IEEE Technology and Society Magazine - September 2019 - 19

are already obsolete. This happened
to Amazon, which took 8 months to
get permission to test its drones in
the United States.
The health sector is one of the
most regulated and bureaucratic,
especially when compared, for ex-
ample, to robotics in manufacturing.
Despite delays that this can gener-
ate for technologies to leave the test
environment and reach the popula-
tion, for safety it is prudent that such
health developments are duly regu-
lated and controlled. The connec-
tion and interoperability between
chain links puts patient information
at stake, and the fact that "medical
things" are becoming more connect-
ed may increase the impact of cyber-
attacks. Considering this, Health
4.0 should guarantee the safety of
data, sector, and patients. Likewise,
it should encourage the creation of
patient-centered healthcare, with
the possibility of interconnecting
a global health technology system
through open systems and the use
of common standards, resulting in
technological advances with para-
digm shifts. This change should
avoid what Thuemmler and Bai [8]
called "Patchwork Progress," where
innovation and evolution occur only
in parts of the industry, with het-
erogeneity of closed technologies,
without interoperability, without
exchange or sharing of data, with
ample competition for domain mar-
ket, and as a focus on the recovery
of investments.

innovative improvements and likely
will not in the forthcoming years.
While developed countries have an
Internet penetration rate of 81%,
only 17.5% of the population in less
developed countries has Internet
access [9]. Given this scenario, it is
important that the emergence of a
new concept of healthcare does not
decrease access to basic services,
and that neither does it increase the
disparity of access in less developed
countries when compared to devel-
oped ones. In addition to being
innovative, Health 4.0 needs not
only to address reducing the health-
care burden in developed countries,
but also to focus on inclusion of
less developed countries in the digi-
tal age, with technological innova-
tion making comprehensive and
high-quality care available.

Perspectives
The fourth revolution promises to
transform health by providing more
accurate and personalized service.
This personalization of medicine will
boost the emergence of increas-
ingly effective and near-real-time
treatments. This can be achieved
through the integration of medical
devices (which will also tend to be
more accessible, smaller, and per-
sonalized), with cyber-physical sys-
tems, software building blocks, Big
Data tools, IoT, 5G, among other
features [8]. Personalized health will
integrate the patient and give them
autonomy and participation in their
treatment. The benefits in fact are
numerous, and the implementation
of these technologies will allow
great advances in the treatments
available today.
However, it is important to be
aware of the challenges this revolu-
tion creates, and to ensure that it is
being properly regulated, with a bal-
ance between safety and develop-
ment. The establishment of norms
and standards may help, and will

Health 4.0 Remains
Unconnected
Health 4.0 proposes a more con-
nected health system where, for
instance, with the use of the Inter-
net of Things (IoT) even a hospital
bed may be connected to the net-
work, thereby providing and making
use of data. However, a large part of
the world population unfortunately
still does not have access to such

SEPTEMBER 2019

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IEEE TECHNOLOGY AND SOCIETY MAGAZINE

dictate the direction of Health
4.0. These should ensure that
technological development takes
place in an open and comprehen-
sive manner. Resistance to closed
developer- owned systems can
ensure that development occurs
seamlessly across all health areas,
enabling data sharing and sus-
tainable innovation.

Author Information
The authors are with Gaesi, Depart-
ment of Energy and Electric Automa-
tion Engineering, Polytechnic School,
University of São Paulo (USP), SP,
Brazil. Email: emdias@pea.usp.br.

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https://www.bls.gov/oes/2017/may/oes_nat.htm#29-0000
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