The COVID-19 pandemic has made telehealth and remote patient care more acceptable, but what are the challenges and potentials?

As healthcare facilities embrace telehealth alternatives to traditional hospital visits, what is the role of technology in driving a full-scale rollout, driving patient care and managing costs?

Huei Sin Ee, Vice President and General Manager for General Electronics Measurement Solutions at Keysight Technologies, shares with DigiconAsia her perspectives on the state of telehealth and 5G, and the development of healthcare facilities toward leveraging the technology.What are the current technology challenges hospital and healthcare facilities are facing regarding technology powering remote patient visits?Ee: Telehealth today is limited by the network capacity required to manage massive telehealth data optimally. 5G can provide the solution by enabling an ultra-reliable, high-speed, wide-bandwidth and low latency network infrastructure to support the robust needs of telehealth.

Huei Sin Ee, VP & GM for General Electronics Measurement Solutions, Keysight Technologies

What are the current technology challenges hospital and healthcare facilities are facing regarding technology powering remote patient visits?

Ee: Telehealth today is limited by the network capacity required to manage massive telehealth data optimally. 5G can provide the solution by enabling an ultra-reliable, high-speed, wide-bandwidth and low latency network infrastructure to support the robust needs of telehealth.

These include remote patient monitoring (RPM) where real-time monitoring, streaming and analysis of patient data from massive medical devices and Internet-of-Medical-Things (IoMT) will be required, remote surgery using robotics and emergency signals that rely on extremely low latency, connect smart ambulance that facilitates real-time streaming of patient data and emergency consultation via video, as well as virtual consultation via high definition video.

In addition, hospitals also require secure and efficient health systems to advance patient care and manage electronic medical records (EMRs), alongside patient and hospital workflow, and connected devices. When enabling external mobile access to EMRs, ensuring patient data security and privacy is especially crucial.

Integrated health system software performance and efficiency is also vital to streamline clinical workflow, engage community and advance patient care.

How will this change following the COVID-19 pandemic?

Ee: Even before COVID-19, we have seen collaborations between hospitals and telecommunication companies in establishing 5G capabilities at medical centers.

There was also a clear convergence of consumer and medical devices, and rapid growth in Internet-of-Medical Things (IoMT) for telehealth remote monitoring. For instance, consumer electronics companies have entered the wearable medical device market and moved up higher on the value chain. Medical device companies are also launching portable devices to be worn outside a medical facility to capture higher volume in the consumer market.

The pandemic has accelerated the rise and advancement of telehealth considerably. Doctors and patients have turned to telehealth during the crisis for routine medical care without risking a visit to the hospital. Greater self-isolation and the increased need for medical services have driven strong demand for telehealth today.

Governments, insurance companies and healthcare providers are pushing for telehealth services, and we expect this will accelerate policy and regulatory changes, as well as funding and incentive initiatives. For example, insurance companies in Singapore have started to extend coverage for COVID-19 daily hospital benefits and telemedicine claims during the “circuit breaker” period.

Broader investment on 5G infrastructure and development of AI and big data analytics for healthcare have also propelled telehealth growth. In China, 5G-powered telemedicine, remote ultrasound and CT scanning have been utilized to tackle the shortage of medical personnel.

According to Frost & Sullivan, the demand for telehealth will soar this year as the COVID-19 pandemic disrupts the practice of healthcare delivery. Asia Pacific is expected to become the highest growth market globally by 2025, with 64 percent growth in 2020 and 38 percent CAGR for the next 5 years, due to high rural population, improving healthcare scenarios and high mobile adoption rate.

Near-term trends for telehealth post-COVID-19 pandemic include more hospitals adopting 5G technology and expanding telehealth services beyond teleconsultation, and also increasing coverage to rural areas. 5G will transform telehealth services through the advancement of massive remote monitoring devices, mission-critical remote surgery and smart ambulance, as well as real-time AR/VR applications. Chronic disease management using smart devices, remote surgery using robotics, as well as the use of AR/VR in diagnosis and treatment will become more prevalent. There will be higher integration and better patient care as hospitals, healthcare providers and device manufacturers work closely on data sharing and online care coordination. We can expect more innovations in medical services leveraging 5G, AI and edge computing to allow more immediate and actionable patient monitoring in real-time.

What benefits would 5G bring to the healthcare industry?

Ee: 5G is the next evolution of wireless communication that advances telehealth, not only in areas of remote and real-time healthcare, but also telesurgery and AR/VR applications. It broadens the access to more patients by pushing smart devices and decisions from core to edge, in tandem with artificial intelligence (AI) and edge computing architectures.

Telehealth leverages IoT technologies in healthcare to move the medical diagnostic and patient monitoring from hospital-centric to home-centric, and this creates immense benefits for patients and consumers.

Hospitals in Asia Pacific have started to collaborate with telcos and service providers to set up 5G infrastructure and develop new use cases.

For instance, the collaboration between ZTE and China Telecom in completing the first 5G-enabled remote diagnosis of coronavirus pneumonia via a 5G telehealth system, and the partnership between KT Corporation and Samsung Medical Center in developing 5G-enabled medical services spanning digital diagnostic pathology, AI-enabled care for in-patients in Korea.

Does 5G meet current needs for bandwidth, connectivity and security, and what needs to change?

Ee: 5G technology was designed to support a large amount of connectivity and complex use case such as telehealth.

These include enhanced mobile broadband (eMBB) for high bandwidth to support real-time 3D video, augmented reality (AR) and virtual reality (VR) applications; high speed up to 20 Gbps (based on IMT-2020) and 1 GHz bandwidth supporting 10000 times more traffic then the current 4G network; as well as ultra-reliable low-latency communications (URLLC) for time critical communication such as remote robotic surgery which requires extremely low latency.

Latency for 4G is around 50 milliseconds, but 5G could achieve well below 10 milliseconds, and in best cases around 1 millisecond delays. This supports massive machine type communications (mMTC) to enable millions of devices to communicate with each other incorporating low data rates, less energy and lower costs. It also supports connection density of 1 million devices per square kilometer, versus around 4000 devices in current 4G network.

In addition, 5G supports network slicing for seamless resource management, better data security, and to fulfill diverse applications and service requirements. New architecture allows service providers to build virtual and independent networks tailored to specific applications, versus “one-size-fits-all” in 4G.

For telehealth to truly take flight, there is a need to develop more 5G infrastructure to widen the coverage, especially in rural areas, to help local communities benefit from telehealth.

As 5G architecture advances, the platform for higher frequency spectrum will take shape and unlock the full potential of 5G applications.

Government support will accelerate the adoption of 5G, in areas including early consultations with the industry, planned infrastructure, technology funding, as well as policies that support applications and encourage university research and university-industry collaboration on biomedical technology and other 5G advanced applications.

In addition, we expect more advanced applications such as medical services, robotics and smart home devices to be the main driving force for 5G demand.

Unleashing more innovations in healthcare applications in tandem with other technologies such as AI, machine learning (ML), AR/VR and edge computing is needed. More new medical device developments, especially wearables and hearables, that leverage 5G technology for remote patient monitoring, are required to realize the full promise of telehealth.

At Keysight, we are actively addressing the 5Cs (namely connectivity, continuity, compliance, coexistence and cybersecurity) of IoMT, especially for mission-critical media devices. Eggplant, which was acquired by Keysight recently, also uses artificial intelligence and behavioral analytics to optimize digital experience in the healthcare system.