There’s no scientific evidence linking the emergence of fifth-generation wireless technologies to COVID-19 or cancer, the Veterans Affairs Department’s Dr. Ryan Vega confirmed Tuesday.
But that doesn’t mean there aren’t other risks as 5G comes to fruition inside America’s hospitals. So, as an early federal adopter, VA is proceeding thoughtfully, he said, to ensure the heaps of new attack vectors that come with it don’t put patients in harm’s way.
“I think we’re going to see more impact on actually how we experience health care, with little concern to our own individual health,” Vega told Nextgov at the first session of Government Executive Media Group’s 5G Futures series.
As the VA’s chief officer for health care innovation and learning, Vega has a front seat view to the department’s three ongoing 5G-centered deployments. He provided new context on those, combatted some health-related falsehoods surrounding the evolving technology—and teased fresh pursuits surfacing on the department’s horizon.
Exploring the Possibilities
The VA’s 5G journey kicked off early last year, with the launch of Project Convergence at its Palo Alto Healthcare System in California. Through that effort, a Verizon-made 5G network underpins officials’ experimentation with clinically relevant products and applications from Microsoft and Medivis. Even from the earliest days, Vega emphasized, efforts have been made to guarantee the pursuit is not technology-centric.
“We really want to build a veteran-centric health system, and ensure that their experience, their outcomes, are front and center. So the technology will enable us to get there, but it’s about putting them front and center,” Vega said. “And then equally, [for] our clinicians—making sure that we’re developing solutions and workflows that fit into their daily practice.”
Situated in a prominent U.S. tech hub, Palo Alto made sense for the initial rollout for a number of reasons, according to Vega. For instance, VA really aimed to interrogate 5G use cases around augmented and virtual reality for things like surgical navigation. “So, being able to take an MRI and actually layer it over the patient … and the way we imagine it, a surgeon being able to see below the surface before they ever make a cut,” he explained. “A lot of the technology, the hardware, that will enable that software to work comes from Silicon Valley.”
Not to be curbed by the pandemic, VA announced its next foray into 5G early this year, led by its Office of Information Technology. Through it, the department’s footprint was extended to its Seattle-based Puget Sound Health Care System. That deployment is unfolding with AT&T, and it marks the first time 5G will be made available across the entirety of a large VA health care and training facility.
“That particular area is one of our largest catchments. If you look at just the sheer population of veterans, as well as the expansive network—I’m including all the surrounding community-based outpatient clinics—it’s one of the largest catchments of veterans we have in the country,” Vega said, adding that it’s also a future site where the department will roll out its electronic health record modernization effort with Cerner. “If you’re looking at narrowing down a market, that may be an interesting case or a use case, because it has a lot of different moving parts,” he said.
And most recently, the VA’s Center for Strategic Partnerships steered a new collaboration with T-Mobile in 5G experimentation in Miami, Florida. The department’s diversification of partners is deliberate, Vega confirmed.
“Anytime you have an emerging technology, such as 5G—and particularly, what 5G enables—they’re each going to come at it with a different lens,” he explained. “We really want to ensure that we are sort of putting our best foot forward, and really continuing to push that envelope. The best way to do that, we believe, is to partner and to partner extensively and not exclusively.”
Officials involved, and their patients, are already getting a taste of what the next-generation capabilities can offer, like moving massive volumes of data incredibly quickly. Health care imaging data, specifically, came to Vega’s mind.
“Actually being able to pull up a CT scan, or an MRI, with stunning clarity on my cell phone, on my iPhone or my Android—whatever device you use. People may say, ‘Well, so what?’ Well, what we’re learning is that the ability to have these types of data far more accessible is actually promoting collaborations that I think we sort of thought wouldn’t happen,” Vega said. “But now we’re actually seeing them come to light.”
Remote, telesurgery is also an evolving 5G-enabled application that holds a great deal of promise for VA. With such solutions, surgeons on the other side of the world can support and perform complex procedures—without ever physically being in the same room as those being treated. To help paint the picture, Vega spotlighted the experience “a very dear friend” of his had in the trauma unit treating people injured during the Boston Marathon bombing.
“He tells the story of actually them being in the operating room and feeding in surgeons from the battlefield in Iraq and Afghanistan to help them walk through—because what were they seeing for these unfortunate victims? They were seeing blast injuries. And they weren’t really well-trained,” he explained. “And so, while that was sort of a specific use case, you can already see that these types of technologies, as they become more practical I think, particularly in that space, that’s really where it gets exciting.”
Regarding the VA’s near future, Vega was relatively tight-lipped. But he said there’s more in the pipeline for innovation in this realm. Though he couldn’t share much, Vega said to keep an eye for developments in Florida’s Lake Nona area.
“I think the next iteration of what this landscape looks like, from an infrastructure standpoint for VA, is really creating the capability to test and evaluate these emerging technologies in a more simulated world, to better inform what solutions are going to work best for our clinicians and patients,” Vega said. “So, I would stay tuned to that—there’s some things in-the-works.”
No Room for Falsehoods
5G’s promise is coming to light in the shadow of conspiracy theories about the perceived dangers it could pose. The generally baseless claims have disseminated rapidly online amid that pandemic, and have also made their way into American doctors’ offices.
“I’ve heard a lot of the conspiracies. I’ve certainly been asked from patients concerned about cancer risk,” Vega said. “I think one of the things that’s really important is to establish and make sure there’s a clear understanding that the use of these types of devices and technology is regulated by the [Federal Communications Commission].”
He explained the agency recently reaffirmed its position that “based upon thousands of scientific papers” and expert consensus, people will experience levels of radiation that are too low to pose any severe health risk or cause cancer. According to Vega, there is also “just not evidence to support” claims that 5G is connected to the novel coronavirus pandemic.
“I think, you know, these things do come about,” he said. “And it’s our job to combat that information with correct and good information.”
The novel technological capabilities and heightened connection, however, will usher in the need for stronger protections of patients’ private information—and technologies used to help treat them. “The security apparatus around having this many more devices connected with a distributive network is something that a lot of agencies who are thinking of the impacts of 5G further upstream have to be obsessed with,” Vega said. “Because the vulnerability, right—the points of attack, as they call them—are substantially more.”
A standard, interoperable “language” to enable relevant devices to safely communicate without compromising patients’ sensitive health information is needed for more meaningful use. “And we’re still learning a lot about no trust networks, and what that means within the walls of a hospital network optimization,” he noted.
Project Convergence was built on a zero-trust approach, meaning VA must grant permission to anything before it can actually connect. The newer pilots will also shed light on how to optimally secure components of this burgeoning landscape.
“Again, it’s about being patient-centric—put the patient first,” Vega said. “So, there’s security concerns. We have to protect their privacy and their rights, while also figuring out how to best make use of the technology to enable us to deliver better care and service to them.”