By The Open Group
RTI is a Silicon Valley-based messaging and communications company focused on helping to bring the Industrial Internet of Things (IoT) to fruition. Recently named “The Most Influential Industrial Internet of Things Company” by Appinions and published in Forbes, RTI’s EMEA Manager Bettina Swynnerton will be discussing the impact that the IoT and connected medical devices will have on hospital environments and the Healthcare industry at The Open Group London October 20-23. We spoke to RTI CEO Stan Schneider in advance of the event about the Industrial IoT and the areas where he sees Healthcare being impacted the most by connected devices.
Earlier this year, industry research firm Gartner declared the Internet of Things (IoT) to be the most hyped technology around, having reached the pinnacle of the firm’s famed “Hype Cycle.”
Despite the hype around consumer IoT applications—from FitBits to Nest thermostats to fashionably placed “wearables” that may begin to appear in everything from jewelry to handbags to kids’ backpacks—Stan Schneider, CEO of IoT communications platform company RTI, says that 90 percent of what we’re hearing about the IoT is not where the real value will lie. Most of media coverage and hype is about the “Consumer” IoT like Google glasses or sensors in refrigerators that tell you when the milk’s gone bad. However, most of the real value of the IoT will take place in what GE has coined as the “Industrial Internet”—applications working behind the scenes to keep industrial systems operating more efficiently, says Schneider.
“In reality, 90 percent of the real value of the IoT will be in industrial applications such as energy systems, manufacturing advances, transportation or medical systems,” Schneider says.
However, the reality today is that the IoT is quite new. As Schneider points out, most companies are still trying to figure out what their IoT strategy should be. There isn’t that much active building of real systems at this point.
“Most companies, at the moment, are just trying to figure out what the Internet of Things is. I can do a webinar on ‘What is the Internet of Things?’ or ‘What is the Industrial Internet of Things?’ and get hundreds and hundreds of people showing up, most of whom don’t have any idea. That’s where most companies are. But there are several leading companies that very much have strategies, and there are a few that are even executing their strategies, ” he said. According to Schneider, these companies include GE, which he says has a 700+ person team currently dedicated to building their Industrial IoT platform, as well as companies such as Siemens and Audi, which already have some applications working.
For its part, RTI is actively involved in trying to help define how the Industrial Internet will work and how companies can take disparate devices and make them work with one another. “We’re a nuts-and-bolts, make-it-work type of company,” Schneider notes. As such, openness and standards are critical not only to RTI’s work but to the success of the Industrial IoT in general, says Schneider. RTI is currently involved in as many as 15 different industry standards initiatives.
IoT Drivers in Healthcare
Although RTI is involved in IoT initiatives in many industries, from manufacturing to the military, Healthcare is one of the company’s main areas of focus. For instance, RTI is working with GE Healthcare on the software for its CAT scanner machines. GE chose RTI’s DDS (data distribution service) product because it will let GE standardize on a single communications platform across product lines.
Schneider says there are three big drivers that are changing the medical landscape when it comes to connectivity: the evolution of standalone systems to distributed systems, the connection of devices to improve patient outcome and the replacement of dedicated wiring with networks.
The first driver is that medical devices that have been standalone devices for years are now being built on new distributed architectures. This gives practitioners and patients easier access to the technology they need.
For example, RTI customer BK Medical, a medical device manufacturer based in Denmark, is in the process of changing their ultrasound product architecture. They are moving from a single-user physical system to a wirelessly connected distributed design. Images will now be generated in and distributed by the Cloud, thus saving significant hardware costs while making the systems more accessible.
According to Schneider, ultrasound machine architecture hasn’t really changed in the last 30 or 40 years. Today’s ultrasound machines are still wheeled in on a cart. That cart contains a wired transducer, image processing hardware or software and a monitor. If someone wants to keep an image—for example images of fetuses in utero—they get carry out physical media. Years ago it was a Polaroid picture, today the images are saved to CDs and handed to the patient.
In contrast, BK’s new systems will be completely distributed, Schneider says. Doctors will be able to carry a transducer that looks more like a cellphone with them throughout the hospital. A wireless connection will upload the imaging data into the cloud for image calculation. With a distributed scenario, only one image processing system may be needed for a hospital or clinic. It can even be kept in the cloud off-site. Both patients and caregivers can access images on any display, wherever they are. This kind of architecture makes the systems much cheaper and far more efficient, Schneider says. The days of the wheeled-in cart are numbered.
The second IoT driver in Healthcare is connecting medical devices together to improve patient outcomes. Most hospital devices today are completely independent and standalone. So, if a patient is hooked up to multiple monitors, the only thing that really “connects” those devices today is a piece of paper at the end of a hospital bed that shows how each should be functioning. Nurses are supposed to check these devices on an hourly basis to make sure they’re working correctly and the patient is ok.
Schneider says this approach is error-ridden. First, the nurse may be too busy to do a good job checking the devices. Worse, any number of things can set off alarms whether there’s something wrong with the patient or not. As anyone who has ever visited a friend or relative in the hospital attest to, alarms are going off constantly, making it difficult to determine when someone is really in distress. In fact, one of the biggest problems in hospital settings today, Schneider says, is a phenomenon known as “alarm fatigue.” Single devices simply can’t reliably tell if there’s some minor glitch in data or if the patient is in real trouble. Thus, 80% of all device alarms in hospitals are turned off. Meaningless alarms fatigue personnel, so they either ignore or turn off the alarms…and people can die.
To deal with this problem, new technologies are being created that will connect devices together on a network. Multiple devices can then work in tandem to really figure out when something is wrong. If the machines are networked, alarms can be set to go off only when multiple distress indicators are indicated rather than just one. For example, if oxygen levels drop on both an oxygen monitor on someone’s finger and on a respiration monitor, the alarm is much more likely a real patient problem than if only one source shows a problem. Schneider says the algorithms to fix these problems are reasonably well understood; the barrier is the lack of networking to tie all of these machines together.
The third area of change in the industrial medical Internet is the transition to networked systems from dedicated wired designs. Surgical operating rooms offer a good example. Today’s operating room is a maze of wires connecting screens, computers, and video. Videos, for instance, come from dynamic x-ray imaging systems, from ultrasound navigation probes and from tiny cameras embedded in surgical instruments. Today, these systems are connected via HDMI or other specialized cables. These cables are hard to reconfigure. Worse, they’re difficult to sterilize, Schneider says. Thus, the surgical theater is hard to configure, clean and maintain.
In the future, the mesh of special wires can be replaced by a single, high-speed networking bus. Networks make the systems easier to configure and integrate, easier to use and accessible remotely. A single, easy-to-sterilize optical network cable can replace hundreds of wires. As wireless gets faster, even that cable can be removed.
“By changing these systems from a mesh of TV-cables to a networked data bus, you really change the way the whole system is integrated,” he said. “It’s much more flexible, maintainable and sharable outside the room. Surgical systems will be fundamentally changed by the Industrial IoT.”
IoT Challenges for Healthcare
Schneider says there are numerous challenges facing the integration of the IoT into existing Healthcare systems—from technical challenges to standards and, of course, security and privacy. But one of the biggest challenges facing the industry, he believes, is plain old fear. In particular, Schneider says, there is a lot of fear within the industry of choosing the wrong path and, in effect, “walking off a cliff” if they choose the wrong direction. Getting beyond that fear and taking risks, he says, will be necessary to move the industry forward, he says.
In a practical sense, the other thing currently holding back integration is the sheer number of connected devices currently being used in medicine, he says. Manufacturers each have their own systems and obviously have a vested interest in keeping their equipment in hospitals, so many have been reluctant to develop or become standards-compliant and push interoperability forward, Schneider says.
This is, of course, not just a Healthcare issue. “We see it in every single industry we’re in. It’s a real problem,” he said.
Legacy systems are also a problematic area. “You can’t just go into a Kaiser Permanente and rip out $2 billion worth of equipment,” he says. Integrating new systems with existing technology is a process of incremental change that takes time and vested leadership, says Schneider.
Cloud Integration a Driver
Although many of these technologies are not yet very mature, Schneider believes that the fundamental industry driver is Cloud integration. In Schneider’s view, the Industrial Internet is ultimately a systems problem. As with the ultrasound machine example from BK Medical, it’s not that an existing ultrasound machine doesn’t work just fine today, Schneider says, it’s that it could work better.
“Look what you can do if you connect it to the Cloud—you can distribute it, you can make it cheaper, you can make it better, you can make it faster, you can make it more available, you can connect it to the patient at home. It’s a huge system problem. The real overwhelming striking value of the Industrial Internet really happens when you’re not just talking about the hospital but you’re talking about the Cloud and hooking up with practitioners, patients, hospitals, home care and health records. You have to be able to integrate the whole thing together to get that ultimate value. While there are many point cases that are compelling all by themselves, realizing the vision requires getting the whole system running. A truly connected system is a ways out, but it’s exciting.”
Schneider also says that openness is absolutely critical for these systems to ultimately work. Just as agreeing on a standard for the HTTP running on the Internet Protocol (IP) drove the Web, a new device-appropriate protocol will be necessary for the Internet of Things to work. Consensus will be necessary, he says, so that systems can talk to each other and connectivity will work. The Industrial Internet will push that out to the Cloud and beyond, he says.
“One of my favorite quotes is from IBM, he says – IBM said, ‘it’s not a new Internet, it’s a new Web.’” By that, they mean that the industry needs new, machine-centric protocols to run over the same Internet hardware and base IP protocol, Schneider said.
Schneider believes that this new web will eventually evolve to become the new architecture for most companies. However, for now, particularly in hospitals, it’s the “things” that need to be integrated into systems and overall architectures.
One example where this level of connectivity will make a huge difference, he says, is in predictive maintenance. Once a system can “sense” or predict that a machine may fail or if a part needs to be replaced, there will be a huge economic impact and cost savings. For instance, he said Siemens uses acoustic sensors to monitor the state of its wind generators. By placing sensors next to the bearings in the machine, they can literally “listen” for squeaky wheels and thus figure out whether a turbine may soon need repair. These analytics let them know when the bearing must be replaced before the turbine shuts down. Of course, the infrastructure will need to connect all of these “things” to the each other and the cloud first. So, there will need to be a lot of system level changes in architectures.
Standards, of course, will be key to getting these architectures to work together. Schneider believes standards development for the IoT will need to be tackled from both horizontal and vertical standpoint. Both generic communication standards and industry specific standards like how to integrate an operating room must evolve.
“We are a firm believer in open standards as a way to build consensus and make things actually work. It’s absolutely critical,” he said.
Stan Schneider is CEO at Real-Time Innovations (RTI), the Industrial Internet of Things communications platform company. RTI is the largest embedded middleware vendor and has an extensive footprint in all areas of the Industrial Internet, including Energy, Medical, Automotive, Transportation, Defense, and Industrial Control. Stan has published over 50 papers in both academic and industry press. He speaks at events and conferences widely on topics ranging from networked medical devices for patient safety, the future of connected cars, the role of the DDS standard in the IoT, the evolution of power systems, and understanding the various IoT protocols. Before RTI, Stan managed a large Stanford robotics laboratory, led an embedded communications software team and built data acquisition systems for automotive impact testing. Stan completed his PhD in Electrical Engineering and Computer Science at Stanford University, and holds a BS and MS from the University of Michigan. He is a graduate of Stanford’s Advanced Management College.