee's practice in Wyoming attempts to address a similar issue - far-flung patients with medical needs that might not be addressed by the sparse local-care options. From his main office in Cody, he said, he can cover half the state via telepresence, using a purpose-built system that is based on cellular-data connectivity from TCT, Spectrum and AT&T, as well as remote audiovisual equipment and a link to electronic health records stored in distant locations. That allows him to receive patient data, audio/visual information and even imaging diagnostics remotely. Some specialists in the state are able to fly to those remote locations, others are not.

While Gee's preference is to meet with patients in person, that's just not always possible, he said.

"Medical specialists don't get paid for windshield time," he noted. "Being able to transfer information from an EHR facilitates the process of learning about the patient."

5G is coming

According to Alan Stewart-Brown, vice president at infrastructure management vendor Opengear, there's a lot to like about current carrier networks for medical use - particularly wide coverage and a lack of interference - but there are bigger things to come.

"We have customers that have equipment in ambulances for instance, where they're livestreaming patients' vital signs to consoles that doctors can monitor," he said. "They're using carrier 4G for that right now and it works well enough, but there are limitations, namely latency, which you don't get on 5G."

Beyond the simple fact of increased throughput and lower latency, widespread 5G deployments could open a wide array of new possibilities for medical technology, mostly involving real-time, very-high-definition video streaming. These include medical VR, remote surgery and the like.

"The process you use to do things like real-time video - right now on a 4G network, that may or may not have a delay," said Stewart-Brown. "Once you can get rid of the delay, the possibilities are endless as to what you can use the technology for."

Citizens band

Ron Malenfant, chief architect for service provider IoT at Cisco, agreed that the future of 5G for medical IoT is bright, but said that the actual applications of the technology have to be carefully thought out.

"The use cases need to be worked on," he said. "The innovative [companies] are starting to say 'OK, what does 5G mean to me' and starting to plan use cases."

One area that the carriers themselves have been eyeing recently is the CBRS band of radio frequencies, which sits around 3.5GHz. It's what's referred to as "lightly licensed" spectrum, in that parts of it are used for things like CB radio and other parts are the domain of the U.S. armed forces, and it could be used to build private networks for institutional users like hospitals, instead of deploying small but expensive 4G cells. The idea is that the institutions would be able to lease those frequencies for their specific area from the carrier directly for private LTE/CBRS networks, and, eventually 5G, Malenfant said.

There's also the issue, of course, that there are still a huge amount of unknowns around 5G, which isn't expected to supplant LTE in the U.S. for at least another year or so. The medical field's stiff regulatory requirements could also prove a stumbling block for the adoption of newer wireless technology.

This story, "Carrier services help expand healthcare, with 5G in the offing" was originally published by Network World.