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.\nTelehealth systems, for example, are still a relatively new facet of modern medicine, but they\u2019re 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.\n\nGreg Hall is the director of IT at UMMC\u2019s center for telehealth. He said that the remote patient monitoring system is relatively simple by design \u2013 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 \u2013 depending on who\u2019s got the best coverage in a given area \u2013 back to UMMC\u2019s servers.\nAccording 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 \u2013 some of whom live in remote parts of the state \u2013 to their caregivers.\n\u201cWe weren\u2019t expecting everyone who uses the service to have Wi-Fi,\u201d he said, \u201cand they can take their tablet with them if they\u2019re traveling.\u201d\nThe 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 \u2013 Hall said that it\u2019s already been extended to patients suffering from chronic obstructive pulmonary disease, asthma and even used for prenatal care, with further expansion in the offing.\n\u201cThe goal of our program isn\u2019t just the monitoring piece, but also the education piece, teaching a person to live with their [condition] and thrive,\u201d he said.\nIt hasn\u2019t 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.\nNeurologist Dr. Allen Gee\u2019s practice in Wyoming attempts to address a similar issue \u2013 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.\nWhile Gee\u2019s preference is to meet with patients in person, that\u2019s just not always possible, he said.\n\u201cMedical specialists don\u2019t get paid for windshield time,\u201d he noted. \u201cBeing able to transfer information from an EHR facilitates the process of learning about the patient.\u201d\n5G is coming\nAccording to Alan Stewart-Brown, vice president at infrastructure management vendor Opengear, there\u2019s a lot to like about current carrier networks for medical use \u2013 particularly wide coverage and a lack of interference \u2013 but there are bigger things to come.\n\u201cWe have customers that have equipment in ambulances for instance, where they\u2019re livestreaming patients\u2019 vital signs to consoles that doctors can monitor,\u201d he said. \u201cThey\u2019re using carrier 4G for that right now and it works well enough, but there are limitations, namely latency, which you don\u2019t get on 5G.\u201d\nBeyond 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.\n\u201cThe process you use to do things like real-time video \u2013 right now on a 4G network, that may or may not have a delay,\u201d said Stewart-Brown. \u201cOnce you can get rid of the delay, the possibilities are endless as to what you can use the technology for.\u201d\nCitizens band\nRon 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.\n\u201cThe use cases need to be worked on,\u201d he said. \u201cThe innovative [companies] are starting to say \u2018OK, what does 5G mean to me\u2019 and starting to plan use cases.\u201d\nOne area that the carriers themselves have been eyeing recently is the CBRS band of radio frequencies, which sits around 3.5GHz. It\u2019s what\u2019s referred to as \u201clightly licensed\u201d 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.\nThere\u2019s also the issue, of course, that there are still a huge amount of unknowns around 5G, which isn\u2019t expected to supplant LTE in the U.S. for at least another year or so. The medical field\u2019s stiff regulatory requirements could also prove a stumbling block for the adoption of newer wireless technology.