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Security Crisis of Cardiac Pacemakers Paves the Way for IoT Security Evolution in Cardiology

By INGA SHUGALO

While the healthcare IoT demand forecasts are more than generous, anticipating the market to hit $158.07B by 2022, there is still a certain delay in IoT adoption across the industry. Connected medical devices, especially those that are directly involved in patient care, are adopted cautiously due to potential security vulnerabilities and risks to patient safety.

One of the reasons behind the hesitant adoption of healthcare IoT in cardiology is preexisting concerns about the security of implantable medical devices, such as pacemakers.

The recent pacemaker crisis revealed the vulnerabilities in pacemaker software across several major vendors. If exploited, software vulnerabilities would allow hackers to take over the device and control it fully. The crisis led to device recalls, certain features disabled, and even remote updates cut off completely to avoid unacceptable health risks.

This series of events led to a cautious attitude toward the emerging cardiology IoT. Since we can’t be sure that all exploits and vulnerabilities are eliminated in less advanced systems, are we really ready to take a step forward to more elaborate healthcare software solutions at this point?

The fact of the matter is, cardiology is already taking these steps. The new generation of pacemakers has embedded sensors to monitor a patient’s blood temperature, sinus node rate, breathing, and other vitals. This data is used to flexibly alter the heart rate, slowing or speeding it depending on a patient’s current activity level. They also inherited remote control from their predecessors. Practically, next-gen pacemakers are IoT devices.

Accordingly, the industry can either stigmatize the security concerns or choose to adopt a new perspective, seeing the pacemaker crisis as an opportunity to create a solid platform for unbiased adoption of upcoming connected cardiac devices.

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IoT: A Transformative Ecosystem or a Race to the Bottom?

A couple of weeks ago, I was invited to speak on a panel at the Brookings Institution discussing the 5th-Generation (5G) wireless revolution, how it will enable the Internet of Things (IoT) and the implications for healthcare. In the paper that spawned the Brookings panel, Darrell West noted that 5G networks will incorporate cloud storage and a distributed computing model into a true Internet of Things, where billions of devices will share data in new ways.

The possibilities for identifying important health trends and intervening at just the right time to affect behavior — using everyday objects and systems — opens the door to all kinds of possibilities for improved health. But for me, that idea is positively frightening, given the current state of interoperability in healthcare.

The IoT only works if there are standards. An essential function of IoT standards is to allow devices to identify their capabilities to each other, and provide basic information regarding format. Several organizations are working on this, but none seem well-versed in healthcare needs.

As low-cost, consumer-grade sensors are embedded into devices without regard for the unique needs and requirements for healthcare data exchange, will we experience trouble? Will the 5G healthcare IoT become a ‘race to the bottom,’ where data of dubious or unknown quality will power our new healthcare ecosystem?

Take, for example, a connected weight scale. Even if a device collects data accurately, the way the scale transmits data can enhance or nullify its accuracy. For general wellness, this probably doesn’t matter. But for monitoring a condition like heart failure, it does.Continue reading…

The Thing About the IoT

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In the coming years, the number of devices around the world connected to the Internet of Things (IoT) will grow rapidly. Sensors located in buildings, vehicles, appliances, and clothing will create enormous quantities of data for consumers, corporations, and governments to analyze. Maximizing the benefits of IoT will require thoughtful policies. Given that IoT policy cuts across many disciplines and levels of government, who should coordinate the development of new IoT platforms? How will we secure billions of connected devices from cyberattacks? Who will have access to the data created by these devices? Below, Brookings scholars contribute their individual perspectives on the policy challenges and opportunities associated with the Internet of Things.

The Internet of Things will be Everywhere

Humans are lovable creatures, but prone to inefficiency, ineffectiveness, and distraction. They like to do other things when they are driving such as listening to music, talking on the phone, texting, or checking email. Judging from the frequency of accidents though, many individuals believe they are more effective at multi-tasking than is actually the case.

The reality of these all too human traits is encouraging a movement from communication between computers to communication between machines. Driverless cars soon will appear on the highways in large numbers, and not just as a demonstration project. Remote monitoring devices will transmit vital signs to health providers, who then can let people know if their blood pressure has spiked or heart rhythm has shifted in a dangerous direction. Sensors in appliances will let individuals know when they are running low on milk, bread, or cereal. Thermostats will adjust their energy settings to the times when people actually are in the house, thereby saving substantial amounts of money while also protecting natural resources.

With the coming rise of a 5G network, the Internet of Things will unleash high-speed devices and a fully connected society. Advanced digital devices will enable a wide range of new applications from energy and transportation to home security and healthcare. They will help humans manage the annoyances of daily lives such as traffic jams, not being able to find parking places, or keeping track of physical fitness. The widespread adoption of smart appliances, smart energy grids, resource management tools, and health sensors will improve how people connect with one another and their electronic devices. But they also will raise serious security, privacy, and policy issues.

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