IoMT in Swiss hospitals: increasing efficiency and sustainable cost management

As part of a semi-structured literature search, current studies were analysed in order to assess the impact of IoMT on cost management and efficiency improvements in hospitals. To this end, scientific databases were systematically searched for relevant publications. Studies from 2015 onwards were included that focus on Western healthcare systems and provide practical recommendations for the integration of IoMT technologies into everyday hospital life. The identified studies were analysed thematically and evaluated in terms of their implications for organisational efficiency and financial impact.

The research was based on a combination of relevant keywords using Boolean operators. The terms used included, among others: Internet of Medical Things (IoMT), healthcare, cost management, efficiency, integration, medical devices, data security, hospital management, process optimisation, challenges and Swiss hospitals.

The analysis shows that IoMT offers considerable potential for increasing efficiency and optimising cost management in Swiss hospitals. The networking of medical devices and the collection of real-time data enable the automation and improvement of medical processes. This can speed up and refine diagnostics, improve the quality of treatment and relieve the burden on medical staff by taking over routine tasks. At the same time, this leads to better resource utilisation and a reduction in operating costs (Axisbits, 2024; Marheine et al., 2021).

One solution currently being developed as part of the SHIFT A.1 sub-project is the Tech-Foundation. This aims to create secure and standardised middleware that seamlessly integrates IoMT technologies into existing hospital IT systems. With standardised interfaces such as FHIR and modularised services such as identity management, this solution could help to improve interoperability and lay the foundation for more efficient digital processes (SHIFT, 2024).

Despite these advantages, hospitals face considerable challenges when introducing IoMT technologies. High implementation costs, the purchase of new devices and the necessary adaptation of existing IT infrastructures are key hurdles. Interoperability, i.e. the seamless integration of new technologies into existing systems, is crucial and often requires high investments, especially for smaller hospitals with limited budgets. (Darms et al., 2019; Monteiro et al., 2021).

In addition, there are ongoing costs for maintenance, software updates and training to ensure the secure and efficient use of the systems. At the same time, the management and protection of sensitive patient data is a key issue that requires continuous investment in data protection measures in order to comply with both legal requirements and security standards (Darms et al., 2019; Monteiro et al., 2021).

Another obstacle to the widespread introduction of IoMT is the lack of clear billing models (Mischak, 2017; Rawas, 2024). One example of this is the "Hospital@home" model, which enables patients to receive treatment at home and both improves care and relieves the burden on hospitals (see B.3). Despite these advantages, however, there are no financial incentives for large-scale implementation. The responsibilities of the cost bearers differ: while inpatient costs are borne jointly by the cantons and insurers, insurers bear outpatient costs in full. This division leads to ambiguities in hybrid models such as Hospital@home (Hehli, 2024). However, the planned introduction of standardised funding for outpatient and inpatient services in Switzerland from 2028 could create a clearer basis that will facilitate such models in future (Besson, 2024). Until then, outpatient care will remain economically unattractive, which will hinder the large-scale implementation of these promising approaches.

The results make it clear that the digitalisation of healthcare, including the integration of IoMT, must be strategically planned in order to realise the benefits in the long term and sustainably (Hehli, 2024).

• Development of clear billing models: The introduction of specific models for billing IoMT services is essential in order to transparently present both the costs and the added value of the technology and ensure its economic sustainability (Hehli, 2024).
  
• Pilot projects to minimise risk: The use of IoMT technologies with Leitwert AG's DeviceHub in smaller pilot projects offers a controlled test environment for new applications(Device Hub - Leitwert, n.d.). This allows potential risks to be recognised at an early stage and adjustments to be made before large-scale implementation (Darms et al., 2019).
  
• Ensure seamless integration: The smooth integration of IoMT technologies into existing IT infrastructures, for example by using the health engine from The I-Engineers AG (TIE, 2022), ensures efficient use of the collected data and thus optimises process flows (Monteiro et al., 2021).
  
• Ongoing staff training: Without sufficient staff training, the IoMT loses its effectiveness. Staff must be able to use the technologies correctly, as insufficient knowledge can lead to errors and inefficiencies (Darms et al., 2019).
  
• Optimise data security: Ensuring data security and protecting sensitive patient data is a top priority (Monteiro et al., 2021).
  
• Carrying out a comprehensive cost-benefit analysis: Before implementation, a comprehensive cost-benefit analysis should be carried out to assess the long-term economic benefits of IoMT technologies (Monteiro et al., 2021).