Something’s wrong. Shanice’s young son Terrance has lost consciousness. His limbs start jerking and his eyes roll back. Terrance has some special needs — he’s diabetic and allergic to penicillin. And he needs help. Right now.
As soon as Shanice calls 911, the operator moves into action, dispatching an ambulance that’s personalized for Terrance. Once inside, an EMT sends his vitals — including internal scans — to the hospital in real time, letting the doctors on site prepare for his arrival. By the time the ambulance pulls up to the ER, the doctors and nurses are ready for Terrance, knowing exactly what they need to do to save his life.
Shanice’s emergency is a hypothetical situation, but one that is all too common — and 5G, with its ability to relay large medical files remotely, can offer a lifeline.
“In a situation where minutes count, that can totally be a game changer in terms of preventing neurologic damage,” said Dr. Scott D. Boden, who serves as business innovation vice president at Emory Healthcare in Chicago. “In the past, you’d have to get to the hospital, go through imaging and then make decisions.”
When it comes to health care, seconds can mean the difference between brain damage and full recovery, between paralysis and a short stint in physical therapy, between life and death.
The heavy bandwidth pipe required for those speedy response times is slowly becoming reality. 5G, which is seen pushing many key technologies like self-driving cars in the future, is expected to serve as a key pillar in health care, enabling fast data rates, rapid-fire responsiveness and dependable connections.
The technology can eventually help doctors prevent neurological damage, save limbs and detect strokes. It will also allow health care to become more personalized and efficient. And with 5G, techniques like X-ray vision and robotic, remote surgeries — pipe dreams in medicine for years — can become a reality.
And let’s not forget about telehealth. As the coronavirus pandemic rages on, it’s forcing hospitals to rethink health care — right now, not five years in the future. They’re turning to more digital offerings that allow for more remote care.
“COVID is the moment that has changed the face of health care forever,” said Mo Katibeh, chief marketing officer for AT&T Business.
But while the coronavirus is creating dozens of solid cases for why 5G is necessary — everything from powering augmented reality to remote monitoring — it’s likely to delay the adoption of the technology, said Lisa Unden-Farboud, an analyst at research firm Gartner.
COVID-19 has caused a slowdown in the consumer embrace of the technology as people aren’t upgrading their phones — especially in Western markets — as well as a holdup in further 5G standards being set.
Remote health care
When you can’t make it to a medical facility or want to avoid the crowds in an emergency room, 5G could become the key to getting treatment.
While remote health care is possible with 4G LTE, 5G can link thousands of devices without slowing down the connection, making real-time patient monitoring more of a reality. Gadgets like wearables, medical implants, aged care trackers and even connected toothbrushes could look for symptoms and spot viral infections, feeding that information back to a doctor.
It’s not only isolated communities needing remote health care anymore. We’re now seeing the rapid rise of telehealth everywhere due to the spread of the coronavirus, AT&T’s Katibeh said. Doctors are using video calls to diagnose illnesses and prescribe medication.
“We’re seeing immediate and material adoption of telehealth,” he said, especially in areas where immuno-compromised patients like those going through cancer treatments can’t enter crowded hospitals.
The pandemic is not only creating the impetus for physical health checkups to take place virtually, it’s also provoking a host of mental health problems in the community, said Dr. Shafiq Rab, chief information officer at Rush University Medical Center. Anxiety and depression are on the rise.
“COVID-19 is not going away … economic distress, job distress, money distress, loved ones dying,” Rab said. “It’s creating a lot of mental health issues.” With 5G, VR could be used to recreate doctors’ office environments so patients feel more at ease during virtual mental health checkups.
It’s less awkward than a choppy video call, Rab said, because it gets patients into that calming environment. “It becomes as real as possible because you’re immersed in it,” he said. “You are part of the environment rather than just looking at a picture of a video.”
It’s not just mental health services that could benefit from the combination of 5G and VR. Verizon has experimented with delivering physical therapy services through 5G-powered VR headsets.
“The dream that we as technologists have is that of people being able to interact with each other as naturally as possible when they’re not in the same place,” said Columbia University professor Steven Feiner, who worked on the project two years ago at Verizon’s New York 5G lab.
Smart hospitals
The smarts enabled by 5G will also be apparent when patients make it to the hospital.
Taking over from first responders, smart hospitals will be the next step in helping patients and doctors. AT&T installed a 5G network at Rush University Medical Center a year and a half ago. The goal is to “create one of the smartest buildings on the planet,” said Katibeh.
Everything can be connected inside a hospital, Katibeh said — like medicine cabinets that only open for registered users and track the medicine that’s been pulled, or tags used to locate equipment such as oxygen tanks and ventilators.
“Smart hospitals will be self-aware, intelligent, interactive and predictive,” Rab said. “Everything will be connected and interconnected from the time you get to the parking lot. Body temperature will be scanned, devices will talk to one another, notifications will be sent to the patients and doctors.”
When a health care worker walks into a patient’s room, their ID badge could be read by a scanner, which instantly flashes their name and speciality onto the TV. 5G hospitals could send notifications to nurses and doctors for patient care, like when someone has been lying on their bed for too long and needs to be rotated so they don’t develop a bedsore.
Smart hospitals will know where all medical staff are within a facility at all times, without having to call for them. “Right now, we have paging systems — that was great technology for the ’70s, but I think we’re a little bit beyond that,” Boden said.
Certain areas of the hospital could also be restricted to specialized health care workers. “You could use video cameras as a sensor that are enabled by 5G to immediately be taking video and photos of someone walking up to that door,” Katibeh said. “The doors only unlock if they’re a registered user.”
In the age of COVID-19, that also helps reduce the spread of infection. Instead of physically touching objects like handles, the doors could open automatically when they detect an authorized worker approaching.
“Think about the pandemic and touching things,” Boden said. “If I’m walking to an elevator, it should be able to call that elevator without me touching the same button that everyone else around there is touching.”
Augmented reality
Another area that could be transformed by 5G connectivity is internal imaging, like ultrasounds, X-rays and MRIs. They’re vital to help doctors understand what’s going on inside patients, but the files generated from the tests are massive. Today, it can take a minute or more to load them into digital health care records or share them with other providers.
5G enables those staggeringly large files to be uploaded by technicians and downloaded by specialists within seconds, which could make a life-and-death kind of difference.
“Think about the golden hour for a stroke patient,” said Maggie Hallbach, whose team at Verizon led the 5G installation for Boden’s Emory Healthcare Innovation Hub. “Think about a heart attack patient and being able to understand blockages in a much more real-time basis.”
The impact of this is doctors will be able to compare a patient’s internal scans to hundreds of thousands of other images by using mobile imaging units. Within seconds, they’ll have the “likely diagnosis delivered to the consultant who is standing next to the patient,” Gartner’s Unden-Farboud said.
Those images won’t be confined to two dimensions. Holographic projection could become possible with 5G, guiding the surgeon’s hand and bringing augmented reality into the operating room.
Picture needing to drill through a bone that’s four inches below the surface of the skin. You can’t see it; you can’t even feel it. But via AR, doctors could project internal scan images to wearable glasses to see exactly where to make an incision.
“If you’re a spine surgeon like I am, when you look at somebody’s skin you’ve got to figure out where you’re going to make an incision,” Boden said. “The more accurately you can figure that out, the smaller the incision can be.”
AR, which overlays digital images on top of the real world, would give a doctor X-ray vision through the patient, speeding up the surgery duration and the healing time, while also helping doctors avoid mistakes like removing the wrong kidney. And virtual reality, which transports users to a digital realm through a headset, is also finding a footing in health care applications.
AR and VR could also be used to train medical students. Such a thing is possible with older technology — Microsoft’s pricey, Wi-Fi-connected Hololens goggles are used in medical training — but 5G makes them much more responsive and realistic.
And the pandemic could heighten the need for accurate virtual simulations. Katibeh expects to see a surge in the adoption of mixed-reality training in a post-COVID-19 world. Newer doctors could learn how to perform surgeries without needing to stand next to another doctor during the procedure.
“COVID-19 is here to stay,” Rab added, predicting that for the next two years, most if not all surgical learning will be done via virtual reality.
Boden thinks augmented and virtual reality will have a place in medical schools to replace the cadavers students currently dissect to learn anatomy. “The thing about that is once you dissect it, it’s dissected,” he said. But with virtual reality, students could perform surgery an unlimited number of times using different techniques.
That way, by the time trainees get into a live procedure, “they’re not learning the anatomy and it’s not the first time they’re seeing things in three-dimensional spatial relationship to each other,” Boden said. “They become a much more advanced learner.”
Robotic surgery
Besides holographic images and virtual realms, the ultimate hallmark of futuristic health care is robotic surgery, an idea that’s been kicked around for years. AT&T believes 5G could make it a reality, because of its low latency — or how quickly the network responds to the command someone gives it.
“If you’re doing something like brain surgery, you really want that latency to be sub-10 milliseconds … as fast as your mind processes reality,” Katibeh said. “You want the robotic surgeon to be responding in real time along with the actual surgeon who may be dozens or hundreds of miles away.”
If 5G can reliably keep that latency, there would be “absolutely no difference for that doctor being in the room with the patient, or they can be dozens or hundreds of miles away,” Katibeh said.
Not everyone believes remote surgery in remote areas using robots will be possible. And even in metro areas where 5G is more mature, there remain questions about whether the latency can stay low enough for something as critical as surgery. “No one in their right mind would do this right now,” Rab said. “Without bandwidth being real time, it’s not going to happen.”
Unden-Farboud agrees 5G-driven robotic surgery “is still very much in the proof-of-concept stage.” And with so much regulation in the health care sector, especially when it comes to data protection and security, it might be a long way off yet.
For the foreseeable future, Rab says robotic surgery is doable to the point where there will be an assistant at the remote patient’s side to guide the robotic tool via the direction of the distant surgeon.
Remote assistance surgery with 5G was demonstrated at last year’s Mobile World Congress in Barcelona. Dr. Antonio de Lacy, head of gastrointestinal surgery at the Hospital Clinic of Barcelona, gave advice live to his medical team on the other side of the city — in real time, without any lag, he drew diagrams on a video of the patient’s colon, which told his team exactly where to make their incisions.
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