Guest speakers at a sideline discussion on the Internet of Medical Things at the Global Health Forum of Boao Forum for Asia pose for a photo in Qingdao, east China's Shandong Province, on June 10 (COURTESY PHOTO)
When Bai Chunxue was first exposed to the concept of the Internet of Things (IoT) nearly a decade ago, as a doctor of respiratory medicine, he was troubled by the unsatisfactory feedback of patients about the experience of seeing a doctor. The complaints of patients include waiting too long to get a diagnosis. To better meet patients'needs, Bai, who works at the Zhongshan Hospital affiliated to Fudan University in Shanghai, began to explore the application of IoT in medical treatment.
Bai's vision was fulfilled as his research team makes initial progress on Internet of Medical Things (IoMT) facilities that can provide early diagnoses for patients. As he described at a sideline discussion of the Global Health Forum of Boao Forum for Asia held recently in east China's Shandong Province, the facilities can save people with minor illnesses from a trip to the hospital through remote monitoring and provide timely warnings for those likely to suffer from severe diseases.
IoT is only one of the many technologies expected to help both doctors and patients. The Internet, 5G and artificial intelligence (AI) are all making medical treatment smarter and more accessible to the public.
"Technologies will promote the sharing of information, boost innovation in medical treatment and make distribution of medical resources more balanced, which will in turn upgrade the healthcare industry," Zhang Wei, professor at the West China School of Medicine, told the forum.
For China, with an expanding middle-income group and aging population, technology-based healthcare services have grown in demand.
On March 16, Ling Zhipei, a doctor at a Beijing hospital conducted China's first 5G-based remote surgery lasting three hours on a patient suffering from Parkinson's disease. Through remote control of robots, the brain surgery was completed successfully with technological support from the country’s largest telecom carrier China Mobile and technology giant Huawei.
According to Zhao Jie, an official with the Chinese Health Information Association, the low latency, large bandwidth and high speed of 5G-based Internet transmission can meet rising demands for smart medical treatment and revolutionize the industry. "5G is 100 times faster than 4G. The time gap (between surgeons and experts in another place) in 5G-based surgery can be reduced to two milliseconds, which is next to nothing," he said.
As Zhao highlighted, effective 5G transmission of information has made long-distance diagnoses possible and medical treatment more accessible and affordable. Patients in lower-tier hospitals can now also enjoy top-level medical treatment.
Earlier this year, doctors in Shenzhen People's Hospital in Shenzhen, south China's Guangdong Province, completed a complicated hepatic operation with online guidance from an expert based in Beijing, thanks to a high-definition 5G-based live stream. Otherwise, the surgery would have been too difficult for the doctors to carry out.
5G technologies will allow real-time transmission of patients'information without the need for monitoring facilities, remote ward rounds with robots, and quick searches of patients' medical records to better provide emergency treatment, Zhao said.
China issued 5G commercial licenses on June 6. As the wireless technology sees wider application, smart medical treatment is expected to maintain strong growth momentum. According to Dai Zhong, General Manager of China Mobile Group's Government-Enterprise Customer Branch, the company has provided smart medical services for 150 million patients and covered 50,000 medical institutions across the country. It plans to expand its 5G network to 40 domestic cities this year.
AI has also been increasingly adopted to assist medical treatment. Diagnoses based on big data and AI can help doctors develop optimal plans and make patient health prognoses to decide whether surgery is necessary, reducing the rate of disability or death, Zhang said.
In his view, the focus of modern medical treatment is shifting from treating diseases to monitoring people's health and providing early diagnoses through technologies. To render better healthcare services to the public, treatment of chronic diseases and elderly care need greater focus.
A report recently issued by Peking Union Medical College and the Chinese Aging Well Association showed that the burden of chronic non-communicable diseases in China will rise by at least 40 percent by 2030 compared to 2012. Meanwhile, China will be an aged society with more than 14 percent of the total population aged 65 and older by 2026.
According to Zhang, to better treat chronic diseases and provide more sophisticated elderly care, IoMT devices such as wearable devices and sensors need to be improved to monitor people' health in a real-time and accurate manner.
"IoMT will allow patients to be treated before they get worse and free them from the burden of high medical expenses, which can help improve people’s well-being," Bai said.
Medical staff in a hospital in Shitai County, east China’s Anhui Province, operate under the guidance of experts from a major Anhui hospital through a 5G remote collaborative operation platform on May 10 (XINHUA)
As Chinese hospitals seek to cooperate with technology providers to realize Internet-based services, online consulting sites developed by technology startups, such as haodf.com and chunyuyisheng.com, have also emerged in recent years. In 2018, the country's authorities gave nod to Internet hospitals operated jointly by medical institutions and Internet companies as long as approved services are offered and offline treatments are ensured.
Through Internet hospitals, people can choose doctors from across the country on websites or apps and provide medical scans and descriptions for consultation. While doctors give advice online, some are also supposed to ensure the accuracy of the diagnosis by meeting patients in person, especially if they suffer from a severe disease.
Meanwhile, physical hospitals also provide online services such as making appointments, checking exam results and ordering medication for delivery.
Since China has been promoting the stratified healthcare system to ease the shortage of medical resources and reduce the gap between different regions, Internet-based hospitals are expected to play a key role in this move. According to Zhang Ligang, Chairman and CEO of iKang Guobin Healthcare Group, Inc., the lack of doctors is still a prominent problem in China. The best doctors in China are mainly found in about 500 top-tier hospitals in major cities, leading to the uneven distribution of medical resources.
Lu Qingjun, an official with the National Health Commission, said that Internet-based hospitals can encourage patients with minor illnesses or stable conditions to choose online diagnoses and allow them to enjoy more in-house treatment rather than having to make hospital trips.
According to a report by Qianzhan, a Beijing-based industry consultant firm, China's online healthcare market will be worth 90 billion yuan ($12.9 billion) by 2020 with an expected annual growth rate of around 40 percent. Thus, the market is a vast new ocean of opportunities.
Improving technologies have brought many prospects to China's healthcare industry, but the gap between vision and reality remains. According to Lu, the application of 5G technologies in medical treatment is still limited by high costs as the current infrastructure based on 4G needs to be massively upgraded. Meanwhile, the stability and sustainability of the 5G network needs to be further tested, which requires great prudence before it is applied to practical medical treatment.
The adoption of AI also faces technological limitations since deep learning based on data collection and models is not enough to meet the demands of targeted and customized medical treatment which calls for complicated analyses. Doctors'experience and knowledge are still very much needed to prevent risks in treatment, Lu said.
"There is a long way to go before the further application of AI in medical treatment due to ethical and legal issues such as the lack of psychological care and difficulties in identifying accountable parties when accidents occur," he told Beijing Review.
In March, Tencare Doctor, an online medical consulting product developed by technology giant Tencent, was shut down. Since Internet hospitals are not allowed to provide first-time diagnoses for patients, many of the newly emerging enterprises are finding it hard to gain a share in the medical market.
According to Lu, the service chains of many online consulting sites are not complete since patients can't always get appropriate medical treatment through the platforms. Therefore, a possible option for further growth for Internet hospitals is to focus on providing technological support for brick-and-mortar hospitals.
Although technology continues to rise in significance, talent is still a key force for driving medical progress. According to Zhang Wei, the advent of big data and AI will not lead to doctors losing their jobs, although those who refuse to adopt the latest technological trends can be exposed to the risk of unemployment.
"Medical professionals are supposed to upgrade their knowledge as new technologies emerge. For colleges and universities, interdisciplinary training needs to be put in place to improve the medical talent pool," he said.
Copyedited by Rebeca Toledo
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