The era of the Internet of Medical Things (IOMT) can be best summarized into five broad categories of relevancy for the practicing emergency physician.
First, there are devices that an emergency physician uses directly with patients. An example of this would be a digital stethoscope that augments sounds and creates new data sets that can be analyzed in real time.
The second category of IOMT devices is that which we as emergency physicians will be called on to interpret by our patients. A good example of this would be a connected inhaler that gives the emergency physician significantly more information about the patient’s recent use and exacerbation patterns.
Devices that enhance communication within the emergency department or hospital are a third broad category of devices that allows for more efficient and new forms of communication. Patient-monitoring technology is another broad category of devices that will connect the emergency physician to patients in new and exciting ways. Imagine pre-hospital ECG readings but for a whole host of new applications.
The final broad category is more on the fringe: the overlay of robots and deep learning and computer vision tools to help with diagnosis and treatment. Robots are now involved in surgery and the delivery of medication and supplies throughout hospitals. Drones are being tested for delivery of medication and blood to remote locations that can’t be accessed by ground transport. And entrepreneurs are looking to leverage deep learning to assist with radiology imaging, dermatology, and ophthalmology.
Devices for Direct Patient Care
The Digital Stethoscope. Auscultation using a stethoscope has been a hallmark of the physical exam for much longer than anyone who is alive and reading this article. Small advances in technology have improved portability through size reduction and increased volume emitted by the device. Now, we are seeing a revolution in design and function. New digital systems are augmenting traditional stethoscopes, and there are now smartphone cases that can act as conduits for auscultation. These devices can capture sound and represent it as an amplified digital signal or display the data in completely new user experiences. Imagine devices that not only augment and refine the sound experience but also tell you, “Hey, there is an s3 heart sound.” In this example, you can imagine patients using the device at home and texting their primary care provider or telling an emergency physician upon arrival that the device detected an s3.
As an example, CliniCloud’s digital stethoscope not only gives you information on the heart sounds but also heart rate and respiratory rate. This device retains sound information at lossless 44.1 kHz audio, stores it locally on the device, as well as backs it up on a HIPPA-compliant cloud platform so that your information, as well as that of family members, is retrievable and also sharable. The smartphone app allows you to follow trends, share the data with health care providers, and gives tips on data acquisition and interpretation of data. Also very compelling, this device can be used with telemedicine services like Doctor on Demand, giving more information to the clinician on the other end of the video call. The CliniCloud, with stethoscope, thermometer, and case, is priced at $150.