Driven by the agility of a smaller country, Luxembourg is clearly one of the innovative places in Europe when it comes down to healthcare. Knowing that the enabling factor for innovation in healthcare is data, regulations on real world patient data are more important than ever. Pseudonymization and anonymization of patient data are the enablers for the success in this important domain.

With the recently successfully closed first 5G project of Hôpitaux Robert Schuman (HRS) and NTT on the use cases of heart disease treatment and stroke patients, Luxembourg achieved another milestone on the journey to bring digitalization into healthcare. 

Combining mobile applications with telemedicine, IoT monitoring devices and a reliable and fast connection such as 5G unlocks many possibilities : (1) providing patients with the right information at the right time, anywhere, allowing them to make informed decisions and be real partners of their health care, with all its associated improved outcomes, including a decrease in mortality (2) unlocking patient monitoring at home and thus (2a) helping to conduct the switch from stationary towards ambulatory medicine, (2b) decreasing hospital readmissions. Finally, (3) allowing access to care from anywhere, anytime, thereby limiting unnecessary consultations at the emergency room or transfers between institutions. 

Indeed, digital health uses advances in computing power and data techniques to improve healthcare, to make it safer, faster, and more accurate. 

Artificial Intelligence / Machine Learning

Artificial intelligence is transforming the way we provide care by delivering decision-support to clinicians (e.g. image analysis, treatment recommendation), streamlining documentation (i.e., voice recognition) or resource optimization. AI needs data and data is more and more collected through IoT. 

Public and Private 5G network

To succeed in their digital transformation journey, healthcare institutions need a Digital Integration Platform, accessible from anywhere, and thus with a tight integration with the public 5G Telco network. HRS and NTT Luxembourg teamed up in a consortium to address this challenge. The envisioned open Digital Health Platform connects apps, services, and health related IOT devices, while exchanging all sensitive relevant data and content in real time, in a secure and reliable way. 

5G plays an essential role in Digital Health. It is not just faster than 4G connectivity, it also offers much greater capacity, enabling millions of devices to be connected simultaneously. In addition, much lower latency means the delay between a device being instructed to perform an action and that action being carried out is reduced to less than 10 milliseconds: essentially real-time.

Based on the Digital Platform structure behind, any real-time health data collection and analytics for treatment and prediction becomes possible, from anywhere. 5G offers, due through higher bandwidth and network slicing, the required means to collect a massive amount of data while offering QoS (Quality of Service) and a secure context isolation. Artificial Intelligence is not only available at the backend, but models can be executed on tablets, Smart Phones, further AR (Augmented Reality) devices or on IOT devices themselves. By that, AI supports real-time health features straight on the device.

As opposed to a simple performance upgrade, private 5G changes the game as organizations can have 5G infrastructure where the spectrum – and hence the network, as well as the data on the network – are owned by and under the control of the organization. The concept of enterprise-owned (and enterprise-focused) cellular networks is quickly gaining popularity as the combination of the performance improvements of 5G networks and the control and security enterprises need is potentially too good to pass up.

Overall, the Digital Health Platform properly combined with the 5G network has the potential to facilitate AI applications for medicine, including decision-support, treatment recommendation or early detection of diseases. Public 5G will continue to play a significant role in regional and global projects. It further will be the layer to interconnect Private 5G campus networks. 

Remote medical and care practices

New technologies have led to a digital revolution of medicine. Remote consultations and the immediate transmission of data such as scans, electrocardiograms and other reports allow patients to seek specialist advice or a second opinion almost anywhere in the world.

These new forms of care require intersectoral networking of all the actors involved in the care pathway. This care is strongly oriented towards patients and adapted to their personal needs  - a step towards personalized medicine - while encouraging them to participate actively in improving or stabilizing their health situation. However, the training of health professionals as well as patients and their families in these new professional practices remains a major challenge. 

The results of the HRS Digital Health Platform project encourage to go further and define a national project by constituting a ‘national heart failure network’, which should not only include hospitals, cardiologists, and general practitioners, but also nurses trained in heart failure, other health professionals and technology providers.? 

During the HRS project we had great support from the SMC, eSante and CGDIS. The Société Luxembourgeoise de Cardiologie and CNS are involved in supporting us driving the project further. We started to explore with University of Luxembourg (SNT) how we can use AI/ML to leverage the pseudonymized data for Research, but also for Diagnosing and Treatment planning.

There is evidently an incredible potential behind the Digital Health Platform project, and the key objective could be to allow the emergence of a real ‘5G Health operator’, who can rely on public 5G networks, but potentially also on a set of private 5G networks, deployed in certain hospitals. Those networks could be fully under the control of a hospital for simplified coverage, security, and performance.

Gaia-X

Finally, compliance, specifically when it comes to data exchange in healthcare, is crucial. Together with the national HUB, coordinator of Gaia-X in Luxembourg, we share the vision that an existing development, which is part of the global healthcare platform in Luxembourg will now flow into Gaia-X. As this platform is today real, this accelerates the process that things in Gaia-X are becoming reality and are not just ambitious goals.

What HRS and NTT build in Luxembourg around 5G connectivity and the digital healthcare platform, is a foundation layer for the future.

The pace of innovation in healthcare will not slow down. Today modern medicine tells us mainly what is happening and what has happened. NTT Research  is today already working on technology that let us investigate the future to predict and treat heart failures before they occur. We call this the Cardiovascular Bio-Digital Twin. It is a complete virtual representation of a patient’s physiology. New technologies like new generations of smart sensors based on advanced nano technologies and micro actuators are required to fulfil that vision. Reliable and secure connectivity, like 5G is key! The aim is to create in the future a cardiovascular system up to the cellular level. We will not only be able to predict and assess cardiovascular disease, but further allow to treat them. The goal is to treat them in a virtual world before they appear in the real world. Even if we are not yet there, we clearly see the future of healthcare in front of us as it has already started today.