Operators must do more than just make telemedicine possible

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Technology has always been central to modern medicine, from the discovery of X-rays to the first heart transplant. This is still true, with mobile networks now taking a key role in everyday health services. For example, it’s never been easier to call for help in an emergency. Cooperation between operators and regulators means that any network can be used for emergency calls. In some places, first responders now receive the personal details of the individual calling in an emergency, and GPS coordinates.

The increasing ubiquity of smarter wearable devices—plus more advanced networks—means there is potential for telecoms to have an even greater impact on healthcare, beyond emergency calls. Telcos, through their networks, will of course be an essential part of these advances. Simply put, Telemedicine, requires “tele-“—without it Remote Patient Monitoring (RPM) will not be possible.

Data is be at the heart of the telemedicine revolution. We already record our steps and food intake, track changes in weight and assess our progress against various Government guidelines and fitness targets. If we add to that the evolving ability to measure vital body parameters through connected wearable medical grade sensors, such as glucose levels, heart rate, blood pressure, blood oxygen levels, body temperature, lung capacity and more, we get a plethora of data that can be used to constantly monitor our health. This is especially important for people suffering from chronic conditions that need to be alerted when, and even before, a situation develops that can trigger a rapid deterioration in their health.

The rise of telemedicine

Providing healthcare is an expensive business, especially in remote locations. However, by providing telemedicine through a combination of telecoms infrastructure, smart devices and IoT, “virtual hospitals” can be created to provide remote consultation, diagnostics and treatment to patients. Remote Patient Monitoring (RPM) enables doctors to connect with their patients through video calling and similar channels, meaning there’s often no need for an in-person visit.

RPM can also be performed automatically with the collection of patient data. Now, the most common way to collect data today is through doctors, nurses, and administrators manually updating patient records, but this is now possible through connected devices. Advanced analytic techniques, such Root Cause Analysis (RCA), outlier detection, trend analysis and others, can then be applied to analyse the data collected from connected devices, and other relevant sensors, and even combine it with data from digital medical files to provide a comprehensive view of the patients’ situation. This way, it’s possible to diagnose a medical condition and suggest recommended treatment much faster.

Whether a patient has a heart condition, diabetes, or another chronic ailment, remote monitoring can ensure faster alerts of irregular symptoms. Smart home speakers like Amazon Echo or Google Home can also provide further engagement, including reminders on taking medication, delivering alerts and running through automated medical questionnaires.

But it’s not just out-patients who can benefit. The rollout of smart city technology will make it easier and quicker to get emergency response to the patient. By analysing smart city data it’s possible to find the best means of transportation, the most efficient routes, alert the most relevant medical professionals and assess which hospitals have the most appropriate equipment for an individual incident. Emergency services no longer have to be frustrated by traffic, instead medical control centres will be able to analyse traffic and other data and update emergency responders on their best course of action. In the future, drones will be part of the operational mix to aid the response to medical emergencies by delivering medicines, defibrillators or any other portable live saving device into hard to reach places.

Mobile operators and telcos will have to choose whether they simply enable telemedicine, or whether they can take a more active role in its success.

Interoperation between NOC and MOC

There are two key considerations for operators when it comes to telemedicine. The efficiency, availability and reliability of the mobile network needs to be assured so that both medical professionals and their patients can trust that data will be transmitted reliably. This is no small thing if this data is to be relied upon for critical, potentially life-saving decisions and alerts. Mobile network service assurance will play a big part in telemedicine.

There is also a need to collate all of this data together and ensure that it is readable by the analytical algorithms that aid with key decisions. This is a big data exercise—inter-sensor correlation, machine learning, outlier analysis and more will all play a big part in this.

Mobile operators do this every day. The big difference is that the body they are monitoring, diagnosing, and repairing is inorganic: the mobile network. A Network Operations Centre, or NOC, has specialists and software to collect, correlate and analyse all the data coming from any number of connected devices. A NOC is responsible for monitoring and assuring telecom networks and the services delivered on top of it—looking out for power failures, transmission outages, network alarms, Quality of Service degradation trends and any other performance issues that may cause issues. Specialised NOCs, managing and analysing the growing amounts of data being generated from our new world of interconnected things, will be necessary in many industries, such as supply chains, factories, farming, smart city—or medical.

A Medical Operations Centre, or MOC, will bring together the monitoring and analysis of data so that these can integrate multiple data layers, apply customisable rules, and share data with other bodies as appropriate. But who should operate the MOC? While it’s clear that the NOC can take a very important part in monitoring the quality and availability of the telecommunication services employed by telemedicine (e.g., video conferences, VoIP calls, sensor connectivity, etc.) the MOC operation requires a separate set of skills that span areas such as health sensor data interpretation, the application of specific analytical methods on medical data and the application of operational rules related to the management of medical emergencies. This means that in order to provide highly effective telemedicine services, optimal interoperation between the NOC and the MOC is necessary.

In addition, healthcare organisations should use and promote open APIs to combine with other information sources to improve the understanding of the situational context, to help both patient care and the ability to reach people in an emergency. This could include analysis of weather data, pollution data and concentration of allergens, data from emergency systems, and traffic data and road closure data.

Telemedicine is one of the fastest growing IOT verticals. For instance, in 2016, the number of patients being monitored remotely grew by 44 per cent to 7.1 million and is projected to exceed 50 million by 2021. This clearly means that healthcare is an increasingly significant part of mobile operator and internet service provider remits. Operators will need to guarantee that data will be transmitted but they are also set to play a much bigger role—in medicine and in other data-heavy areas, such as manufacturing or logistics. Operators already have the expertise in analysing data to look for power failures, network alarms and other performance issues that may affect their user’s experience. It’s just a case of using this same experience to monitor the network services delivered as part of telemedicine and interacting with the MOC to optimise the efficiency and agility of all relevant operational processes.

Telemedicine represents a large potential healthcare resource, and with the right support, service assurance solution and proactive awareness, it can lead to real, tangible benefits for healthcare organisations—and their patients. Mobile operators have struggled for some time to be more than organisations that are good at moving data around. The specialised NOC, making use of their experience in managing networks that create huge amounts of data, is that opportunity.

Danny Itzigsohn, Senior Director, TEOCO