Leveraging Emerging Technologies and the “Internet of Things” to Improve the Quality of Cancer Care

Abstract

Kevin Ashton coined the term “Internet of Things” in 2009 in the setting of supply chain management, but since that time, the Internet of Things (IoT) has had an impact on many other markets. Over the past several years, advances in computing and sensing have sparked the emergence of the IoT for health care. The IoT refers to a connection of smart objects such as appliances, sensors, controllers, wearables, andmedical devices to the Internet. Overall, the IoT health care market is predicted to grow from 32.4 billion in 2015 to 163 billion by the year 2020. In 2015, there were already 25 billion Internet-connected devices, which is double the number of humans on Earth. In addition, the number of IoT devices will have unprecedented growth and is expected to increase to more than 50 billion by 2020. Within the IoT, wearable devices and sensors alonewill grow tomore than 118 million devices predicted to be sold by 2018. As health care moves away from traditional encounterand office-based care paradigmstomorecontinuous interactions between the patient and the health care system, there is an unparalleled opportunity to leverage emerging technologies to create an ecosystem with the patient at the center. It is now possible to track various types of data in the patient’s own environment. Examples include accelerometer data (physical activity and intensity), temperature, heart rate and heart rate variability, blood pressure, sleep, caloric intake/expenditure, brain wave activity, pulse oximetry, glucose, and other biometric data. Wristbands and smartwatches currently predominate the fitness wearables market, but there will be a shift toward smart garments by 2020. There are also several ingestible and implantable sensors for tracking biometric data that already have or are currently undergoingUS Food andDrugAdministration approval. Beyond wearables, sensors can now be attached to appliances, objects, and the environment to detect carbon dioxide and carbon monoxide, particulate matter, ambient room temperature, light, and allergens such as pollen. Information technology was cited as a key requirement forbuildingahigh-quality cancer care delivery system by the Institute of Medicine and also as the foundation for a learning health care system. This vision for digitally capturing the health care experience for “real-time generation and application of knowledge for care improvement” has made substantial progress since that report in 2009. One exemplar is CancerLinQ, which is an initiative of the American Society of Clinical Oncology for aggregating and analyzing data from electronic health records, clinical trials, and clinical practice guidelines. Recently, CancerLinQ and the Cancer Informatics for Cancer Centers announced a collaboration to apply big data methodologies to drive discovery in cancer care. Understanding health care delivery through