This article first appeared in Enterprise, The Edge Malaysia Weekly on August 10, 2020 - August 16, 2020

The possibilities and use cases of telehealth will increase drastically with the deployment of 5G networks throughout the country. This will further transform the healthcare industry, which has already seen innovations such as technology-assisted remote surgery and the Internet of Medical Things (IoMT) become a reality.

“When we talk about telehealth, it includes basic teleconsultation [between a doctor and a patient], which is already becoming popular due to the Covid-19 pandemic as people want to avoid going to hospitals. Remote monitoring and IoMT are also part of telehealth, where doctors can monitor patients’ conditions remotely using connected devices,” says Ee Huei Sin, vice-president and general manager of general electronics measurement solutions at Keysight Technologies Inc.

Telehealth includes digital pathology, which enables the quick transfer of large data files, like photos or e-prescriptions, that need to be sent by doctors to pharmaceutical companies. “With telehealth, doctors or specialists can be far away and still work remotely with nurses in the intensive care unit. This also extends to emergency care on ambulances. With 5G, emergency procedures can be performed in the ambulance [with instructions given by doctors in the hospital],” she says.

In the same way, remote surgery can be done in rural hospitals under the direction of specialists who are based elsewhere. In addition, medical education can be transformed with the use of augmented reality and virtual reality.

Some services, like teleconsultation, have already been implemented in several private hospitals in Malaysia. Meanwhile, remote surgery has been done successfully in China.

“The doctor performed a remote surgery on a patient with Parkinson’s disease sometime last year. This year, the US Department of Veterans Affairs launched its first 5G-enabled hospital in California, which can deliver remote surgery,” says Ee.

Is it possible for these innovations to be done without 5G? Yes, she says. But for it to be done on a bigger scale, better connectivity via 5G will be critical.

“The enhanced mobile broadband network of 5G will give you the speed and performance that you can never achieve with 4G and Long-Term Evolution (LTE). 5G can support real-time, high-resolution and even 3D videos. This is very important if we want to carry out remote surgeries or transfer patients’ data between hospitals,” says Ee.

Enabling 5G for telehealth

Since 2013, Keysight has been participating in the 3rd Generation Partnership Project (3GPP), a global initiative that sets mobile broadband standards, including for 5G. The company has been working with mobile operators, chipset and device manufacturers as well as other industry players to accelerate the commercialisation of 5G solutions.

“We are working on a number of new standards for 5G and are continuing to refine it. One of the standards involves ultra-reliable low latency communications,” says Ee.

“This means there is minimum or little delay in the transfer of data. It is also ultra-reliable, so the connection cannot drop.”

Another new standard it is working on relates to massive machine-type communication, which supports the IoMT by enabling millions of devices to communicate with low data rates, lower costs and less energy.

“We already have people using wearable devices to maintain a healthy lifestyle. But we also have devices for critical things like monitoring one’s glucose levels, pacemakers and hearing aids that are linked to the internet. 5G can support up to one million devices per sq km, whereas 4G can only support up to 4,000 devices in that range,” says Ee.

These 5G features are crucial for telehealth, where critical procedures like remote surgery cannot be interrupted by communication failure or network disturbance. Keysight tries to address any technical shortcomings by focusing on the “5Cs of IoMT”, she says.

“The first is connectivity as IoMT requires everything to be connected wirelessly. The second is continuity, which is about battery life as most of these devices operate on batteries.

“The third is compliance as all these technologies must meet the standards, whether it is the wireless standard or standards for health devices. The fourth is about coexistence. We must make sure the IoMT devices out there can coexist with other devices.

“The fifth is cybersecurity. Patient data is very critical and we need to protect it.”

Growth of telehealth

The pace of adoption for telehealth has been picking up globally, especially in the US. Hospitals, insurance companies and the government are working together to accelerate the development of telehealth, Ee observes.

“The highest growth is expected to be seen in Asia-Pacific due to the high number of people living in rural areas. We think it will grow very fast in China as the country is already leading in 5G implementation. Due to the pandemic, it has already set up teleconsultation in more than 100 hospitals,” she says.

The pickup in Malaysia has been slower, although Ee is confident that more hospitals will begin offering such services going forward. “Teleconsultation services are already being offered in places like Sunway Medical Centre, Pantai Hospital and Gleneagles Hospital. Digi is partnering with Hospital Sultanah Maliha and Collaborative Research in Engineering, Science and Technology (Crest) in Langkawi on the country’s first 5G-connected ambulance,” she says.

“We encourage the government’s initiative to move ahead with developing 5G. I am hoping we can quickly deploy the technologies and have wide coverage of even rural areas.

“If we do that, we will see the benefits of telehealth. There are not enough specialists in rural hospitals, so the operating theatres there can benefit from telehealth to provide the best care at the lowest cost.”

It is also important for the government to support companies that are developing IoMT innovations and provide funding for universities and industry players that are doing research in this area. In addition to the 5G infrastructure, the government should work on policies, regulations and the standardisation of IoMT devices. “This is not just to ensure healthcare performance but also cybersecurity,” says Ee.

To support the growth of the 5G environment, the biggest investment will be needed from the government and mobile operators to build the infrastructure. “Although it is expensive, it is cheaper than building hospitals in rural areas all over the country,” she says.

For hospitals, investments will be needed in areas such as software development, ambulance care and intensive care units. Also, hospitals will need to be linked to pharmaceutical companies while remote monitoring devices must be available to enable teleconsultations.

Keysight will continue playing its role as a technology enabler and work with industry players, says Ee. “We are looking into the area of artificial intelligence and behavioural analytics to optimise the digital experience in the healthcare system. The company’s recent acquisition of Eggplant, an intelligent software test automation platform provider, will expand its solution offerings to address this area.”

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