Title: Challenges of Implementing Internet of Things (IoT) in Malaysian Private Healthcare Industry, Case Study of AK Hospital
CHAPTER 1. INTRODUCTION/ RESEARCH BACKGROUND
The healthcare industry through the use of information technology have not only improved patients’ quality of life, but it has also impacted the practise of medicine including medical processes (Banova, 2018). Some of the breakthrough includes new ways of collecting patient data; research and treatments which equips medical providers with new tools, fresh and innovative ways leading to better accessible treatment. As stated by Iman Ghosh (2019) in her article, there are 5 ways technology is already transforming the health industry. Among the 5 are AI (Artificial Intelligence) which could help to diagnose skin cancer, eye and heart disease and maybe strokes. Virtual healthcare or known as telemedicine enables both doctors and patients to not only communicate virtually/remotely but sharing and monitoring of health data. VR (Virtual Reality) a cost-effective and efficient tool could be used to train surgeons in a less risky replicated situation while offer potential rehabilitation for patients with anxiety disorder, which according to ABI research (2017) it is a growing industry with an estimation of $285million in 2022.
The tech-driven possibilities in this healthcare industry is essential in meeting the demands of the ever-increasing and aging population, coupled with complex health diseases and issues (Meinert, 2018). The implementation of IoT (Internet of Things) could provide one of the possible answers to these new challenges. According to Forbes, IoT is the concept of connecting any devices to the Internet (talking to each other), for example the mini van dashboard, the engine of an aircraft or the coffee machine in the office (Morgan, 2017). Basically, the IoT is a giant pool of network with connected devices (including people) that exchanges data and information.
IoT in healthcare is mainly focused on remote monitoring and telemonitoring and on tracking, monitoring and maintenance of assets. IoT-based healthcare system typically connects all resources on a network to carry out activities such as remote diagnosing and monitoring over the Internet (Yin, 2016). The scope of activity is even extended to improve patient outcomes, and also takes some of the burden off health practitioners. Tasks such as treatment progress observation, and the housing of vaccines are all capabilities of medical devices with integrated IoT.
1.1 Problem Statement
Healthcare in Malaysia is ranked as the best in the World category of the 2019 International Living Annual Global Retirement Index, scoring 95 out of 100 (Thestar, 2019). The IoT market potential in Malaysia is predicted to register $2.2 billion by 2020 and according to Prof. Dr. Sharin bin Sahib, the Vice Chancellor of the Universiti Teknikal it is expected to grow exponentially beyond 2020 to reach $10.5 billion in 2025 (Ho, 2017).
In order to materialise the greater benefits of IoT in healthcare, this qualitative case study will explore the benefits such as remote monitoring, remote diagnosis, use of big data analytics and integrated healthcare solutions. The data to be gathered in this study may be able to provide healthcare professionals, hospitals and medical equipment providers with information on how they may mitigate or combat the challenges in our healthcare system.
1.2 Research Objectives
The objective of this paper through a revised theory of the topic is to provide the following:
1) to determine what are the advantages with IoT implementation
2) to determine what are the challenges and issues with IoT implementation
3) to identify key use cases demonstrating technology capabilities,
1.3 Research Questions/ Hypothesis
1) What factors affect the development of IoT in healthcare in Malaysia
2) What are the advantages/disadvantages of deploying IoT in healthcare
3) What are the issues and challenges of IoT in healthcare
1.4 Significance of the Study
This case study hopes to showcase the benefits of IoT in healthcare in overcoming Malaysia’s ageing population with increased healthcare needs, increasing chronic medical diseases including cardiovascular diseases and strokes.
1.5 Research Scope and Limitation of the Study
This case study will focus on the IoT concept, framework and case studies cited in articles, literature, and journals. The scope of the healthcare case study will be limited to the AK group of private hospital, where they currently have presence in Melaka, Malaysia. The study will not cover other issues or topics unrelated to Healthcare IoT as well as non-private hospital/clinics.
1.6 Proposed Research Methodology
The proposed research method for this case study will be in qualitative form, hence there will be interviews, participant observations, open-ended surveys and content analysis.
CHAPTER 2. CASE DESCRIPTION / HISTORY
Every individual has the fundamental right to have access to quality healthcare where governments and administrations constantly endeavour to provide via an affordable, cost-effective and competent system (Mehta, 2019). Over the years, healthcare with the advancement of technology have enabled patients to get better treatment and diagnosis which in turn have not only save lives but also improve quality of life (Medical, 2013). Technological growth in the health industry offers excellent benefits to patients, increases efficiency and helps health care professionals with their difficult jobs. Innovation in medical technology plays a crucial role in biotechnology, pharmaceuticals, as well as the development of medical devices (Medical, 2013).
Adoption of Internet of Things or IoT in healthcare started with the usage of devices such as smart sensors, patient bed remote monitoring, medication dispenser, medical device integration and so on (Shashank, 2018). Basically, IoT in healthcare aims to combine the best of these three aspects (convenience, efficient, automation) and integrate into the healthcare provider, patient and medical stakeholders (Shashank, 2018). Despite the expanding adoption of IoT in the medical industry, these changes bring together challenges as well. Among them are the connection and performances of medical instruments/devices, standardization of IoT protocols, security risks containing sensitive information such as patient’s medical history, data and diagnosis (Chernyak, 2019).
The main purpose of this case study is to determine what are the factors driving the private healthcare industry to adopt IoT and what are the issues and challenges that comes with it. The first part of this paper will explain about the industry profile as well as an overview of what is IoT, the concept and how it works. The second part will provide an overview of the company background being the subject of this research paper.
2.1.1 Global Private Healthcare and Impact of Technology
According to the 2019 US and Global Health Care industry report by Deloitte, the healthcare industry continues to grow with no signs of slowing down (Burril, 2019). Health care stakeholders struggling to manage clinical, operational, and financial challenges envision an industry in which new business and care delivery models, aided by digital technologies, may help to solve today’s problems and to build a sustainable foundation for affordable, accessible, high-quality health care. Aging and growing populations, greater prevalence of chronic diseases, and exponential advances in innovative, but costly, digital technologies continue to increase health care demand and expenditures (Burril, 2019). Among the key take away from the Deloitte report are as follows:
Financial sustainability in an uncertain health economy – introduce rigorous financial management, efficient operational performance, outcomes-based care, and innovative solutions
Adapt to various consumer needs and demands – digital technologies can improve engagement, enable convenience-driven access to care, and nurture a two-way relationship for the long term.
Invest in digital innovation and transformation – lead to better usage of health data in research supporting personalized health care, allowing highly trained resources to focus on more valuable, patient-facing activities.
Regulatory compliance and cyber security – health care organizations should focus on compliance, ethics, and risk, driving awareness throughout the enterprise.
An article by Mckinsey (2018) stated that services and technology have become the fastest-growing profit pool in the healthcare industry over the past five years, a trend driven by the significant value creation potential of technology-based and -enabled innovations. Major technological advances (e.g., interoperability, advanced analytics, machine learning, digitization, the Internet of Things) have found numerous applications in healthcare—and present important opportunities to address the half a trillion dollars of annual spending resulting from low productivity and waste (Onitskansky, 2018). Big data, analytics, and the cloud have thus combined to become the “Internet of Things” as humans, devices, and machines communicate continuously and in ever-greater numbers. Another technological force, artificial intelligence, includes programs and algorithms that have been developed and applied to practices ranging from drug development to patient monitoring and care (Yadav, 2018). Robotics is also one of the most exciting and fast-growing fields in healthcare. With developments ranging from exoskeletons to nanodevices, companies like SuitX and ReWalk Robotics are building suits that enable paralyzed people to walk and aid in the rehabilitation of stroke or spinal cord injury patients (Brewster, 2016).
2.1.2 Global Challenges in Private Healthcare Industry
The global healthcare industry constantly face many changes that pose new challenges to healthcare organizations big and small, be it from the government in terms of regulations, technology advancement or patient’s care expectation (Sullivan, 2018). Below are five major challenges that is currently upsetting the healthcare industry:
a) Increase in cost of healthcare – As more people strive to live longer, healthier and more active lifestyles, healthcare concerns increase and so does the costs. Research reveal healthcare costs and spending often rise at rates exceeding inflation, and is expected to increase in the future (Teel, 2018).
b) Healthcare Regulatory – Regulatory challenges drive up the cost of providing services and care. Hospital and healthcare providers needs to actively engage in awareness and information sharing regularly including implementing document control programs, compliance training and routine audits (Teel, 2018).
c) Cybersecurity – In 2017, the US medical and healthcare sector experienced over 350 data breaches, exposing 4.93 million patient records and highly sensitive patient information collected by healthcare organizations (Sullivan, 2018).
d) Big data – Although more and more healthcare data is being generated, it’s scattered across multiple parties and systems including payers, providers, and patients. For healthcare organizations to successfully harness the power of big data, leadership needs to embrace data-driven decision-making. The use of analytics should be woven into the organization culture to develop a trust in data so the insights can be used to support decision-making at the executive level (Sullivan, 2018).
e) Shortage of primary care professionals – The shortage of primary care professionals is partly due to the low number of new doctors and nurses competent enough to replace retiring doctors and nurses. This shortage can lead to problems in the accessibility of health care Accessibility depends on availability of these professionals. The shortage of medical professionals can lead to declining quality and effectiveness of the health care system (Johansen, 2017).
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