Internet of Medical Things (IoMT): a comprehensive review

The integration of IoMT devices into healthcare is set to revolutionize healthcare delivery.

Digitalization is the key to the future of the healthcare industry. The global digital health market is expected to exceed $650 billion by 2025. In addition to helping doctors identify and diagnose diseases more quickly, the digitization of healthcare allows individuals to educate themselves about their health. The Internet of Medical Things (IoMT), also known as the healthcare Internet of Things (IoT), simplifies the digitalization of healthcare by uniting devices and systems into a single network.

As IoMT advances, it will help to provide healthcare more quickly and at a lower cost. Our article examines IoMT, its specifics, and the advantages of implementing it in global healthcare systems and medical services. We also discuss the types of IoMT applications, challenges and considerations, trends and innovations, and best practices in data governance for IoMT.Figure 1. Structure of IoMT.

Understanding IoMT

IoMT is a subset of the Internet of Things specifically tailored for the healthcare sector. It encompasses internet-connected medical devices that are used to collect, analyze, and transmit health-related data. IoMT can range from wearable health monitors to advanced diagnostic machines in hospitals. These devices connect patients, healthcare providers, and medical equipment, facilitating data exchange over secure networks.

The IoMT term describes the use of communication technologies to transfer data from a patient’s device to a cloud computing framework. The main application of IoMT is the real-time monitoring of patients’ vital signs via cloud computing, medical sensors, and mobile computing. Physicians can access this data to monitor, diagnose, and treat patients efficiently. IoMT blends traditional medical equipment’s dependability and safety. It can manage multiple devices that are deployed for multiple patients and is general enough to handle a variety of conditions that require incredibly diverse monitoring.

The Internet of Medical Things is a complex and layered network. Below, we describe the nuances of each layer and their functions:

1. Device layer (body sensor network or BSN). This is the most fundamental layer, consisting of various medical sensors attached to the patient’s body or used within the patient’s immediate environment. These sensors collect vital health data such as heart rate, blood pressure, glucose levels, etc. The BSN is responsible for initial patient data acquisition and is crucial for continuous health monitoring.
2. Fog layer (gateway node). It acts as an intermediary between the device and cloud service layers. The fog layer receives data from the BSN and performs preliminary processing. This may include data cleaning, local storage, and initial analysis. The fog layer can make quick decisions and perform actions without needing to send data to the cloud, which is beneficial for time-sensitive applications.
3. Cloud service layer. This layer provides extensive data storage and advanced processing capabilities. It utilizes complex algorithms and machine learning models to analyze the data received from the fog layer. The cloud can identify patterns, predict outcomes, and support decision-making processes for healthcare providers.
4. Transmission layer. It ensures secure and efficient data transfer between the BSN, fog layer, and cloud service layer. The transmission layer uses established threshold values to detect anomalies in the sensor data before it reaches the cloud.
5. Online portal. Healthcare providers access this portal to review processed data, verify diagnoses, and make informed decisions regarding patient care. It serves as the interface for physicians to interact with the IoMT system.

Together, these layers create a cohesive system that not only collects data but also processes and utilizes it effectively to enhance patient care.

Benefits of IoMT

IoMTs have a number of benefits, such as enhanced patient care and efficiency, advanced data management, cost reduction, patient engagement and empowerment, scalability and accessibility, and personalized medicine. Let’s delve deeper into each advantage:

• Enhanced patient care. IoMT devices enable real-time monitoring, which can lead to early detection of diseases and conditions. The immediate response capability can prevent complications, reduce the severity of illnesses, and even save lives. For chronic diseases, such as diabetes or heart disease, IoMT devices can help manage the illness more effectively, leading to better long-term outcomes and enhanced visibility into patient health.
• Increased efficiency. IoMT streamlines healthcare processes by automating tasks such as data entry, patient monitoring, and even certain diagnostic procedures. It reduces the likelihood of human error and frees healthcare professionals to provide more direct patient care. IoMT also speeds up the process of collecting and analyzing data, leading to faster diagnosis and treatment plans.
• Advanced data management. The IoMT’s ability to handle large volumes of data with precision transforms the way health data is managed. It facilitates the collection, analysis, and sharing of health information. This medical data can then be used for predictive analytics, helping to forecast outbreaks, patient admissions, and other important trends.
• Cost reduction. IoMT can significantly lower healthcare costs by minimizing unnecessary hospital visits and reducing the length of hospital stays. Remote patient monitoring and telehealth services (telehealth services refer to the distribution of health-related services and information via electronic information and telecommunication technologies) mean that patients can receive high-quality care from the comfort of their homes. Additionally, IoMT helps in preventive care, which is generally less expensive than treating advanced stages of diseases.
• Patient engagement and empowerment. With IoMT, patients have more access to their health data and are encouraged to take an active role in their health management. This engagement can lead to better adherence to treatment plans and lifestyle changes that promote health. Patients feel more in control of their health, which can lead to increased satisfaction and better overall health outcomes.
• Scalability and accessibility. IoMT makes it possible to extend healthcare services to underserved and remote areas, overcoming geographical barriers. It also allows for scaling healthcare services to larger populations without a proportional increase in healthcare facilities or providers, making healthcare more accessible to everyone.

Personalized medicine. The detailed data collected by IoMT devices allows treatments to be tailored to each patient’s individual needs. Personalization can increase the effectiveness of treatments and reduce the risk of adverse reactions. It also opens the door for personalized health plans that can adapt to changes in a patient’s condition.Figure 2. Benefits of IoMT.

These benefits demonstrate how IoMT has the ability to completely change healthcare delivery and make it more patient-focused.

Types of IoMT applications

IoMT is changing healthcare, making patient monitoring and treatment more efficient. In this section, we’ll look at how different types of IoMT technologies improve patient care:

• On-body IoMT or wearable health monitors. Wearable devices like smartwatches and fitness bands are among the most popular IoMT applications. They track a wide range of health metrics, including heart rate, sleep patterns, and physical activity levels. These devices sync with mobile apps, allowing users to monitor their health trends over time and share this data with their healthcare providers for more personalized care.
• Glucose monitors. Continuous glucose monitoring (CGM) devices have revolutionized the way patients with diabetes live. These IoMT devices provide real-time insights into glucose levels throughout the day and night, alerting users to hyperglycemia or hypoglycemia before it becomes dangerous. Some CGM systems can even administer insulin automatically, functioning as an artificial pancreas.
• Smart pills. Smart sensor-equipped pills that detect stomach acid instantly begin sending doctors vital data about medication adherence, absorption rates, and physiological responses. One such medication is the FDA-approved Abilify MYCITE, which allows for exact tracking of medication administration and patient reaction. 
• Hospital-based applications. In hospitals, IoMT takes the form of advanced medical equipment such as connected inhalers, smart beds, and remote patient monitoring systems. These devices can automatically update patient records with vital signs, medication adherence, and other important health data, freeing healthcare professionals to focus on direct patient care.
• Mobile health applications. Mobile apps are essential components in the IoMT ecosystem, offering functionalities from appointment scheduling to medication reminders. They can also provide educational content, track medication adherence, and even connect patients with virtual consultations, making healthcare more accessible. 
• Specialized IoMT devices. There are also specialized IoMT devices designed for specific health conditions. For example, wearable ECG monitors can detect arrhythmias, while smart inhalers for asthma patients track usage of the inhaler and environmental triggers. These devices provide personalized data, which improves treatment outcomes.
• Public IoMT. These devices, which are distributed over a particular area, are also known as community IoMT. They enable the delivery of healthcare services to individuals who cannot access traditional medical institutions in remote places.

Each use of IoMT makes a unique contribution to enhancing patient care and healthcare delivery. By employing these technologies, medical practitioners can provide more proactive, efficient, and customized care.Figure 3. Types of IoMT devices.

Challenges in IoMT implementation

Although IoMT is at the forefront of transforming healthcare, offering many opportunities for patient care and data management, its rapid advancement also brings a host of challenges that should be navigated carefully:

• Security and privacy challenges. One of the most pressing concerns in IoMT is the security and privacy of patient data. As medical devices become more connected, the risk of data breaches and cyberattacks increases. Protecting sensitive health information requires robust security protocols and encryption methods to prevent unauthorized access and ensure data integrity.
• Interoperability. This is another significant challenge — making different IoMT devices and systems work together seamlessly. With a multitude of manufacturers and protocols, ensuring devices can communicate effectively is crucial for the smooth operation of IoMT solutions.
• Compliance. Compliance with healthcare regulations and standards is also crucial. IoMT devices must adhere to stringent regulations such as HIPAA in the US, GDPR in Europe, and other local laws that govern the handling and sharing of health data.
• Data ownership and consent. The integration of IoMT into healthcare systems brings forth challenges regarding data ownership and patient consent, as the ambiguity surrounding who rightfully owns the data — be it the patient from whom it originates, the healthcare providers who utilize it, or the manufacturers of the IoMT devices — can lead to legal complexities and undermine patient trust.

Discover how Avenga developed a state-of-the-art patient engagement platform for Klara, setting new benchmarks for healthcare communication and guaranteeing strict adherence to industry regulatory requirements.  Success story

Trends in IoMT

IoMT is shaping the standard for innovation in healthcare technology, bringing about profound shifts in the administration and provision of medical services. The predicted financial trajectory for the linked medical device market is one of the most convincing signs of IoMT’s expansion. Based on Acumen’s figures, the market for connected medical devices is expected to reach US$181.9 billion by 2030, with a compound annual growth rate (CAGR) of 22.1%. Several key trends drive this remarkable growth:

RTLS

Real-time location systems (RTLS), also known as location monitoring, are being used by an increasing number of healthcare organizations to track and monitor the location and movement of medical equipment, staff, and patients within healthcare facilities. This technology is essential for optimizing workflows, reducing equipment theft, and improving patient care.

RTLS contributes significantly to patient safety by ensuring that medical equipment is readily available when needed and by monitoring patients’ locations to facilitate timely assistance.  By providing real-time data on the whereabouts of assets and personnel, RLTS enables healthcare facilities to make informed decisions, thereby increasing operational efficiency and resource utilization.

RTLS generates valuable data that can be analyzed to identify bottlenecks in healthcare delivery, understand resource usage patterns, and improve patient flow within the facility.

Nanotechnology

The integration of nanomaterials and nanodevices into IoMT, known as nanomedicine, is transforming disease prevention, diagnosis, and treatment. These tiny yet powerful tools can operate at a cellular level, offering previously unattainable precision.

The Internet of Nano-Things (IoNT) paradigm extends the concept of IoMT by connecting nanodevices to the Internet, enabling more personalized, timely, and convenient health monitoring and treatment. This connectivity is essential for the next generation of medical devices that can communicate and operate on a nano-scale.

Nanotechnology in IoMT facilitates targeted drug delivery. Nanoparticles can deliver medication directly to the affected cells, minimizing side effects and improving treatment efficacy. It also enhances diagnostic capabilities by enabling the detection of diseases at their earliest stages. Nanosensors, for instance, can detect biomarkers at very low concentrations, leading to early intervention and better patient outcomes.

Nanotechnology is being used to develop intelligent implants that can monitor and respond to body conditions in real time, providing continuous feedback and adjustments to treatment regimens.

As research progresses, nanotechnology is expected to lead to more innovative applications in IoMT, such as nano-robots that can perform complex medical procedures internally and biosensors that can track health metrics at a molecular level.

AI and data analytics

AI algorithms are being used to analyze the vast amounts of data generated by IoMT devices to predict health events. This predictive capability can lead to early interventions and personalized care plans.

The combination of AI with data analytics enhances the accuracy of diagnostics. Machine learning models can identify patterns in medical data that may be too complex or subtle for human detection, leading to more accurate diagnoses.

AI-driven data analytics can streamline hospital operations by predicting patient admissions, optimizing staff allocation, and managing inventory. This operational efficiency can reduce costs and improve patient care.

Integrating AI with IoMT enables real-time decision-making. Healthcare providers can receive immediate insights from data analytics, allowing them to make informed decisions quickly, which is crucial in emergency situations.

Finally, AI and data analytics allow for the creation of personalized treatment regimens based on individual patient data. This approach ensures that patients receive the most effective treatments tailored to their needs.

5G technology

5G technology brings high-speed connectivity to IoMT, enabling the transmission of large volumes of medical data at faster rates than ever before. This is crucial for applications that require real time data analysis, such as remote patient monitoring.

One of the most transformative aspects of 5G is low latency, which is essential for medical applications where immediate response is critical. It allows for near-instantaneous communication between devices, which is vital for emergency services and critical care scenarios.

5F networks can support a much higher number of connected devices simultaneously, which is beneficial for hospitals and clinics that deploy numerous IoMT devices. This capacity ensures that the network remains efficient and reliable even as the number of devices grows.

With 5G, telemedicine can reach its full potential, powering high-quality video consultations and remote diagnostics without any lag, thus making healthcare more accessible, especially in rural and underserved areas.

The robust bandwidth of 5G networks facilitates the integration of AI and big data in healthcare. It enables the handling of complex algorithms and vast datasets required for predictive analytics and personalized medicine.

As we look into the future, the trends in IoMT paint a picture of an increasingly interconnected, intelligent, and patient-centric healthcare system. IoMT’s potential is vast, and the trends we’ve discussed will continue to get more traction.Figure 4. Global IoMT market (2018-20230).

Data governance in IoMT

Proper data governance ensures the integrity, security, and usability of vast amounts of health data. As IoMT continues to expand its footprint across healthcare systems, the need for robust data governance frameworks becomes vital. This section delves into the challenges that organizations face in managing IoMT data and outlines the best practices that can lead to a secure and efficient IoMT ecosystem.

Challenges in data governance for IoMT

The main challenges in IoMT data governance include:

• Managing data complexity. The IoMT generates a staggering volume of data, characterized by its variety and the speed at which it is produced. The challenge lies in effectively managing this data flow to harness its potential without being overwhelmed.
• Data quality and consistency. In the IoMT ecosystem, data quality and consistency are paramount. Poor data quality can result in inaccurate analyses, leading to flawed decision-making and incorrect patient care. The integrity of IoMT data is crucial, as it forms the basis for critical decisions and predictive analytics. Ensuring the accuracy, reliability, and timeliness of data from a multitude of devices requires robust validation processes and standardization protocols.
• Technology and infrastructure limitations. The deployment of IoMT is often hindered by technology and infrastructure limitations. Many healthcare facilities face challenges in integrating IoMT devices with existing systems, leading to interoperability issues. The lack of standardized protocols and the rapid pace of technological advancement further complicate the exchange of data. Additionally, the security infrastructure must be robust enough to protect sensitive health data, requiring continuous updates and monitoring.
• Cost efficiency. Cost efficiency is a significant hurdle in the adoption of IoMT, particularly for smaller organizations. The high costs associated with implementing and maintaining IoMT solutions and infrastructure can be prohibitive, limiting the scope and effectiveness of data governance. Small healthcare providers may struggle to justify the investment, especially when the return on investment is not immediately apparent.

Best practices in data governance for IoMT

Among the top IoMT data governance techniques are:

• Establishing governance frameworks. Clear data governance policies and procedures are the foundation of a secure IoMT environment. These frameworks should define roles, responsibilities, and processes for managing IoMT data throughout its lifecycle.
• Robust security measures. Implementing state-of-the-art data security measures, such as encryption and access controls, is essential to safeguard data against unauthorized access and breaches.
• Data quality and integrity audits. Regular audits of data quality and integrity are crucial to ensure that the IoMT data being used for decision-making is accurate and reliable.
• Staff training. Educating staff on data governance principles and practices is vital for maintaining a data security and compliance culture. Continuous training ensures all personnel are up-to-date with the latest governance strategies and technologies.

IoMT data governance is complex, and navigating it requires a proactive strategy that strikes a balance between the demands of security and compliance and the need for innovation. Healthcare companies that follow best practices can fully utilize IoMT data while preserving patient privacy and building trust.

Takeaways

IoMT represents a confluence of innovation in healthcare, where every connected device and data point can help achieve better health outcomes and more efficient care delivery. IoMT is making healthcare more proactive, personalized, and accessible. With a keen focus on enhancing healthcare through technology, Avenga is well-equipped to collaborate with organizations seeking to harness the capabilities of IoMT. Reach out to Avenga today to let us unleash the full potential of IoMT for your healthcare operations.