5G in healthcare

How the new wireless standard can connect

a post-COVID healthcare ecosystem
Executive summary

In a hospital ward in Wuhan, China — at the peak of the COVID-19 pandemic in the city that was the
epicenter for the global outbreak — 12 robots glided across the floor. Their primary tasks: taking patient
temperatures, delivering meals and disinfecting the facility. More than just an advance in automation,
these robots were saving lives. Ill patients received much-needed attention, and healthcare workers were
afforded distance from the contagion and a safer ward to work in.

Easily lost in the details of the story of this eye-popping, unique healthcare automation is the
telecommunications breakthrough that made it possible; namely, a 5G network, the next generation of
wireless communication technology. Without the significant speed, reliability and quality of 5G, managing
a fleet of robots to do such intricate chores would be out of the question.

But perhaps more important, this innovation hints at the ways 5G networks could transform — and
improve
— all of the critical components of healthcare, a subject especially meaningful today as the spread of
the coronavirus has put unprecedented stress on healthcare systems around the world. 5G’s features
could prove valuable in many areas of healthcare, including telehealth, remote surgery, transferring large
medical files, tracking patient movements inside facilities, using wearable devices for real-time monitoring,
and delivering continual treatment information and support to patients. In short, 5G promises to provide
essential levels of connectivity to enable a new health ecosystem — one that can meet patient and provider
needs accurately, efficiently, conveniently, cost-effectively and at substantial scale.

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5G’s remote
possibilities
The potential of 5G springs from the fact that its technical attributes
represent a quantum leap forward from its predecessor, 4G. 5G is
capable of achieving speeds approximately 100 times faster than 4G’s
while also handling vastly more connections. And these advantages are
strengthened by ultra-low latency, the time it takes for the network to
process a request.

In assessing the impact that 5G could have on healthcare, it’s important to keep expectations in check.
For one thing, widespread implementation of 5G is still some ways off. Although there are pockets of 5G
installations by telecom companies in all of the largest countries, the availability is generally limited to
small cell zones in urban areas. Extensive deployment is not expected until about 2025 in many developed
markets. In addition, broad consumer acceptance of 5G applications like wearable medical devices and
telemedicine is unlikely to occur in the next few years, though the COVID-19 pandemic has probably
accelerated this timeline significantly. And with how sensitive and confidential medical data is, concerns
about security and privacy are already being raised about healthcare records being transferred across
enormous, often global public networks.

In the context of the COVID-19 pandemic, much attention has focused on 5G’s potential to support
telehealth services, or doctor’s visits conducted via computer, which are helpful when physical distancing
is required or when patients are located far from healthcare facilities. Basic, one-on-one, low-touch
sessions are already feasible over existing 4G and fixed broadband infrastructure. But 5G offers the
potential of moving these interactions a big step forward by, for example, adding sensors and virtual

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 reality to teleconferencing, enabling healthcare workers to remotely monitor vital signs during calls. In
addition, because 5G can transmit sizeable data packages, testing patients with conditions for changes in
their heartbeat, blood sugar and blood pressure multiple times a day using cloud-linked scanners is also
possible. These advances, in turn, would unlock more insights into the day-to-day health of patients.

As in other sectors, including transport, manufacturing and retail, combining and integrating 5G with a
wide array of other advanced technologies — AI, the Internet of Things (IoT), the cloud, big data analytics,
geolocation sensors, real-time monitors — is essential for healthcare to apply the full potential of 5G.

5G’s technology specs far surpass those of other wireless protocols

Real-time high-capacity,
low-latency applications

Feature Description Wi-Fi6 4G 5G

Latency Delay between the sender and receiver of the 20 milliseconds 30–50 ms 1–10 ms
data — the lower the latency, the more ‘real (ms)
time’ the experience of the event

Reliability/availability How efficient the network is in transporting 99.99% 99.99% 99.99%

data between the source and destination
without packet loss

Throughput Theoretical maximum amount of data moved 9.6 Gbps 300 Mbps– 10 Gbps
from one place to another in a given period 1 Gbps

Speed (project driven) Expected practical speeds per user or device 1 Gbps 20–50 Up to
Mbps 1 Gbps

Connection density Number of connected devices per unit area 8 per part 12 per part 100 per part

Energy Comparative power consumption levels Medium High Medium

Source: PwC

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5G’s impact on the
healthcare value chain

The benefits of 5G will be felt differently by each of the key participants

in the healthcare value chain: providers, payers and pharmaceutical
companies. But on the whole, 5G networks hold out the promise of
major improvements in efficiency and outcomes, positive results that
ultimately feed through to patients.

Providers

The onset of the COVID-19 crisis exposed a flaw in the operations of many healthcare providers — including
hospitals and local/regional health authorities — who found themselves at the eye of the storm: manual
inventories of devices. As the anticipated need for ventilators and other emergency devices grew, hospitals
were scrambling to figure out whether they would have sufficient equipment to deal with the expected crush
of seriously ill patients. In many cases, device inventories were not electronically tagged, and manually
maintained lists were ragged at best. Hospitals have generally resisted sophisticated inventory monitoring
systems because their tight profit margins make them loath to earmark expenditures for new computer
systems and training that could upgrade efficiency but not generate a tangible return on investment.

But 5G could do much more than just track equipment. 5G-enabled devices could also monitor vital
variables such as bed occupancy levels, as well as the movement of people — physicians, nurses, patients
— around the hospital. These insights could then be integrated into the hospital’s electronic medical
records (EMR) system, making it possible to visualise and manage hospital activities with unprecedented
clarity and granularity. The resulting visibility would provide the basis for highly effective operational
improvement initiatives.

In perhaps a more futuristic vein, 5G technology could change the face of how providers deliver medical
care and alter the relationships between patients and doctors. Telehealth, which we are just beginning to

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Expanding the use of wearable monitoring equipment to, for instance,
more diabetics or patients at risk for cardiac issues could save lives
and cut payer outlays significantly.

harness, will in time be routine. And it will be amplified by the use of wearables. Remote monitoring via
wearables, 5G networks and cloud analysis and processing has been termed the ‘Internet of the body.’

A further 5G opportunity for providers is so-called remote operations. Although video demonstrations of
surgical techniques and broadcasts of operations via fast-speed 5G networks are already viable, the real
breakthrough will come with the emergence of the ‘tactile Internet.’ Enabled by the ultra-low latency of
5G, the tactile Internet would enable a physician to perform a procedure on a patient who is in a different
location. The surgeon’s movements at one site would be recreated instantaneously by computerised
equipment at the other site, an innovation that could particularly benefit patients in rural areas or smaller
regions, where surgeons specialising in complex procedures may not be readily available.

Payers

5G-networked wearables can also be a boon for healthcare payers — whether they are a private insurance
company or a government. Payers have large financial incentives to keep their individual clients healthy
and to catch medical emergencies early so they can be treated before the situation requires outsized and
expensive diagnostic tests and treatments. Expanding the use of wearable monitoring equipment to, for
instance, more diabetics or patients at risk for cardiac issues could save lives, improve the health of the
general population and cut payer outlays significantly. As the price of setting up 5G connectivity declines,
it will become feasible for health plans to provide monitoring devices to every policyholder whose health
outcomes (and costs) could be improved by such equipment.

Payers will also benefit from the substantially increased speed and bandwidth available on 5G networks,
compared to current telecommunications systems, inasmuch as these capabilities enhance the treatments
that physicians can employ — leading to better patient outcomes. For instance, in many cases, MRI scans
and other critical images must be sent to a specialist for review, a transmission that can take a long time or
even fail if the network is not equipped to handle large files the way 5G can. As a result, diagnoses could
be slowed and compromised and treatment delayed, ultimately adding significant costs to the physician–
patient interaction that will be borne by the payer.

Similarly, 5G can enable advanced technology-assisted treatments that have been shown to improve
outcomes and potentially lower costs associated with individual cases. One illustration: augmented
reality (AR), virtual reality (VR), AI and robotic equipment linked to large databases and sensors can aid in
complex operations by offering surgeons visibility that they may not have otherwise and by recommending
procedural steps based on the latest accumulated medical knowledge.

Pharmaceutical companies

Clinical trials greatly depend on a constant flow of data detailing patients’ responses to the therapies under
investigation. In some cases, the participants in the trial take their own vital signs every day and self-report
them via a website. In others, they go into a doctor’s office or hospital for diagnostics.

5G infrastructure and connectivity may now provide drug manufacturers with the incentive and opportunity
to place IoT-connected monitoring devices in the participants’ homes during clinical trials. This would
reduce administrative overhead and processing costs, in turn bringing down the price of each trial and
enabling pharma companies to trial more drugs each year. And the availability of the data in real time might
shorten the cycle time of a trial from, say, eight months to six, meaning the company can get the drugs to
market faster or more quickly halt trials that aren’t working.

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A new
health ecosystem

As use of 5G in healthcare increases, with its applications boosted

by advances in robotics, IoT and AI, a new connected healthcare
ecosystem will take shape. In our view, this ecosystem will align with
a relatively recent idea known as 4P medicine — that is, it will be
predictive, preventative, personalised and participatory.

Predictive

Equipped with a constant flow of instantaneous data on patients’ vital signs and relevant alerts, blended
with information on lifestyle behaviors and social factors, the new health ecosystem will be better able to
predict risks to patients. Simultaneously, it will furnish healthcare providers with early warnings of patients’
problems. In turn, physicians and nurses can use these insights to intervene or respond effectively before
the problem escalates. Although 5G won’t be central to the predictive process itself, it will underpin the
ubiquitous connectivity and scale of the ecosystem that collects, analyses and shares the data.

Preventative

Being predictive boosts the ability to take preventative action. An apt example — especially relevant in
the context of the COVID-19 outbreak — is the ability to track and trace with unprecedented accuracy
the location and proximity of vast numbers of people using smartphone apps, as evidenced in South
Korea. During a contagion, this geolocation data can be combined with diagnostic profiles and ongoing
testing results to pinpoint factors like who is most at risk and who may be unwittingly passing an as-yet
asymptomatic illness on to other people. Individualised alerts and interventions to stifle the spread of the
outbreak can then be initiated.

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Personalised

The combination of constant real-time health monitoring over 5G networks will provide substantial
opportunities for personalising people’s healthcare experiences and interventions. Care providers can use
the tactile Internet, for example, for remote examinations of patients who are unable to get to a large clinical
facility that specializes in their condition. In addition, well-being advice can also be tailored and delivered to
the individual, confidentially, at a population-wide scale.

Participatory

In the 5G-enabled health ecosystem, patients will become less passive consumers of healthcare and more
engaged participants in driving their own outcomes. Currently, the average patient in the US spends about
15 hours a year with a healthcare provider, but has more than 5,000 waking hours to care for themselves.
By ‘activating’ some of those 5,000 hours — that is, taking independent actions to manage their well-
being, diagnostics and treatments — patients can improve their quality of life and medical outcomes and,
at the same time, reduce overall costs in the healthcare system. One study found that after controlling for
demographics and health status, an activated patient costs US$1,987 less annually than a less activated
patient, a 31% difference.

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The privacy
challenge

To realise the full potential of 5G networks in healthcare settings,

network security and data privacy are paramount. Nothing is more
sensitive than an individual’s medical records. And in order for patients
and participants in the healthcare value chain to freely use, without
fear of data theft, advanced communications programs for healthcare
interactions and activities, the 5G networks that serve as the backbone
must be protected from cyber intruders.

In our view, there are three prongs to a robust and effective cybersecurity and privacy strategy for 5G
networks used in healthcare:

Zero-trust approach. There should be a robust security posture from end to end for all devices and
software on a 5G network. Each device and application must be assessed for cyber risk and allowed
access to network resources only if they meet high security standards. Also, all software must be
constantly checked for vulnerabilities and malware. Permission to view the most sensitive patient data
should be reserved for limited communications nodes, and these connections must be continually and
rigorously tested for potential security gaps.

Universal encryption. To minimise the risk of data being compromised or corrupted, telecom operators
and other 5G participants should adopt strong encryption methods for traffic between endpoints and
services. These methods should be flexible enough to be strengthened progressively over time as
standards and risks evolve. And they should be sufficiently agile to thwart ‘man in the middle’ attacks,
in which hackers eavesdrop on communications between two network participants who believe they’re
communicating directly with each other.

Orchestration by AI. Machine learning and AI should play a big role in identifying and mitigating mutable
cyber risks, providing high levels of automated intelligence to manage and root out security intrusions

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Government regulators and policymakers must develop rules and
provide oversight to protect patient privacy as 5G in healthcare
expands.

across hyper-dense communications and ultra-low latency applications. These technologies can be
counted on for traffic analysis, network packet inspections, threat identification and infection isolation.

Government regulators and policymakers must also develop rules and provide oversight to protect patient
privacy as 5G in healthcare expands. These measures should be designed to enable interoperability and
the expansion of communications networks, programs, applications and devices while ensuring end-to-end
security and data privacy for sensitive information. There should be rigid privacy standards for connected
medical devices, data processing equipment and activities and always-on networks that give end users
control over the data generated, stored and communicated by 5G-driven equipment and networks.

Defined parameters for testing all new equipment and software for cyber threats and privacy vulnerabilities
in real-life healthcare use cases should also be established. Moreover, periodic revision of the data-security
testing and approval regime for technologies that are still evolving, such as medical applications of the
cloud, AI, sensors and the IoT, should be undertaken to guard against privacy gaps arising during the
development of new platforms and devices.

ADAPT

Although this paper focuses on advancing telecommunications

technology primarily in a post-COVID environment, it’s our view
that similar transformations are occurring in commercial, economic,
fiscal and monetary policy writ large. Broadly speaking, the virus is
both accelerating powerful existing trends, such as automation and
inequality, and slamming the brakes on trends that had, until very
recently, possessed tremendous momentum, such as globalisation.
PwC has developed an ADAPT framework — addressing economic
asymmetry, technological disruption, population age, political
polarisation and trust in
institutions — for companies,
technologists, government and
organisations to deal with this
rapidly changing landscape.
For more on this, see
Adapting to a new world:
Facing the challenges of the
post-
COVID-19 landscape.

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Conclusion:
The 5G future

5G could help transform healthcare, providing networking reliability, speed and scale that advance
medicine, patient services, treatments and wellness programs in significant ways, as we’ve seen in the
examples described above. But with so many new ideas floating around this topic these days, especially
as a pandemic reminds us of how impotent and fragile our healthcare systems can be in the face of natural
disasters, we believe that healthcare companies and healthcare technology providers should determine
the soundness of their proposed 5G applications by testing to see if they would be markedly improved by
any of the three primary advantages of these networks: ultra-fast broadband, ultra-low latency and massive
machine connectivity.

Overall, the message is clear. By combining 5G with other leading-edge technologies, we can create
the opportunity to transform many aspects of patient care, while catalysing the emergence of a new
healthcare ecosystem — one that will be more connected, more intelligent and more efficient in its use of
resources than the current systems. There are still many hurdles to overcome — institutional, cultural and
technological — before 5G networks will be commonplace in healthcare. But the success of 5G-enabled
applications will most likely depend upon taking into account what patients (who are really the center of the
healthcare ecosystem, new or old) need most and want.

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Contacts

Wilson Chow
Global Technology, Media and Telecommunications Leader
Partner, PwC China
+86 755 8261 8886
[email protected]

Kelly Barnes
Global Health Industries Leader
Partner, PwC US
+1 214 754 5172
[email protected]

Rolf Meakin
PwC Global Telecommunications Advisory Leader
Partner, PwC UK
+44 7801 247667
[email protected]

Kai Lakhdar, PhD

Partner, PwC Canada
+1-416-941-8383, ext. 18705
[email protected]

William Perry
Principal, PwC US
+1 678 613 8484
[email protected]

Chris Bartlett
Partner, PwC Australia
+61 414 835 935
[email protected]
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