Global Research Letters

Unlocking IoT Data for Research in Healthcare

Questions please use the live event Q&A and iot research paperswe’ll. have monitor moderators answering your questions as. they come through and iot research paperstime permitting will probably take some questions. at the end to go over as well. Thank you. and iot research paperswill start at 11 five. No. Hello everyone and iot research papersthank you for joining us today, I’m. my name is Dustin Person and iot research papersI’m joined today with my colleague Nate Mola by. and iot research paperswe’ll be talking about unlocking Iot data for research. in healthcare iot research papers. To start with, I’ll go over the brief session outline, so we’re going to. cover Iot in healthcare iot research papers. Go through. some of the challenges you might face if you’re using Iot. With healthcare iot research papers data and iot research papersthen we’re going to cover. what we have done so far in the health cloud and iot research papersdata team. to solve these problems and iot research papersthen later. needs going to be going over several examples on how you can use. Iot data in some of the technologies we’ve developed. through our an end to end solution. So to start with, what is Iot in healthcare iot research papers or? as we call it? I OMT, well, I am T stands. for Internet of Medical things, so you can think of this as a subset. of medical devices that deal with. specifically patient data. They can come in many. shapes and iot research paperssizes that can be worn, so a lot of you be familiar. with devices like Fitbit and iot research papersApple Watch. that person could. Where’s all the time? And iot research papersthey’re passively monitoring things. at the. Person does and iot research papersbattle signs there’s. also a class of devices that are ambient, so you can think of sensors. that exist in, say, a hospital bed or. monitor room. And iot research papersthey either take medical readings. or vital signs, or report on patient. behavior. And iot research papersthere’s a class of devices that can be. used, so they’ll be like injectables pills and iot research papersthings like that. So what are some of the key scenarios so? We see them as a kind of three pillars, the. first to be patient monitoring. So where we use sensors? an pieros which stand iot research papersfor patient reported outcomes. which are surveys of the patient will. fill out to add subjective feedback to any of the sensor data.

And iot research papersthis is valuable in a lot of remote care. Telehealth, an chronic disease management. scenarios. Another pillar that we see is in. research and iot research paperslife sciences, specifically around clinical. trials. An lab, data, analytics and. then third, there’s a whole category of smart hospitals. We’re not going to really focus on for this presentation. but just wanted to make it aware that it’s out there. Another thing they call out is the use of Iot. and iot research papersIO T. Devices within healthcare iot research papers is growing rapidly. It’s projected to reach a 340 billion. dollars by the end of 2025, so it’s a. Very exciting and iot research papersgrowing space. So with that brief introduction, what are some? of the challenges of implementing an Iot solution? So if you’re going to be building your own IMT? solution, there’s several things that you may need. to account for. The first is ingestion. of high frequency data, not all devices. are high frequency. Some of them run may only be. reading once a day, but there’s also a lot. that can produce data at very high rates. Every second or sub second. So if you want to be able to interact with that class of devices. you would need to account for that. You also have. a desire attention for low latency so. you want to be able to get or ingest the data and iot research papersmake it available. As soon as possible as you can. You also have to associate data between. from the device to a patient record to make it. meaningful. There’s also a. multitude of devices out in the ecosystem, there’s not. a lot of standardization out there and iot research papersthey. all report data in their own. unique way. Another key thing that you would need to account. for is interoperability specifically within the healthcare iot research papers. data realm and iot research papersspecifically here. This is where we’re targeting fire, which is a healthy open. healthcare iot research papers standard. That’s gaining traction in the community. And iot research papersprovides us a way of. sharing data across hospital systems. You also have to be aware of privacy and iot research paperssecurity. In account for those and iot research papersalso what? do you do when you need to update the data that’s coming from the device? So with those key points.

Gone through, what are some of? the challenges that you’ll counter, especially if you’re building your own solution? So one of the key ones is late arriving data. especially if you have a wearable device. that’s using some kind of gateway for. Internet connection, like a like a smartphone you. can have data that’s being collected for. hours or even days at a time, and iot research papersthen once internet. connectivity is established. That data will all be sent in transmitted, so you need. to be able to one be able to handle that burst. of data and iot research papersthen make sense of it. appropriately and iot research papersassociated with the right time period. Similarly to that, there’s. really no standard and iot research papershow the device may send data. So if it’s been offline, it may send the most. recent data first. And iot research paperswork back chronologically. Or it could send out. the oldest data. An there’s really no particular order so. whatever solution you have would need to account for that. There’s also the problem of duplicates because. The device itself may choose to resend data because. it was in the middle of transmitting. Connection was lossed in it. didn’t get the acknowledgement that UPS particular piece of data. was successfully received. Yeah, to be able to handle link in the data to the patient and. there’s this. Tension between balancing latency and iot research papersload on the system. So I mentioned earlier you wanted. to get the data available as quickly as possible. But if you’d go with near real time. or real time processing that adds significant. challenges on the back end. There’s also, as I mentioned earlier. there’s devices that run the gamut of how they send. or represent their data streams. There’s really no clear standardization. And iot research papersthis particular last one is. managing the number of resources created an fire so. Sources you can think of them as like entities. specifically in fire. We call them observations when they were.

Dealing with health data specific to. a patient. So you can imagine is if I have a device that streaming. health or heart rate data every second an I’m. creating the distinct observation for each of those that. can present some challenges and iot research papershow to enumerate. or retrieve that data ’cause even. Pulling back a patients days. worth of data presents several. thousands of records. So we’ve had through the years. several prototypes in partners that we’ve been. working with. As we come try to come up with solutions, Ann wanted to. go over some of the lessons learned in. Kind of what? e have used. As. Guiding principles when we built their solution. so one of the things is I just alluded to in the last slide is. that a single value observations are not sufficient, so. we don’t want to just store or have it, only the option. of storing that heart rate data. as a single point. Thankfully fire does have. a time series format called Sample. data that allows us to essentially group collections. of data into a time series format, so. We one of the things that we do here is you. define an observation that say it could be for an hour. and iot research papersthen every single measurement within that hour for. that’s a heart rate would be represented within that observation. The when we’re looking at prototypes or how we might tackle. this problem, one of the first places we went to. was on the device itself is what could we put on the device? you? How can we standardize and iot research papershave basically? some code that would run on the device that would handle? the recording of the measurements and iot research paperssending? them to the cloud? That presented several challenges an. we opted to actually try to make the solution. device agnostic and iot research papersessentially allow. us to receive the data in any way. Some of the problems are device. complexity. They run in the gamut of similar. so I have a lot of processing power, somehow very little in. y little in also, if you’re doing all the processing on the device itself.

Ently introduces the. ncy. The device manufacturer or the person that writes. the gateway may have a buffering period. which is fine if that’s what they choose to implement, but we didn’t want to. have an inherent solution that. Had latency built in. And iot research papersthen code portability the each. device runs on its own particular OS. or firmware version, so making A1 size. fits all solution that lived on the device was. problematic. Another thing is fire is an evolving standard and. One of the things we didn’t want to do is if we were doing. the conversion and iot research paperscollection into fire. on the device itself, then we have to ensure. that if we want to upgrade the version of fire. That when we have to make sure all the devices are upgraded as. well, where if we do that in the cloud, we can kind of decouple. those things the other interesting. tension point is specifically when we get into these. values. Sample data. Time series formats the fire payloads themselves can. be very large and iot research paperswe wanted to kind of keep. the footprint to a very small size. ’cause some of these. devices are very. tiny. So that brings us to kind of two solutions that we built. so we have both in OSS version. the IMT Fire connector for Azure and iot research papersa. pass option currently in public preview the Azure. IoT connector for fire. The IMT Fire Connector for Azure allows. you full control over the code, so if you want to take the. basic building blocks and iot research papersthen extend it or. add enhancements to support your specific scenario, you’re free. to do that. But if you’d like. to have a one stop shop an use. the solution that we built as is then. I encourage you to look at the Azure IoT. Connector for fire. So what is the IMT? So. We provide an endpoint that can process high frequency IMT data. Process payloads with mixed data types and iot research paperswe. ccomplish this by first normalizing data, so we take. ata that’s in a non fire format an merge it into. a common intermediate format. Then we group that data by. various properties.

And iot research papersthen we do the transform step where we converted into. fire observations, and iot research papersfinally it’s persisted. in the target fire server. So we’re going to go through the steps a little bit. in more detail to kind of highlight what’s going. on there. So in the normalization step. we take these arbitrary device payloads represented. here with H rate heart rate. in HR so. Think of these as three different devices that are owned singing sending their. own discrete payload to the cloud. With that data as it’s coming in will. normalize it into a common model where in. tput would be based off this simple example heart rate. 65 heart rate 59. Heart rate 88. Another important thing that we can we do in normalization. is projection. So a lot of times devices. will send up essentially one message with various attributes. for different vital signs. This is great from the devices standpoint because you. re usually sampling these at. the same frequency and iot research paperssending one message is. convenient and iot research paperspractical for them, but on. the processing side and iot research papersstorage side. You a lot of time your heart rate doesn’t really have. any direct correlation to your steps or your heart. rate variability, and iot research papersyou’d want to store them in separate observations. in fire. So to accomplish that are normalization step? also supports projection? So you can configure it such. that these would get split out and iot research papersthen conversely they. could be stored as separate observations and iot research papersfire. once we get to that step. And iot research papersthe grouping name Buffering stage we have data. at grouped according to the type. So think of like this is. like a semantic type that the person configuring. the system defines heart rate step count. blood pressure, etc. Window time and iot research papersdevice. This is this essentially controls your end to end latency. latency an as one of the options. in the open source that you can tweak. That’s configurable, it’s. urrently locked into 15 minutes in the public preview. but it’s going to be something that we’re going to open up is configurable.

So this is essentially controls how often data. is egressed from the connector into fire. So if you tweak it lower. you’re going to. Get data into fire sooner, but you’re potentially going to increase. the load on your fire server. So depending on your use case. you may want. to have it very small because you need to do some real. time analytics, real time processing or. if you are doing something that’s more. Analytical you may set a higher value. because you want to have the system, it doesn’t matter. if it’s on the minute available in the fire server. So finally the fire conversion. We have several options, so you can. define the period, so this is if you’re using the. time series format that I mentioned. So you can say. I want this observation for heart rate to be bucketed by saying. n hour, so every hour as data is streamed. in or uploaded to the connector will figure out. what our time period that data belongs. to and iot research papersmerge it into that observation. We also support various coding, so this is where you would. define your loinc snow med or other code systems. for annotating your data. You also can set the data type. This is where if you were using the sample data. type for time series I mentioned, or if you have. scenarios for string data or value. quantity because the measurements are infrequent, you can. configure that there. We handle for you, mapping the data to the correct. observation based off the time that it was recorded as. being observed an we also. make it deterministic identifier so as data. comes in. We can save it and iot research papersthen if data for that same observation. that needs to be amended later, we can identify it. an update it accordingly and iot research papersthen all. the observations that we create are linked to both the patient and iot research papersthe device. Ann, for those that are familiar with fire we support. not just single value observations, but there’s a concept of components. An example of this would be you have a blood pressure and iot research papersobservation.

And iot research papersyou can have components for diastolic and iot research paperssystolic. blood pressure. And iot research papershere’s a quick example of fire. observation that would be created by the connector so. we can have here up like the internal ID and iot research papersthe resource type. We have the device and iot research paperssubject. references, which is the patient reference in this case. Coding is right here. We have a link code for heart rate. the effective period and iot research papersthis one is. just a simple value quantity. And iot research papersreal quick, and iot research papersI’m going to go through some of the configuration steps. so one the normalization step is we have a concept of device. mapping. So what this may look like here is I have a. sample payload from a device we. have a multitude of different signals that are being recorded. and iot research paperssome properties for the. date and iot research paperstime that the measurement was recorded Anna. device ID. Your responsibility for using the system is to configure a template. t will know how to. identify an match this so some key. Pieces here is we have a template that supposed to map. this to a semantic type of heart rate and. then we achieve this by this type match expression. here. So basically if this evaluates to true then we have. identified as a message of. this type and iot research paperswill proceed then to extract the various values. defined here. And iot research papersthen the output of this is a normalized value. On the fire mapping side will take a collection. of normalized data like this. Combine it with a template where we’re mapping based off of the semantic. type that the configure of the system defines. And iot research papersthen use some other properties to say. In this case we want the period interval 0. means as a single instance, so we’re just going to create this as is. The code we want to associate with it and. then how we extract the values and iot research papershow we represent them. in fire. And iot research papersthis would be the output. So. With that you may be wondering exactly how can. you use the Iot connector. Part of a larger system, so here’s a. kind of reference architecture how we see the connector being used.

So on the left hand iot research papersside we have the ingestion. Where we have data coming from devices. that can either be using a device gateway, using. ne of our Azure Iot products like. Iot Central Iot Hub or going. through a phone gateway and iot research papersconnecting to the Iot. connector directly. The Iot connector then funnels. data into our managed Azure. API for fire, which is the fire server that. you can use to access the data as it’s being streamed in. You can also use this to ingest data. from EHS, ours and iot research papersthird parties into the Azure API. for fire and iot research papersonce there you can use it in. various applications. Similarly, if you wanted to do analytics. once it’s in the Azure API for fire we support. export, anonymization and iot research papersthen you can take it. into various Azure. services from there. With that I’m going to hand iot research papersit over to Nate to go. into the demo. OK honey, I get my screen down here. Can you see my screen? I can. Tell me get over here. There we go. It’s a remote monitoring demo. It does alright, I’m on the right screen then OK, Thanks Dustin. And iot research papersthanks everyone for attending. So the demo I’m going to show today. is an end to end pipeline using the Azure Iot. connector for fire and iot research papersit was really easy to set up. I mean, it basically didn’t require writing any additional code, just. configuring the different components. So the first thing I’m going to do is take a minute to walk through. some of the components in this demo. Deployed an instance of Azure API for fire which is. what we use for persistence layer. So Azure API for. fire meets HIPAA regulatory requirements and. it’s also idolizes certified so it can be used to safely. and iot research paperssecurely store protected health information. Within the Azure API for fire control plane I. enabled and iot research papersAzure Iot connected for fire and. configured the mappings to process the device data that we’re going to be sending. So Dustin talked about those device mappings that are. used to transform an arbitrary Jason payload with fire and.

Will be taking a deep dive into how this conversion works with. data from an actual device. So I have a device here. I’ll hold it with my. camera. It’s an eye health device made. for measuring blood oxygen saturation, it’s. just an off the shelf device. I think it was about $40. And iot research papersI’m also if you look at the right side of my screen. I’m projecting my iPhone and. You can see I installed the eye health app. Is the orange icon labeled I? health and iot research paperswhen I take a measurement using this device? VI Health app will write the blood oxygen saturation measurement. that health kit. So I just want to take a minute to. talk about healthcare iot research papers healthcare iot research papers is available on off iphones. It’s developed by Apple and iot research papersbuilt into the OS and. applications and iot research papersdevices can store health data on. the iphone using health kit and iot research papersthis data can be shared securely. with third party applications. If and iot research paperswhen a user grants permission. to share the data. So our team leverage this capability and iot research papersdeveloped an open. source swift library called Healthcare iot research papers on Fire so. healthcare iot research papers on fire exports data from Healthkit automatically. to the Iot connector. This library is available. on Github, along with documentation. A quick start guide. and iot research papersa sample app that can be deployed in an iphone for testing. and iot research papersevaluation. And iot research papersfor this demo. You can see that I deployed the sample app, it’s the. white app icon labeled Iot Fire and iot research paperspre. demo. I configured the Iot connector endpoint so. it would send data to an IOC connector that I created. and iot research papersalso I created a patient in the Azure. API for fire that represents me. Now with the eye health application saves the blood. oxygen saturation measurement to health kit, it’s immediately. exported to the Iot connector, processed and iot research paperssaved. as an observation resource into the Azure API for fire. So once the data is there, we can then use. the power BI Fire connector to create a report and. here’s what that report looks like. So I created a. kind of a quick and iot research papersdirty dashboard that simulates a scenario where.

A clinician is monitoring blood auction saturation for a. group of patients. This first page shows the. measurements taken today an I’m down at the bottom. my rose highlighted yellow yellow means that the measurement. has not been taken for today and iot research papershighlighted. red means that the measurement is under 95%. As is the case with Grace Owens here, so. I do want to call out with the exception of myself all. of the patients on this list for fictitious. Their data is all synthetic. so let’s take a quick measurement, see what. happens here. So the first thing I need to do is. I need to launch the eye health application. So we’ll launch that and iot research papersthen I turn on the device. that reads with blood oxygen saturation. So when it connects to Bluetooth, what happens? is the phone starts reading data and iot research paperswhen I take the device off. by finger it’s going to create a single blood oxygen saturation measurement. that’s going to be written into health kit. So I pulled that off, it says. 98%. My pulse rate is 128. That’s pretty high. So. The health care on fire at sees the new data immediately and. uploads it to the connector, and iot research papersthis is where the normalization process begins. It extracts the device identifier that I’m the measurement. of curd and iot research papersthe measurement data itself at. this point I’m going to take a minute to go under the hood and iot research paperssee how this. data is being processed. So this is what the payload from healthcare iot research papers on fire looks like. The measurement is here at the top, the. timestamp and iot research papersdevice ID or here. And iot research papersDustin briefly talked about the two mapping. files that help transform arbitrary Jason payload into. fire. On the right is an example of the first mapping. used to normalize Jason data into the format that’s easier. for the IoT connector to work with. So we use this Jason Path expression to determine. if this mapping should be applied to the incoming payload and. we see that there’s a match so we can start extracting the other values.

That we’re going to use to create the fire observation we. use the timestamp expression to locate the extract. the time stamps so we know the date and iot research paperstime the measurements are placed. We use the device ID expression to locate. and iot research papersextract the device ID so we can provide a reference. in the observation resource to the device that generated. the measurement. And iot research papersthen we use the value expression. To extract the measurement value. Once all the values have been extracted, we create a normalized. data object that is used internally by the Iot connector. and iot research papersthis gives us the ability to accept Jason payloads. from many different devices that may have many different data formats. So now that the incoming data is been normalized. we could group the data if needed. In this example we don’t need. to ’cause it’s a single measurement, but grouping is useful. is expected to be streaming or high frequency and. it’s useful because we can, as dust dust mentioned earlier. we can limit the number of observations that are created. So now we take the normalized data and iot research paperswe create a fire observation. So I’m going to jump in and iot research papersshow how that’s done so. this is the example of the second mapping, JSON, the. fire mapping the fire mapping also. uses JSON path to locate and iot research papersextract data. So the first thing we do is check if this fire mapping should be applied. to the normalized data that was created in the first transformation step. This fire mapping should be applied to the oxygen saturation. type and iot research paperswe can see that this normalized data. is of type oxygen saturation and iot research papersbecause the normalized. data type matches, we can start the process of creating an observation. So we establish. The value type that will be included in the observation. and iot research papersas you can see, this observation will contain a value. quantity, so value quantity can be used for single measurements. like what we’re showing in this demo. But there are other types. I think, dustin. entioned about values, sample data, those.

Can be used for streaming and iot research papersthen string values and. also codable types. So we support more than just. quantity types. So we locate the. value by name in the normalized data in. this case auction saturation. And iot research papersthen we write it to the observation resource and iot research papersas. you can see, because the observation value is a quantity, the value. is converted from a string to a number if this normalized. payload that contained a number of we just write the number as is. So then we copy the system unit and iot research paperscode from. the fire mapping to the observation so that the value is coded properly. And iot research papersthen any of the codes in the template or copy to the observation. Here we just have the one code, but you can add as many. codes that are required to support your business case. And iot research papersthen we write the time that the measurement was taken. So we use that timestamp to create an effective period. start mend because it’s a single measurement that start and iot research papersend are. exactly the same. Getting the last step in creating this observation is setting the references. to the patient that took the measurement and iot research papersthe device. The patient. Sorry that the measurements taken from and iot research papersthe device. that took the measurement. So this is done by fetching the device resource using. the device ID from the Azure API for fire. Now the healthcare iot research papers. fire application or at the health kit on fire sample application. will actually create devices for you and iot research papersfire. and iot research papersthat way the data that comes in at a later. date will be linked to it. So the fire ID is then copied from. the observations reference. And iot research papersthe patient reference that’s been taken included. in the device resources copied to the observation. So I want to call this out. Specifically, the Iot connector in. this instance is big. It’s been configured to look up the device and. a patient when the data arrives. So this means there’s an. expectation that a device resource with matching. identifier exists and iot research papersthat device resource. has a reference to the patient resource, the.

Iot connector can also be configured to create device and iot research paperspatient resources automatically. When data is sent to the connector and iot research papersthat’s just by configuring. it to do create. So now that the observation been created, we can persist the data in fire. OK, now we have three resource types in Azure API for fire we. have the patient resource which represents me the. device resource which the healthcare iot research papers no fire sample up created. an then an observation which was created based off of the. data generated from this blood oxygen saturation monitor. For this demo, we’re just going to import the two types to power. BI. To generate, generate a report. It’s going to be. patient in observation. And iot research papersthen we can shape this data. In this case I’m going to merge. the list of the to the patients that they belong to. and iot research papersthat way I can chart the measurements overtime. And iot research papersthen once that dates been shaped, I can create my visualizations. So let’s jump back to the dashboard and. we can see what it looks like. So we’ll refresh this really quick. It might take a little bit of time ’cause I have several. 100 observations now and iot research papersthen. I think we have 10 patients. Once the data is done refreshing it should update the UI and. you can see that the 90% value. Let’s make sure. that’s correct. Yep, 98% from the eye health. application is properly reflect reflected here. I can also go through and iot research papersdrill through so. I can look at these other measurements that I’ve been taking since. the. What is this the 18th of October? And iot research papersso this just maps out all. of my daily measurements that I’ve taken. There was a couple of spots. in here. But for the most part, my trend line is going the right direction it’s going. out, so that’s good. And iot research papersif we go back to the first dashboard. here, we can actually drill into Grace Owens and iot research paperswe can see what’s happening. here. So here Grace I once again. my fictitious patient. Last measurement was 91. and iot research papersit does seem the trend line seems like she’s trending down so.

It might be time to give her a call and iot research papershave her come into the clinic. OK, so I did want to leave you guys with some links to some of the. Tools that we use today. Again, this was no. o code solution. I just literally deployed the sample application on the health. kit on Fire repository. I set up the. power BI Fire Connector, which is a generally available on also. created an instance of Azure Iot connected for fire. along with the along with fire Server. And. So here’s some links to the documentation. And iot research paperswith that, I think we’ll go to questions. It doesn’t look like there’s any questions, just a reminder that. there is a Q&A, so will probably hang on. for a little bit just to see if any new questions trickle. in. Think you need for the demo is very informative. and iot research papersjust wanted to highlight we went into a lot of. the detail that the connector and iot research papersstuff. is doing for you, but like. mentioned he was able to pull the components together. off the essentially off the shelf and iot research papersstitch everything together. to ingest data from an off the shelf device. and iot research papersmake it available in the Azure API for. fire. So we’ve. kind of. Enabled a very easy way to ingest data. an make it available for further evaluation and iot research papersthis. specific case it was clinical monitoring. but you could see that it would be useful in. know collecting data for research studies an. other applications as well. I’m just going to pop the resources, slide back up so that people. have them available. OK, thank you everyone. If you have questions. the our contact information was. at the beginning of the comfort of the presentation. so feel free to reach out to us directly if you have further questions. Thank you, I hope everyone has a great day.

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