The rise of 5G
The pros & cons of each
by Mark Denissen

There’s a lot of buzz in the health care industry about the coming 5G wireless standard, which promises to bring high speed, low latency connections to businesses. With 5G, health care organizations are able to quickly and easily transmit data that requires a high bandwidth, such as CT scans and X-rays. But it will also have an impact on lower bandwidth applications, such as the data found in home health care applications.

The reality is that for most health care organizations and the patients they serve, 5G won’t be available in a broad way for at least a few years. However, remote patient monitoring (RPM) solutions—which can transform seniors’ care by helping them live independently—need reliable connectivity options to transmit data between the patient and the doctor’s office or hospital.

Patients that benefit most from RPM solutions are those who need consistent monitoring of vital statistics, including blood pressure, oxygen level, weight, temperature and other metrics. By being able to take these vital signs at home and have them delivered to their provider automatically, the paradigm of care is shifted from episodic to preventative. This allows providers and patients to work together in new ways to reduce the need for trips to the doctor’s office or hospital. RPM solutions should be two-way, allowing doctors to communicate with patients via voice. Some RPM solutions can also track data over time and spot abnormalities in readings such as low or high blood pressure or oxygen levels, and can connect the patient to the doctor to explore solutions.

These type of RPM solutions allows patients to get involved with their own care, and enable health care providers to:

  • Assess situations in real time
  • Speak with a patient who might not be feeling well
  • Proactively care for patients so they don’t end up in the emergency room unnecessarily
  • Intervene in the patient’s care to stabilize their health

There are two leading technology contenders to connect RPM solutions to the internet: Wi-Fi and cellular. Both are considered ubiquitous, but are they really? Let’s take a look at the benefits and challenges of each.

Wi-Fi Connectivity

Wi-Fi has been around for more than 25 years and has become the de facto home connectivity option for many people. In many cases, small- to mid-sized businesses also use Wi-Fi to connect their workers to the internet. In both of these environments, Wi-Fi can be beneficial. It is relatively inexpensive, upload and download speeds have been consistently upgraded by service providers, and, in general, it works when needed. When it comes to homecare, however, there are places where Wi-Fi faces significant challenges:

  • Lack of ubiquity: Although Wi-Fi may seem ubiquitous, and many homes and businesses do have Wi-Fi connections, that number falls off dramatically in more rural areas. According to the Pew Research Group, in 2019, only 59% of people over 65 had access to broadband connectivity at home. That makes it challenging to utilize Wi-Fi in RPM solutions, which require a continuously reliable 24/7 data connection.
  • Limited ease of use: Wi-Fi requires the use of strong, multi-variable passwords and other configuration steps, which some seniors may struggle with. Some may also be uncomfortable having a lot of equipment in their homes.
  • Lack of 24/7 reliability: Wi-Fi signals drop frequently, and if equipment failure occurs, it could be down for hours or longer. If Wi-Fi has a weak signal, loses power or goes offline for another reason—even if it’s infrequently—it impacts the ability to deliver consistent patient results back to health care professionals.

To understand how Wi-Fi is an unsuitable solution for RPM and other health care tools that require 24/7 connectivity, imagine trying to use a cellphone in Europe and only being able to connect when there is Wi-Fi available. Connectivity would be limited to areas where there are Wi-Fi hotspots. This considerably hampers the types of things users can do. Likewise, if only Wi-Fi is available as a connectivity option in a home health care environment, options are limited if the patient can’t complete setup or if their service is disrupted. Anyone who has ever been in charge of technical support for an older family member’s Wi-Fi service understands that there are challenges.

Cellular Connectivity

Cellular, on the other hand, is a much more reliable option for homecare providers and the patients they serve. While there are certainly rural areas with poor coverage and those that still use 3G wireless, providers like AT&T and Verizon have turned up 4G everywhere and are turning down 3G. In areas with 4G coverage today, it will be consistent and reliable going forward.

Some of the benefits of using cellular connectivity include:

  • Ubiquity: When it comes to people who are 65 and older, 91% own a cellphone and of those, 53% own a smartphone, according to Pew Research Group. With that level of connectivity, it’s easy to see why an RPM solution based on cellular connectivity is a strong option for homecare providers and their patients.
  • Sheer simplicity of setup: For many RPM devices, no configuration is needed. While some solutions providers retrofit tablets for RPM use, making them more difficult to use, others have purpose-built, out-of-the-box solutions that simply need to be turned on to work consistently. Ease of use is also critically important to these solutions. In a recent pilot with a hospital in West Virginia, care was focused on high-risk patients in rural settings. The expected compliance rate was 15%-20%; however, the trial saw greater than 80% patient compliance with taking vital signs. In addition, patient satisfaction was 4.5 out of 5.
  • Consistent real-time data sets: With consistent connectivity comes consistent data. A robust real-time data set developed at regular intervals allows health care providers to see trends and take preventative action, solving small problems before they become larger ones. Take, for example, the case of a patient with high blood pressure. By gathering data over time, RPM solutions can spot anomalies in real time, such as an unusually high blood pressure reading, and contact the health care provider for immediate follow up. Solutions can also “learn” from the patient’s behavior; for example, if a patient does not take their medicine at the same time each day, reminders can be adjusted and establish a time that is better for them. Cellular is a stronger fit for this type of application.
  • An upgrade path to 5G: 5G is on its way, and some vendors are building 5G capabilities into their devices today to prepare for its arrival. When it is more widely available, RPM solutions that use cellular have a clear path to update to high-bandwidth connectivity.

A few additional benefits that cellular connectivity can provide include:

  • The use of open standards and existing infrastructure
  • The ability to cover hundreds of devices simultaneously, ensuring that connectivity is always available
  • Long battery life

End-to-end security RPM is expanding patients’ health data to include real-time and daily readings, extending the access a physician or homecare professional has to data to better understand their patients’ needs. Access to an RPM solution allows patients to get involved with their care, assess situations in real time and be able to speak with a physician when they are not feeling well. While RPM solutions are becoming increasingly easier to use it’s cellular connectivity that will ensure they are available 24/7 to help keep seniors safe.

Mark Denissen serves as the president and chief executive officer of Anelto. He has a storied career in the technology sector.  Denissen worked more than three decades with Texas Instruments (TI), serving in various roles before becoming vice president of worldwide strategic marketing and being responsible for the startup of businesses such as medical devices, LED lighting solutions and motor control solutions. He was also responsible for the commercialization of breakthrough technologies developed in Kilby Labs, TI’s long-range research and development center, and worked directly with TI’s chief technical officer to move numerous projects towards commercialization. He holds a BSEE degree from the University of California Los Angeles.