Government regulations, safety and technical integration are all serious issues facing the use of IoT in medicine, but professionals in the field say that medical IoT is moving forward despite the obstacles. A vendor, a doctor, and an IT pro all spoke to Network World about the work involved.\nVendor: It's tough to gain acceptance\nJosh Stein is the CEO and co-founder of Adheretech, a medical-IoT startup whose main product is a connected pill bottle. The idea is to help keep seriously ill patients current with their medications, by monitoring whether they\u2019ve taken correct dosages or not.\n\nThe bottle \u2013 which patients get for free (Adheretech\u2019s clients are hospitals and clinics, as well as pharmacies and drug companies) \u2013 uses a cellular modem to call home to the company\u2019s servers and report on how much medication is left in the bottle, according to sensors that detect how many pills are touching the bottle\u2019s sides and measuring its weight. There, the data is analyzed to determine whether patients are sticking to their doctor\u2019s prescription.\nThe challenges to reach this point have been stiff, according to Stein. The company was founded in 2011 and spent the first four years of its existence simply designing and building its product.\n\u201cWe had to go through many years of R&D to create a device that\u2019s replicatible a million times over,\u201d he said. \u201cIf you\u2019re a healthcare company, you have to deal with HIPAA, the FDA, and then there\u2019s lots of other things like medication bottles have their whole own set of regulatory certifications.\u201d\nBeyond the simple fact of regulatory compliance, Stein said that there\u2019s resistance to this sort of new technology in the medical community.\n\u201cHealthcare is typically one of the last industries to adopt new technology,\u201d he said.\nDoctor: Colleagues wonder if medical IoT plusses are worth the trouble\nDr. Rebecca Mishuris is the associate chief medical information officer at Boston Medical Center, a private non-profit hospital located in the city's South End. One of the institution\u2019s chief missions is to act as a safety net for the population of the area \u2013 57 percent of BMC\u2019s patients come from under-served populations, and roughly a third don\u2019t speak English as a primary language. That, in itself, can be a problem for IoT because many devices are designed to be used by native English speakers.\nBMC\u2019s adoption of IoT tech has taken place mostly at the individual-practice level \u2013 things like Bluetooth-enabled scales and diagnostic equipment for specific offices that want to use them \u2013 but there\u2019s no hospital-wide IoT initiative happening, according to Mishuris.\nThat\u2019s partially due to the fact that many practitioners aren\u2019t convinced that connected healthcare devices are worth the trouble to purchase, install and manage, she said. HIPAA compliance and BMC\u2019s own privacy regulations are a particular concern, given that many of the devices deal with patient-generated data.\nMoreover, amid all the hype over IoT, it\u2019s easy to forget that the use of the technology in medicine is still relatively novel. Physicians are, of necessity, scientifically minded people, and the fact that there isn\u2019t a large body of rigorous research demonstrating the overall value of medical IoT hasn\u2019t helped to convince them.\n\u201cIt\u2019s not clear to me what the best use of these devices is in the clinical world,\u201d she said. \u201cIt\u2019s not to say that there isn\u2019t utility, it\u2019s that we haven\u2019t conclusively shown that there is utility.\u201d\nMishuris did praise some uses of IoT, including a connected glucometer that has helped some diabetes patients control their symptoms, thanks to the increasingly granular glucose measurements being provided directly to the physician.\n\u201cI think that for the things we have in place, particularly the glucometer, the clinicians really value the data they\u2019re getting from them,\u201d she said.\nIT pro: Diverse medical IoT devices can drive IT 'nuts'\nCambridge Health Alliance is a chain of hospitals and clinics that serves more than 140,000 patients in the north suburbs of Boston. CHA\u2019s senior director of IT applications, Arthur Ream, said that the group\u2019s facilities include a huge range of different IoT equipment, from smart-building systems and connected HVAC to diagnostic and treatment devices.\n\u201cIt\u2019s just such a diverse field, so much coming into organizations,\u201d he said. \u201cIt\u2019s driving CISOs and their technology staff nuts.\u201d\nBiomedical devices, in particular, pose challenges to the IT staff. Diagnostic devices have to be certified by the FDA, and if they\u2019re modified \u2013 say, via a necessary software patch \u2013 they may have to go through the certification process again, depending on whether the inherent functionality of the device is changed by the update.\nMoreover, many of those devices aren\u2019t computationally sophisticated enough to handle some kinds of security software, said Ream.\n\u201cProtecting [them] is tough \u2013 you can\u2019t necessarily put an agent on these things,\u201d he said.\nNevertheless, there are some shortcuts to herding the various cats that Ream has to deal with at CHA. Heavy use of network segmentation is one technique, ensuring that diagnostic devices stay on their own network, separate from the operational Wi-Fi, guest Wi-Fi, and smart building systems, all of which have different segments.\nAnything that helps with automated discovery and monitoring of devices on a given network can help as well, given the rapid advancement of healthcare IoT.\n\u201cFinding out what\u2019s on your network \u2013 nobody\u2019s come up with a real good product that has sensors, starts to pick up on things \u2026 at the lower levels of the network stack,\u201d he said.\nDespite all the headaches, however, Ream said that healthcare organizations should view the IoT as a business opportunity \u2013 the ability to offer new and different services, and to make healthcare more convenient for patients, can be an important competitive differentiator.\nConnecting patient portals to electronic health records and mobile apps could result in a system that automatically checks patients in for appointments when they arrive at an office, said Ream, and even offer automatic handling of things like patient room assignments and co-pays.\n\u201cHealth care is just an enormous business machine, and people completely forget about the monetary side of things,\u201d he added.