Presented by Rick Garibay, VP & Distinguished Engineer, Neudesic. Rick evangelized IoT in healthcare at the Northwest HIMSS NW Technology Conference in Seattle, WA, in November 2014

1. Beyond the Buzz
IoT’s Role in Real-Time Healthcare
Rick G. Garibay
VP, Distinguished Engineer

2. Rick G. Garibay
• VP, Distinguished Engineer leading the Development Platform Group at
Neudesic
• Working on IoT, Intelligent Transportation and Hospitality & Gaming
• 8x Microsoft MVP, Microsoft Azure
• Co-Author, “Windows Server AppFabric Cookbook” by Packt Pub.
• Chairman, Co-Founder Phoenix Connected Systems User Group
(PCSUG.org)
• twitter: @rickggaribay
• blog: http://rickgaribay.net
• email: rick.garibay@neudesic.com | b-rigari@microsoft.com
© Copyright 2014, Neudesic. All rights reserved.

3. Agenda
• Defining the Internet of Things
• IoT vs. “Things on the Internet”
• Devices, Protocols, Messaging & Challenges
• Microsoft’s IoT Strategy: Delivery the Internet of your Things
© Copyright 2014, Neudesic. All rights reserved.

4. What is the Internet of Things?

5. The Internet of Things is the network of physical
objects that contain embedded technology to
communicate and interact with their internal
states or the external environment.

6. The Internet of Things: By the
Numbers
257105B2
© Copyright 2014, Neudesic. All rights reserved.

7. This change is happening more rapidly than anyone
imagined.

8. This change will bring tremendous opportunity to all
industries and healthcare is no exception.

9. Nest Wireless Thermostat
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10. Wearables
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11. Health Monitoring
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12. Grid
Renewables
Oil/Gas/Coal
Recovery and
Distribution
Points
of Sale
Hotels
Restaurants
Fuel
Stations
Patients
Clinics
Hospitals
Nursing
Homes
Mobile
Care
Automation
Safety
Pollution
Control
Comfort
Security
Lighting
Manufacturing
Integration and
Automation
Remote
Servicing
Predictive and
Reactive
Maintenance
Water
Waste
Fire
Emergency
Public
Safety
Law
Enforcement
Cars
Aircraft
Letters
Packages
Containers
Tanks Bulkware
Games
Events
Sports
Television
Streaming
Traffic Buses
Trucks
Trains
Vessels
Bikes
Smart
Energy
Smart
Retail
Smart
Mobility
Smart
Logistics
Smart
Factory
Smart
Cities
Smart
Entertain-ment
Smart
Health-care
Smart
Building
Home

13. The true significance of IoT is the foundation it
provides for enabling new insights and unlocking
new opportunities.

14. From Information Technology
to
Operational Technology
IT
Servers,
Applications,
Systems
OT
Devices,
Telemetry,
Command &
Control
Data-Driven Insight + Action at a Distance

15. Data Driven Insight + Action at a Distance
Data –> Information –> Insight ($+)
• Make more efficient use of
resources
• Provide more targeted products
and services
• Discover patterns, trends that lead
to new business insights
© Copyright 2014, Neudesic. All rights reserved.
Action at a Distance
• Acting on Data Insights (Real-
Time and At Rest)
• The ability to act remotely –
automatically and intelligently
• Remote control is a source of
efficiency
• Enables new forms of customer
interaction and engagement
15

16. Manufacturing: Consumer PRM
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16
Insight
• Mineralization reads
• # of daily work cycles
• Flavor trends
Action
• Request permission to
conduct descaling task
• Upsell to more robust model
• New alliances, e-coupons,
etc.

17. Transportation : Smart Parking
© Copyright 2014, Neudesic. All rights reserved.
17
Insight
• Vehicle ingress/egress from
parking spot
• Meter payment
• Meter expiry
Action
• Dynamic pricing adjustment
based on parking saturation
• Extending meter time
remotely via smart phone
• Directed enforcement of
ticketing

18. Retail: Product Placement
© Copyright 2014, Neudesic. All rights reserved.
18
Insight
• iBeacon signatures
• Area/isle/product interaction
• * Not just opt-in!
Action
• Triangulation
• Customer Experience
• Product placement

19. Healthcare: Patient PRM – Home Blood Pressure Kit
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19
Insight
• # of BP checks compared
to protocol
• High/Low blood pressure
readings
• Food Journaling
• Dangerously high or low BP
Action
• Reminder of importance to
follow prescribed protocol
• Call from care team to follow
up
• Correlation of food choices
• Dispatch 911

20. Healthcare: Supply Chain Management
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20
Insight
• # of suture packs on hand
• Rate of use
• Expiration
Action
• Automatically submit PO for
resupply
• Correlate peaks to match
future orders
• Identify and prohibit use of
expired sutures

21. Healthcare: Equipment Location
© Copyright 2014, Neudesic. All rights reserved.
21
Insight
• Location signatures
• Disposition
• Reservation Status
Action
• Quickly identify floor, room
of Mayo Stands
• Determine if in use or
available
• Proactively and predictably
schedule use of stands
based on patient
schedules

22. IoT Device Taxonomy
Large
Mobile
Small
Micro
© Copyright 2014, Neudesic. All rights reserved.
POS terminal, ATM, MRI
x86, PC-like, apps
Industry handheld, POS tablet
ARM and x86, shell experience, apps
Gateways, wearables, panels, cars
ARM and x86, diverse hardware, no shell
Controllers, fixed-use, sensors, actuators
ARM, constrained hardware, headless

23. Intel Galileo
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24. Netduino Plus 2
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25. 5mm 5mm

26. Various Protocols
UDI SMS
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2G
Wi-
Fi
RFID
3G
LTE
Wi
Max
Custom
ZigBee
NFC
TCP
UDP
BLE
AMQP
MQTT
CoAP
HTTP
…

27. Message Types
Telemetry Inquires Commands Notifications
Voluntary
information
flow from
device to
another
system.
© Copyright 2014, Neudesic. All rights reserved.
Requests for
information
from device to
other systems.
Instructions
from other
systems to a
device.
Information
flow from other
systems to the
device.

28. Pain Points
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29. Ensure/verify the device and
command source is who it
says it is

30. Ensure data is safe from
tampering both in-transit from
device to device as well as at-rest.

31. Modern, scalable, elastic
connectivity capable of
keeping up with demand today
and tomorrow.

32. Valuable insights from data
being produced at a rate that
could only be imagined just 5
years ago.

33. Service Assisted Communications
• Devices connect via open standard protocols
• AMQP 1.0 and HTTP supported natively by the Service Bus
• MQTT, CoAP and others can be implemented via custom gateway/adapter model
• Sockets secured via TLS (or a lightweight variant)
• Each device has a dedicated Inbox/Outbox on the Gateway
• Device sends telemetry/alerts and routes service invocations via its Outbox
• Device receives commands and queries from its Inbox
• Correlated request/reply patterns can be implemented on top of these two messaging channels
• The device knows, and has access to, only its own specific inbox/outbox endpoints (URI’s)
Backend
Components
© Copyright 2014, Neudesic. All rights reserved.
Cloud Gateway
Outbox
Inbox
Command API
Protocol Head

34. Service-Assisted Communications
DNS
myapp.cloudapp.net
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Connections are
device-initiated and
outbound
NAT/Firewall
Device (Router)
IP NAT
Cloud
Gateway
Command
Source
Port mapping is
automatic,
outbound
Device does not
listen for unsolicited
traffic
No inbound ports
open, attack surface
is minimized
Access-controlled
command API
Secure, managed
hosting platform

35. IoT Cloud Platform “Stack” – Abstract Model
Non-IP
Capable
Devices
IP
Capable
Devices
A B C D E F
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Cloud Gateway
Custom
Code
Cloud Platform
Services
Third-Party Data
and Services
Enterprise
Systems
Field
Gateway

36. Azure Hosting Options
Non-IP
Capable
Devices
IP
Capable
Devices
A B C D E F
© Copyright 2014, Neudesic. All rights reserved.
Cloud Gateway
Custom
Code
Cloud Platform
Services
Third-Party Data
and Services
Enterprise
Systems
Web Sites
Mobile Services Cloud Services
External Code
VM Roles
Field
Gateway

37. Azure Platform Services
Non-IP
Capable
Devices
IP
Capable
Devices
© Copyright 2014, Neudesic. All rights reserved.
A B C D E F
Cloud Gateway
Custom
Code
Cloud Platform
Services
Third-Party Data
and Services
Enterprise
Systems
HD Insight
Azure
Databases
Table/Blob
Storage
Service Bus
BizTalk Services
Field
Gateway
Media Services

38. Azure – IoT Cloud Gateway
Non-IP
Capable
Devices
IP
Capable
Devices
© Copyright 2014, Neudesic. All rights reserved.
A B C D E F
Cloud Gateway
Custo
m
Code
Cloud Platform
Services
Third-Party Data
and Services
Enterprise
Systems
Field
Gateway
Pattern 1: Device Direct Pattern 2: Custom Gateway
Service Bus
A/
B
Service Bus
A/
B
Custom
GW Role

39. Microsoft Azure Stack for IoT
Device
Device
Event
Hub Azure
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Event
Processing
Azure
Storage
Azure
3rd Party Solutions
Customer Apps
HDInsights
BI Systems
Data Flow
Event
Hub
SQL
Azure
Basic
Device
Registry
Command & Control

40. Intelligent Systems Service
Device
Device
Event
Hub Azure
Natural
Language Query
ISS Solution
ISS
Agents
ISS
Agents
Rich Device Registry & Object Model of “Things”
© Copyright 2014, Neudesic. All rights reserved.
Event
Processing
Azure
Storage
Azure
3rd Party Solutions
Customer Apps
HDInsights
BI Systems
Data Flow
Event
Hub
SQL
Azure
Basic
Device
Registry
ISS Security,
Privacy &
Sharing Controls
Command & Control
IoT Rule
Templates
ISS
Agents
Single Account, Per device Billing,
etc.
ISS
Portal
ISS

41. Dr. Schmuland, Chief Health Strategy Officer US
Health & Life Sciences
Real-World IoT in Healthcare