Perspective Chapter: 5G Support the Chinese Healthcare 4.0

Abstract

New upcoming network technologies (5G) will be the backbone of future healthcare, allowing the internet of things, intelligent pharmaceutical production, and customized treatment. In this essay, I will describe how 5G may vary from past generations of network technologies (3G and 4G), address new healthcare applications, and demonstrate how these technologies may allow the development of new healthcare delivery systems in China. Demonstrate how linked medicine can improve imaging, diagnosis, and treatment to improve the quality of care provided to patients. Soon, individuals and companies will create a more complete connection with their digital gadgets, allowing them access to superior healthcare in real-time and at a reasonable cost. 5G will not significantly alter computer equipment, but it will usher in an age in which real-time healthcare is the norm rather than the exception. This will bring patients closer than ever before to the futuristic notion of digital inclusion.

1. Introduction

Since the 1950s, China has established a community healthcare network [1]. Urban and tertiary health care is robust and able to offer health services to the local population, which leads to the ultimate organization of primary health care [2]. This method is one of China’s strengths in primary care. Each city has a general hospital with many health departments, health facilities, and medical personnel to serve customers with routine follow-up visits, consultations, medical examinations, perinatal care, newborn care, and other services. Yet, the country’s present status and health care are far from adequate [2]. There is a critical lack of family physicians (GPs). Big general hospitals and specialists are overloaded with patients. In contrast, community hospitals seem to be abandoned [3]. The training and deployment of general practitioners in China are still in their infancy, and there is a severe shortage [3]. According to the appropriate authorities, the lack of 10 million general practitioners in metropolitan community health care centers is mostly attributable to the distribution of medical resources to impoverished rural regions. Vacant community hospitals because of their inability to recruit qualified medical personnel, community hospitals are losing patients to bigger institutions [4]. This has generated two problems: access to notable hospitals and access to renowned physicians. Experts are overburdened. Due to their hectic schedules, physicians at major hospitals are unable to perform their responsibilities in the areas of disease prevention, health care, chronic illness management, and rehabilitation [2]. Often, physicians are unable to fulfill their essential role in the treatment of chronic illness, resulting in inadequate care for recurring acute episodes and even death [2]. Individuals will be able to do daily health monitoring and management activities anytime, anywhere, utilizing virtualized tools and cyber-physical systems based on the design principles of Industry 4.0, linking the physical and virtual worlds in real time [5]. Health 4.0 is a strategy idea for the health industry that is drawn from the notion of Industry 4.0. Health 4.0 aims to allow progressive virtualization to provide individualized health and treatment in near-real time to patients, professionals, and both formal and informal professions [6]. Yet, safety, security, and privacy are important for the development and realization of Health 4.0’s potential benefits. Emerging network technologies, such as the fifth generation (5G) network, will provide ubiquitous access, increase connection, and permit ad hoc service scheduling, thus connecting patients, formal and informal professions, social workers, and health practitioners [7]. In this post, I will describe how 5G may differ from the past generations of technological advancements (3G and 4G), address new healthcare applications, and demonstrate how these advancements may allow for new healthcare delivery systems.

2. Healthcare 4.0

Healthcare 4.0 is seen as a sector with various stakeholders, including patients, caregivers, healthcare providers, hospitals, and pharmaceutical corporations, as well as several constraints, laws, and regulations that have frequently led to substandard patient care [8]. Most of these players are now impacted by the promise and integration of new technologies that assist the healthcare industry, because of the advent of data-driven technologies that have contributed to the development of healthcare. The healthcare industry aspires to develop a system in which everyone is linked via a wearable device and every patient data point is recorded regardless of location. Thus, according to BCC Research, the healthcare industry will increase from 521.2 billion US dollars in 2017 to 674.5 billion US dollars by 2022 [9]. To stay competitive, businesses must consequently discover new markets and novel goods. One of the most significant barriers to early healthcare 4.0 implementation is a lack of digital support alignment among various stakeholders. Due to budgetary constraints, many hospitals may be unable to achieve a complete digital transformation. Furthermore, the growing quantity of medical equipment with millions of items creates new challenges for the healthcare supply chain. With more than 6 million medical devices on the market, it is frequently difficult to manage information on them since they all need human input, which increases the risk of inaccurate, inconsistent, and missing data [10]. So, the healthcare industry requires not only a high degree of technical transformation, but also outcomes that are efficient, dependable, and fast to make totally trustworthy judgments to promote customized health. Patients have difficulty interacting with various parties and storing, analyzing, and interpreting their medical information due to the current fragmentation of healthcare [11].

3. 5G technology: scenarios and requirements

Mobile communication systems have gone from voice-based analog systems to high-speed data networks called “4G” over the course of several generations. In June 2015, the ITU-R put out the official names, use cases, and standards for 5G (IMT-2020). ITU-R use scenarios that are best for supporting vertical industrial applications (healthcare 4.0) are enhanced mobile broadband (eMBB), massive machine-based communications (mMTC), and ultra-reliable low-latency communications (URLLC). The most essential criteria for eMBB are increased data transfer speeds and traffic capacity. ITU-R (2020) specifies the following requirements: 100 Mbps for user experience in urban and suburban regions and 1 Gbps in hotspots; 20 Gbps peak data rate; and 10 Mbps/m² regional traffic capacity. Little cells, e.g., 200 m (diameter) or less, are anticipated to be used in this instance. Connection density and energy efficiency are the primary criteria of the MMTC scenario. ITU-R (2015), for example, specifies that the connection density is equivalent to 106 devices/m² and that the energy efficiency should be 100 times greater than 4G networks. Low latency and excellent dependability are the key criteria of the URLLC scenario. For instance, a 1-millisecond end-to-end latency and an outage chance of 10–7 are defined. The 5G system is anticipated to include [12] emerging monitoring applications with extremely low wireless data rates, very low power consumption, and zero latency (less than 1 millisecond). In these ultra-dense deployments, many devices must be linked in a dispersed fashion, which is more challenging to manage than capacity distribution [13], which has been the major feature in 4G networks since the advent of the Internet.

4. 5G technologies for healthcare 4.0 solutions

4.1 Remote surgery

Doctors may not be able to reach patients in time to conduct surgery because of a lack of medical resources and time, and delays induced by great distances may place patients in undue danger. Remote surgery has been presented as a solution to this difficulty. The patient and surgeon are positioned at the far end in this remote scenario [13]. Using displays and touch-sensing devices, the surgeon can know and comprehend the patient’s health in real-time and execute procedures depending on the patient’s present state. During surgery, the touch device records the surgeon’s posture, position, and arm movement and communicates the data to the patient-side operator through the 5G network; the surgical terminal’s robotic arm then replicates the surgeon’s actions and operates on the patient [12, 13, 14]. Simultaneously, the patient-side sensing device receives and sends the audio and visual signals, as well as the tactile feedback observed by the operator terminal. All the information obtained by the physician may be utilized as a reference r a future procedure. The exchange of data between the surgeon and the patient constitutes a communication loop for remote surgery [15, 16].

4.2 Services for diagnosis in remote areas

It is very important and necessary to put these healthcare resources together and offer 5G services to rural areas in developing countries. Farmers may use these diagnostic services to acquire pertinent healthcare information with relative ease. Rural clinics may check their patients’ health conditions at any moment [17]. All rural clinics are linked to urban hospitals, and new medical monitoring equipment and systems will be implemented in rural regions. This will provide farmers access to improved health care in their communities. This would increase both the quality of health care for farmers and the condition of patients with chronic illnesses. The management team’s use of specialized monitoring systems to predict the risk of illness may aid in the prevention of patients prior to disease detection and reduce disease incidence [17, 18].

4.3 Home medical care

There is now a huge difference in the treatment patients get in hospitals and at home. People would rather get advice or treatment at home than stay in the hospital for a long time and pay a lot of money [19]. Patients often return a few weeks or even days after hospital release. In certain areas, the readmission rate for Medicare beneficiaries older than 65 is as high as 15.5% [20]. Home care has a long way to go before it can be considered a credible alternative to hospital care. 5G networks will help make home care a reality [21]. 5G will contribute to the expansion of home care services, such as video conversations with carers using 5G mobile networks. In addition, 5G will allow a significant number of wearable gadgets and other remote monitoring and rehabilitation devices, which are necessary to make home care the major rehabilitation and treatment option. The minimal latency of 5G services will let physicians and nurses monitor patients in real-time [21]. In addition, any irregularities or crises will be notified quickly, and 5G networks will enable rapid and high-quality connections between caregivers and patients, therefore lowering the probability of additional harm or problems. Using the added potential of home healthcare will enable the elderly to stay in the comfort of their own homes for as long as feasible before migrating to assisted living or advanced care facilities. Due to 5G, a variety of monitoring, rehabilitation, and treatment services may now be accessed at home, therefore enhancing care results, and lowering the growing cost of healthcare.

4.4 Telemedicine and emergency care

In an emergency, it is important to give quick and effective triage treatment to get patients out of cardiac arrest within four minutes [21]; otherwise, brain damage may start to happen. The typical US concept is “patient to the hospital,” but a 5G connection may bring hospitals to patients to expedite treatment [22]. 5G networks, a sort of next-generation network technology, might provide US first responders with a new set of capabilities to expedite good emergency care results. For instance, contemporary medical app developers have created applications that enable paramedics to utilize GPS data from the ambulance and communicate EKGs, personal data, photographs, and other trauma information in advance to advise the emergency department of their approaching arrival with great precision [23]. With patience, the emergency squad will be prepared with the necessary people and equipment. Furthermore, the 5G network may enable 4K in-vehicle cameras to be linked in real-time to physicians or emergency experts to guide paramedics through field operations or to assist in assessing, treating, and preparing wounded patients for transfer [24]. 5G is the only network technology that can deliver the high capacity and low latency necessary to serve these HD streaming video broadcasts. In addition to the necessity for quick reaction times, dispatchers in the public safety sector need situational awareness to offer the right resources and equipment. Some programs allow access to traffic cameras with high-definition resolution. Drones equipped with 4K video may transmit information to public safety dispatchers to give real-time, high-definition emergency data for assessing and dispatching the most suitable response resources [25].

4.5 Imaging

Digital healthcare has many benefits, such as the ability to look at pictures from afar and send information instantly across regions. If a doctor in one region of the nation (or the globe) wants a second opinion, he or she may email a medical picture or test result to another physician and get that physician’s opinion [26]. This permits the healthcare system to overcome disparities based on location, money, and social position while also assisting physicians in acquiring much-needed knowledge. With the Internet of Things, we will see services that just demand a little bit of data and extended battery life, in addition to devices that require rapid speeds and a dependable connection [27]. How 5G technology may facilitate the Internet of Things for health applications. This is especially true for underserved rural and urban communities. Patients in these settings often lack access to the most recent medical knowledge [27]. But, with digital technology, individuals have access to the advantages of remote professionals. This helps bridge the urban-rural gap that occurs in most nations [28]. People are not required to travel to receive appropriate medical treatment. The rapid transmission of X-rays or CT scans enables patients to get a second or third opinion. They will not only have access to experts in their native nation but also to a worldwide network of medical professionals. For the benefit of patients, this will enlarge the skill pool and offer suitable health knowledge to rural areas lacking health facilities [29].

4.6 Medical application of 5G in China

The Chinese government started the International Mobile Communications 2020 (5G) Advancement Group, or IMT-2020 (5G), at the beginning of 2013 as a big step toward 5G research. In 2019, China is putting 5G technology to good use in fields like telemedicine and disaster relief. On April 11, 2019, the first 5G smart medical application demonstration took place at Huashan Hospital in Shanghai. The hospital used 5G to show live HD surgery from 20 kilometers away and real-time remote operation supervision and explanation [30, 31]. On May 15, 2019, the Sichuan University Hospital in western China successfully performed the province’s first telemedicine consultation utilizing 5G technology with the First People’s Hospital of Longquanyi District and Suining Central Hospital of Chengdu City, which are 176 kilometers apart. China officially awarded 5G commercial licenses on June 6, 2019. With the assistance of 5G technology, telemedicine (including cloud-based data storage and retrieval) is projected to evolve at an accelerated rate; distance is no longer a barrier to obtaining high-quality medical resources [30]. On June 25, 2019, the first hospital of Lanzhou University constructed a futuristic, scientific, and open 5G smart hospital in order to study different application scenarios, including stepwise therapy, telemedicine, and internet hospitals [29, 30, 31]. On June 26, 2019, the China Unicom booth will broadcast a laparoscopic root lung cancer operation at Run Shaw Hospital, Zhejiang University School of Medicine [31]. On June 27, 2019, Beijing’s Jishuitan Hospital utilized 5G technology to remotely and simultaneously control two Tiangui orthopedic surgery robots, completing the world’s first simultaneous surgery on two patients located 733 km and 1400 km away, respectively. Using China Telecom’s 5G network and Huawei’s communication technologies, the successful surgery marked a new level of 5G telemedicine and artificial intelligence applications in China [30]. The 5G operation was streamed live on June 28 at the MWC 2019 Shanghai 5G Conference. The director of the Department of Anorectal Surgery at Shanghai Oriental Hospital demonstrated a rectal NOSES surgery at the medical summit of the Shanghai New International Exhibition Center through a 5G UHD live transmission on a high-definition electronic screen. The 5G surgical broadcast was built on the 5G network of Shanghai Mobile, allowing real-time sharing and interaction of 4K 3D laparoscopic pictures and numerous 4K operation movies on a live cloud platform. With the assistance of China Mobile 5G, remote surgery and remote consultation was done safely and effectively in September 2019 in Barcelona, Spain for gastrointestinal surgery [32]. Soon, the promotion and deployment of 5G plus remote robotic surgery will effectively relieve the issue of unequal distribution of medical resources in China and allow more patients to get high-quality medical care.

5. Outlook

As a result of demographic and socioeconomic shifts, healthcare models are fast transitioning from a hospital-based, specialist-centered approach to a dispersed, patient-centered style of care. The empowerment of patients and their official and informal caregivers have been a central focus of healthcare strategy development in China and internationally. New upcoming network technologies (5G) will be the backbone of future healthcare, allowing the internet of things, intelligent pharmaceutical production, and customized treatment. Cloud computing, big data, and improved security will allow the virtualization and customization of healthcare and bring Industry 4.0 design ideas to the healthcare industry (Health 4.0).