Smart Health

As healthcare technologies advance, there's an increased engagement and consciousness of consumers when it comes to their health. Healthcare services are getting costlier, the global population is aging, and the number of chronic diseases are on the rise. Therefore, there is a need to make healthcare easier on the pocket and also more accessible.

Medical diagnostic consumes a large part of hospital bills while technology can move routine medical checks to the patient's home, making it home-centric instead of hospitalcentric. The right and timely diagnosis will also reduce the need for hospitalization [28,29, 31,32, 34]. Thus, the rise in the demand for remote care is the current requirement. The IoT solution equipped with AI termed as smart healthcare systems can allow hospitals these facilities.

Benefits of Smart Health Systems

  • Simultaneous reporting and monitoring: Real-time monitoring via connected devices fitted in the patient's body and storing data on the cloud for the physician to study can be extremely useful in cases of medical urgency such as heart failure, asthma, etc. The health data collected by the IoT device may include blood pressure, blood sugar, oxygen levels, ECGs, etc.
  • Assortment and analysis of data: The vast amount of speedy data sent through healthcare devices needs cloud storage for effective analysis. AI helps real-time analysis of data on the cloud such that the physician gets the final reports with graphs. All this collected data can also help in deriving insights and aid in decision making by health organizations.
  • Real time alerts and tracking: Timely alerts are extremely critical when in life- threatening situations. These real-time alerts by medical IoT devices enable smart health systems that help track and monitor, thus helping in immediate and timely handling by the doctor and enhanced accuracy of treatment. The doctors get vital data for real-time tracking of their patients' health.
  • Remote medical assistance: Remote medical assistance implies providing doctoral support to the patients from a remote location in case of emergency. This also entails provisioning medicines to patients as per their prescriptions and ailments.
  • Medical research: IoT enabled with AI in healthcare systems can be used for research purposes. Because the system will collect massive amounts of data in the form of medical record of patients, this data can be used for analytical studies and help enable bigger and better medical treatments.
  • Personalized treatments through big data: Innovative medical technologies like DNA sequencing are being vastly applied. These techniques along with advanced medical imaging and analysis working on the collected data helps in designing a personalized treatment plan for the patients.
  • 3D printing: The use of 3D printing in healthcare for prosthetics and implants will be extremely useful as it will make complete personalization. Surgeons can use 3D printing for practicing a complicated surgery on a model of the body part of the patient.
  • Robotics: Robots can provide more accuracy than humans for specialized tasks. They can also support people at home, letting them stay safe in their environments.

Use Cases of Smart Healthcare Systems

10.6.4.1 Smart Continuous Glucose Monitoring and Insulin Pens

Smart continuous glucose monitoring (CGM) is a device that helps diabetics to continuously monitor their blood glucose levels for several days at a time, by taking readings at regular intervals. CGMs were approved for the first time by the US FDA in 1999 and are now available as a number of smart CGMs (Eversense and Freestyle Libre). They send data on blood glucose levels to an app on iPhone, Android, or Apple Watch, allowing the wearer to easily check their information and detect trends. Insulin Pens are another smart device that are currently helping the lives of diabetic patients. Smart insulin pens/pen caps such as Gocap, InPen, and Esysta can automatically record the time, amount and type of insulin injected in a dose, and recommend the correct type of insulin injection at the right time. These smart devices interact with a smartphone app that can store long-term data, help diabetics calculate their insulin dose, and even allow patients to record their meals and blood sugar levels, to see how their food and insulin intake are affecting their blood sugar.

10.6.4.2 Connected Inhalers

Asthma is a major problem and needs to be addressed like diabetes. Propeller health is the biggest producer of smart inhaler technology. Propeller does not produce the complete inhaler but a sensor that is attached to an inhaler or Bluetooth spirometer. It connects up to an app and helps people with asthma and COPD (Chronic Obstructive Pulmonary Disease, which includes emphysema and chronic bronchitis) understand what might be causing their symptoms, track uses of rescue medication, and also provide allergen forecasts. Using connected inhalers helps in improving adherence to medication. The Propeller sensor generates reports on inhaler use that can be shared with the patient's doctor, and show whether they are using it as often as is prescribed. For patients, this provides motivation and also clarity, showing how the use of their inhaler is directly improving their condition.

10.6.4.3 Ingestible Sensors

Ingestible sensors can help track and improve the regularity of the patients in taking their medication and allowing them to have a more informed consultation with their physician about treatment. A study by WHO suggests 50% of medicines are not taken as directed. Proteus' Digital Health and Otsuka Pharmaceutical Co. created ABILIFY MYCITE—an antipsychotic medication, the first FDA-approved drug with a digital tracking system. They have created pills that dissolve in the stomach and produce a small signal that is picked up by a sensor worn on the body. The data is then relayed to a smartphone app, confirming that the patient has taken their medication as directed.

10.6.4.4 Connected Contact Lenses

Smart contact lenses are an ambitious application of IoT in the healthcare sector. It all started in 2014 when Verily, a subsidiary of Google' parent company Alphabet, in partnership with Alcon, the eyecare division of a pharmaceutical company Novartis, claimed that they had developed a smart contact lens that could measure tear glucose and provide early warning for blood sugar levels dropping or crossing a threshold. The project was criticized by researchers and proved wrong. But other prospective medical applications for smart contact lenses such as for treating presbyopia (long-sightedness due to loss of elasticity in the eye lens) and cataract surgery recovery are in the pipeline. Swiss company Sensimed has developed a noninvasive smart contact lens called Triggerfish, CE-marked and FDA-approved, which automatically records changes in eye dimensions that can lead to glaucoma.

10.6.4.5 The Apple Watch App that Monitors Depression

In 2017, Takeda Pharmaceuticals USA and Cognition Kit Limited, a platform for measuring cognitive health, explored the use of an Apple Watch app for monitoring and assessing patients with Major Depressive Disorder (MDD). The findings from the study had a very high level of compliance with the app, which participants used daily to monitor their mood and cognition. The study demonstrated the potential for wearable devices to assess the effects of depression in real time. The Apple Watch app could also give patients and healthcare professionals greater insight into their condition, and enable more informed conversations.

10.6.4.6 Apple's Research Kit and Parkinson's Disease

In 2018, Apple added a new Movement Disorder API to its open-source ResearchKit API, which allows Apple Watches to monitor Parkinson's disease symptoms. The symptoms are normally monitored by physicians in clinics through physical diagnostic tests, and patients are encouraged to keep a diary in order to give a broader insight into symptoms over time. The API aims to make that process automatic and continuous. An app on a connected iPhone can present the data in a graph, giving daily and hourly breakdowns, as well as minute-by-minute symptom fluctuation.

Apple's ResearchKit has also been used in a number of different health studies, including an arthritis study carried out in partnership with GSK, and an epilepsy study that used sensors in the Apple Watch to detect the onset and duration of seizures.

Smart Transportation System

Managing transportation is becoming a great challenge in large cities for commuters and traffic officials. The motive is to improve efficiency and reduce pollution and frustration for commuters. The solution to this can possibly be achieved by an Intelligent Transportation System (ITS), which shall include traffic and mobility management, managing movement of vehicles and assisting drivers, enhancing transport infrastructure, and providing improved interfaces for transport systems [25, 28, 29, 32, 33]. ITS helps provide real-time information about traffic and public transportation conditions to all citizens, thereby reducing travel time and making the journey easy and safe. There are four important applications of the ITS, which are discussed here.

10.6.5.1 Advanced Traffic Management System

The advanced traffic management system (ATMS) integrates real-time information from various sources (traffic lights, parking lots, and toll booths) and uses it to manage traffic. ATMS helps to smooth traffic and control pollutants. For controlling traffic, ATMS takes the following steps:

  • • Real-time adjustments to traffic lights and road signals for shifting traffic away from congested roads.
  • • Dynamic rates on toll roads to motivate a public transportation system instead of private vehicles.
  • • Smart management of parking lots as previously described in this chapter.
  • 10.6.5.2 Smart Vehicle Control and Safety System

With sensors installed in vehicles, drivers have access to visual alerts and information about unsafe situations. In a way, smart vehicle control and safety system (SVCSS)-equipped vehicles can be considered the first step toward autonomous vehicles. For safe driving, SVCSS has the ability to:

  • • Control a vehicle automatically, thereby reducing errors by humans while driving.
  • • Help in avoiding risky situations or reacting to them effectively.
  • • Assist in journey overlook, and assistance while parking.
  • 10.6.5.3 Smart Public Transportation System

A smart public transportation system (SPTS) provides information about public transport systems and the journey. It provides a centralized mechanism for making payments in diverse areas, similar to FASTag in practice today. SPTS uses real-time passenger data to improve the safety of people, provide bus arrival notifications, and give priority to buses at various points.

10.6.5.4 Commercial Vehicle Operation

This is similar to SPTS and is used for managing commercial vehicles such as buses, trucks, taxis, and ambulances. It tracks performance and behavior of the driver, manages commercial fleets through GPS tracking, driver's compliance with routes, operating costs, fuel consumption, and so on. The data gathered can help organizations monitor their fleet for reducing costs.

  • 10.6.5.5 Guiding Principles of ITS
  • 1. Collection of traffic data, such as location and speed of vehicles, traffic conditions, and delays through sensors and other distributed devices (GPS devices, road camera, vehicle identifiers) in real time.
  • 2. Data transmission to management center for analysis and forwarding to specific applications.
  • 3. Traffic data analysis after cleaning and customizing the data to reach conclusions and make predictions.
  • 4. Traveler Information such as citizens' data for collection of data and disbursement of information.
  • 10.6.5.6 Use Cases of Intelligent Transportation Systems
  • 10.6.5.6.1 Connected Cars

Connected cars work on a network of sensors, antennas, communication networks, and software to take timely and accurate decisions. The systems are designed to monitor the components such as brakes and engine, tire pressure, and composition of exhaust gas. The future predicts that Vehicle-to-Infrastructure (V2I) may soon help in reserving parking and Vehicle-to-Vehicle (V2V) may support in-vehicle networks while the vehicles are moving, thereby helping vehicles to detect each other and prevent collisions.

10.6.5.6.2 Volvo Uses loTand AI to Reduce Downtime

Every day, the national highways witness millions of trucks transporting fuel, produce, essential commodities, and electronics. But sudden and unplanned downtimes can lead to increase in the toll on the operator and the customers who have tasks dependent on the delivery. Volvo Trucks and Mack Trucks (subsidiaries of the AB Volvo, the Swedish manufacturer) have used remote diagnostic and preventive maintenance for handling this challenge using IoT, AI, and analytics. Thus, they minimize the costs of service disruptions by proactively servicing the connected components of the vehicles.

The Remote Diagnostics of Volvo Trucks monitors data from each truck detecting fault codes when something goes wrong. The trucks are fitted with thousands of sensors to collect real-time streaming IoT data that provides information about the event, where it happened, and the conditions that existed when the fault occurred. On the same lines, the GuardDog Connect of Mack Trucks allows customers to understand the seriousness of the problem and thus manage repairing remotely by checking the parameter data and fault codes, then rank them on the basis of the severity. If the severity is high then the customer is told about the problem and the action to be taken, otherwise the repair is postponed to a later time.

The technology adopted by Volvo Trucks reduced the diagnostic time by 70% and the repair time by 25%.

10.6.5.6.3 App Modifies Traffic Lights for Slower Pedestrians

Launched in April 2018 by Dutch company Dynniq, the Crosswalk app allows pedestrians with restricted mobility sufficient time to cross the road. The system has traffic lights that are fitted with a sensor for scanning the pavements on both sides of the road. If someone using the Crosswalk app is detected, it automatically adjusts the time that the lights remain green. The app has four different time settings, and the light's sensor will select the one suitable for the pedestrian's mobility level and thus ensure that they have sufficient time to cross the road. The app works both with GPS and the software installed in the light. The company is also working for cyclists, notifying the lights when a cyclist is approaching, and also for the visually impaired that activates a sound pattern to let them know if the light is green or red.

Smart Environment Monitoring Systems

Smart cities' infrastructure houses a network of sensors, cameras, wireless devices, and data centers. The setup is utilized by the authorities to provide essential services. Smart cities are also more environmentally friendly because the facilities are built using sustainable materials that lower consumption of energy [25,28,29,32,33]. Technology can be used to create a pollution monitoring system apart from the other systems previously discussed.

The data collected by sensors can be used for controlling, detecting, and managing unnecessary use and making certain adjustments. Environment sensors such as temperature sensors, humidity sensors, flood sensing units, rainfall sensors, sound/noise sensors, and light sensors gather data about pollution, temperature, rain, levels of gases in the city (pollution), and any other events on a daily basis, which is required for taking appropriate actions by authorities or administrators. Sensors are adopted in many wearable devices to monitor weather conditions.

Use Cases of the Smart Environment

10.6.6.1.1 Compact IoT Green Wall Cleans Urban Air

Certain indoor plants can be used to purify the air in homes. A German startup, Green City Solutions, has designed an innovative solution using IoT. They have created a freestanding plant filter, named CityTree, a 12-foot high green unit that is able to clean the surrounding air of pollutants removing 240 tons of carbon dioxide equivalents in a year. It is a moss culture with vascular plants that can ingest polluting gases such as nitrogen dioxide and ozone, providing a cleansing effect the same as that provided by 275 urban trees, for just 5% of the cost and 1% of the space. It needs energy from solar panels and automated provision of water and nutrients using a built-in tank and minimal maintenance.

Apart from the environmental benefits, the CityTree contains sensors that collect and analyze environmental and climatic data, which is used for remotely regulating and controlling the unit to ensure the health of the plants with the changing weather conditions. CityTree also contains space for displaying visual/digital information. Advertisers can rent space on the unit, and nondigital advertising messages can be spelled with plants of different colors. The units can also include benches, Wi-Fi hotspots, and e-bike charging stations.

10.6.6.1.2 Protecting Endangered Species, One Footprint at a Time

Nonprofit research organization WildTrack monitors endangered species to understand how best to protect them and reduce human-wildlife conflict. Traditional methods using radio collars and observational surveys were costly, stressed the animals, and put researchers in danger.

WildTrack wanted to go for a better way. They realized that more information can be derived by monitoring the animals' footprints and coding the expertise of indigenous trackers into sophisticated AI algorithms.

WildTrack's footprint identification technique (FIT) was developed with the help of bushmen trackers in southern Africa. From digital images of footprints tagged with date, time, location, and other information, FIT was able to identify the species, individual, age- class, and gender of an animal. These tracks could be compiled into a collective story that held significant value in conservation efforts.

The only equipment needed in this setup is a digital camera, GPS unit, a scale, and either voice-tag or pen and pencil. Local community members photograph the footprints. The FIT process converts that footprint into a geometric profile and analyzes it for classification. With enough data gathered over a substantial time period, a computer can be trained to accurately identify footprint images and recognize patterns, simulating the methods used by expert trackers. The system is capable of applying these concepts quickly at large scale and coupled with analytics, the whole process effectively gives insights into species populations that WildTrack never had before.

Smart Security

IoT and AI has a huge potential for ensuring public safety and security. Some systems that can be part of smart security systems include:

  • Smart street lights already discussed have a major role to play in security systems. They can become brighter when movement is detected, thereby indicating traffic, and can be used for indicating the coming of an ambulance or fire truck.
  • Drones: They be used for assessing risk, preventing ambushes, searching accidents, investigating crime scenes, and studying factors before sending humans to dangerous situations.
  • Crime prevention and predictive policing: Using big data analysis, we can determine causes of crime and use them to prevent their occurrence in the future. These insights can be extremely useful for government agencies targeting specific localities who can use this information to focus police officer patrols in high risk areas.
  • Emergency apps: Such apps can be used by people to send alerts such as medical or emergency or crimes. The apps detects the locations, along with audio or video recordings if possible, and notifies the nearest police station.
  • Detecting gun shots: Acoustic sensors in the entire city fitted on roof tops of high- rise buildings can help detect gunfire accurately. If 10 sensors simultaneously detect the gunshot, the location can be immediately traced. The accuracy rates are as high as 95% for these systems.
 
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