E-health, IoT and Cloud: standards, challenges and opportunities

​A patient may require the services of various healthcare providers (hospitals/clinics, physicians, dentists, optometrists, radiologists, cardiologists, pharmacists, insurance, etc.). Many different electronic systems might be used, such as modalities (MRI machines, etc.), information systems (such as hospital, radiology, lab, etc.) and disparate (communications) protocols and messaging formats (such as DICOM, HL7, etc. and various forms/interfaces of them) used by the devices and IS. How do we effectively and efficiently provide comprehensive and consolidated electronic health/medical/patient records (EHR) in the presence of such disparateness? What are the relevant standards at the core of e-health?

The domain of e-health is further expanded with telemedicine for long distance patient care over MAN/WAN and with personally wearable or mobile IoT (Internet of Things) devices for home-based or on-the-go (mobile) monitoring of vital data. Telemedicine and IoT require new generations of communication protocols, provisions for the service layer (e.g., as discussed by ITU-T Focus Group on M2M service layer) and interoperability guidelines (e.g., Recommendation ITU-T H.810 “Interoperability design guidelines for personal health systems”). In addition, they also add to distribution of EHR components. How do we address relevant issues?

The use of Cloud has become almost ubiquitous in everyday life. Many day-to-day activities of end users or enterprises and services related to those activities are served from somewhere in the Cloud over the network, public or private, Internet or intranet. The effectiveness of healthcare services can be greatly improved if e-health services are deployed in Clouds. While there are advantages and opportunities, there are also many Cloud related challenges that may add to challenges discussed above. It is also exacerbated by the lack of Cloud related standards at various layers of Cloud infrastructure and services. In addition, there should be some level of confluence of e-health and Cloud related standards. How do we address this?

Privacy and security are increasingly important concerns as well. The secure processing of personal data in the Cloud represents a huge challenge. Adoption of privacy-enhancing technologies to support such activities will depend upon the existence of uniform ways of handling personal data and on technical standards which can help to ensure compliance with legal and regulatory frameworks. How do we safeguard security and privacy for highly sensitive personal information, such as medical data, in a Cloud-based environment?