What is 5G?
Like many acronyms, they are demystified once you know what they stand for. 5G simply means the fifth generation of wireless technology. In simple terms, it means speeding up the data due to bigger channels, more responsive technology due to the lower latency or less lag, and the ability to connect a lot more devices at once. Within 5G, these qualities can differ depending on the channels used. For example, the speed itself may be slower if the frequency being used is lower and similar to that used in previous technology, such as old TV frequencies or current 4G. It may be all that is available if the physical infrastructure for the new frequencies is not available.
Where can I find it being used in health?
Decreased latency leads to less “lag” and, therefore, a more real-time experience. Whilst a delay during a videocall is annoying, it is generally not life-threatening. Transfer that to an operating theatre and the ability to operate remotely does depend on real-time transfer of what is happening, and vice versa, the ability to react and stop unexpected bleeding or coordinated efforts between various surgeons.
Similarly, the ability to connect more devices at once is of great importance in ever more connected health care settings. Physicians are forever being asked to adopt the latest wireless monitoring and sensors to create a more seamless experience for the patient. However, if you are still in a system that uses fax or in a department where the internet connection is flaky, the real game-changer for day to day use will be the ability to connect all the devices at once with confidence. In telemedicine, this translates into the ability to not only be seeing and communicating with the patient but also monitoring and receiving real-time data about their physical status. Many experts in the digital health space see these qualities as the gateway to 4P medicine, which is a digital version of what clinicians have been doing for years. 4P stands for predictive, preventative, personalised and participatory.
Another bugbear of out of hours care or just seeing a patient who does not usually attend your hospital or surgery is the inability to see their previous images. Imaging studies are notoriously complicated to transfer between systems and the ability for either the patient themselves or another health professional to send over quickly in a compatible format MRI or CT scans. It may surprise you to know that as a clinician in the NHS, I could not access the recent CT head scan of a patient done at a hospital only 25km away. Or maybe it’s no surprise, and you just shake your head as an inevitable reality. But we need to demand from our clinical workspace the same fast internet and communication we get from our Netflix subscription!
What is the IoT?
IoT simply stands for the Internet Of Things. In other words, “objects with computing devices in them that can connect to each other and exchange data using the internet”. In healthcare, this translates into sensors and technology linked to the patient rather than the clinical setting giving a real picture of what is going on in a person’s life and health. From distance monitoring which is set to alarm the clinician when certain parameters are reached, to active ongoing monitoring that transforms the patient’s home into a virtual hospital, the IoT with 5G gives clinicians more confidence to extend already existing hospital at-home projects. Well established in older and more frail patients, hospital at home with CGA (Comprehensive Geriatric Assessment) has already been shown to decrease hospital admissions with similar long-term outcomes and greater patient satisfaction.1 Distance monitoring will open this option up also because the carers and patients themselves will feel more supported and empowered. In France, where cancer patients wishing to stay at home are limited by the clinician not feeling with that confidence, a better solution may be found with real-time monitoring.2
Of course, no one person is just a patient or a disease, but rather a combination of roles, identities and functions. Where the IOT comes into its own is bringing all of this to the clinician, the information from all sources, including non-medical aspects such as travel, air contamination, favourite activities, brings clinicians closer to the original definition of being a doctor. When you would have known your patients, their families and everything else going on in their lives. This lack of continuity and depth brings many clinicians to burnout, and 5G and the IOT should be seen as facilitating a return to that holistic vision of a person or patient who comes to see them. Only then can the clinician use their knowledge base and experience to personalise the treatments and solutions they offer fully. Digital health augments a clinician’s practice. Those who argue that doctors will become irrelevant have clearly not sat in on patient clinics and surgeries, going through the options available based on local resources, the latest advances and patient preference. In medicine there is never one right treatment, and the art remains in the ability to pull it all together, making use of all the information and resources available.
1. Shepperd, S. et al. Is Comprehensive Geriatric Assessment Admission Avoidance Hospital at Home an Alternative to Hospital Admission for Older Persons? : A Randomized Trial. Annals of internal medicine 174, 889–898 (2021).
2. Margier, J., Gafni, A. & Moumjid, N. Cancer care at home or in local health centres versus in hospital: Public policy goals and patients’ preferences in the Rhône-Alps region in France. Health policy (Amsterdam, Netherlands) 125, 213–220 (2021).