Medical IoT: Connecting Telemedicine and Patient Monitoring Devices

· 9 min read
9 min read
Sophie Durand
Sophie Durand
Technical Content Writer

Telemedicine and remote patient monitoring rely on an invisible yet critical prerequisite: reliable, secure, and 24/7 connectivity. Here are the technical requirements specific to the healthcare sector and how to address them.

The Context of Medical Connectivity in France​

Widespread Deployment of Video Surveillance​

Since the decree of April 14, 2022, remote medical monitoring has been covered by health insurance for several chronic conditions:

  • Heart failure
  • Diabetes
  • Chronic kidney disease
  • COPD (respiratory failure)
  • Refractory hypertension

This regulatory framework has accelerated the deployment of connected devices in homes and healthcare facilities.

Devices covered:

  • Smart scales (for monitoring weight in heart failure)
  • Pulse oximeters (SpO2 saturation and heart rate)
  • Connected blood pressure monitors
  • Spirometers (lung capacity for COPD)
  • ECG monitors (remote Holter monitoring)
  • Insulin pumps and blood glucose sensors

Specific Constraints in the Medical Field​

Medical IoT is not the same as industrial IoT. The additional constraints are:

ConstraintRequirement
Health dataMandatory use of an HDS (Health Data Host)
AvailabilityCritical — one outage = missing data → patient risk
SecurityEnhanced GDPR compliance (sensitive data), access logging
InteroperabilityHL7 FHIR and DICOM standards for certain devices
ValidationClass I/IIa medical device → CE marking

Connectivity Architecture for Remote Monitoring​

Case 1: Patient Devices for Home Use​

Most patient remote monitoring devices today use Bluetooth to connect to a hub (such as a smartphone or medical device), and then the Internet to connect to the platform:

Problem: Patient's smartphone dependency

  • Patient forgets to charge the phone → no data
  • Patient switches carriers → possible service interruption
  • Smartphone is turned off or too far away → Bluetooth down

Dedicated gateway solution: For high-risk patients, a dedicated medical gateway (similar to a medical box) provides connectivity independent of the patient:

Case 2: Equipment in Nursing Homes and Rehabilitation Facilities​

Healthcare facilities (nursing homes, post-acute care and rehabilitation centers) are deploying connected devices in dozens or hundreds of rooms:

Case 3: Mobile medical units (SMUR vehicles, ambulances)​

Mobile healthcare vehicles require robust connectivity while on the move:

Onboard equipment:
  - Defibrillator Monitor (12-lead ECG, NIBP, SpO2, EtCO2)
  - Infusion Pump
  - Ventilateur de transport

Contraintes :
  → 4G connectivity while on the move (frequent handovers)
  → Seamless VPN reconnection during cell handoffs
  → Real-time ECG transmission to emergency medical services or the cardiology department
  
Solution : OpenVPN (reconnexion < 2s lors des handovers)

Medical Data Security: HDS Requirements​

Health Data Hosting​

Any personal health data collected via medical IoT devices must be hosted by a certified Health Data Host:

Obligations HDS (Certification ISO 27001 + HDS) :
  ✓ Data is stored in France (or the EU in some cases)
  ✓ Tracked and Audited Access Control
  ✓ Encryption at Rest and in Transit
  ✓ Documented and tested PCA/PRA
  ✓ HDS Contract with the Client (Healthcare Facility)

Eziwan routes the collected health data to certified HDS hosting partners—the data does not pass through uncertified infrastructure.

End-to-end encryption​

Data is encrypted starting at the gateway and is never transmitted in plain text over the LTE network. Keys are renewed every 24 hours · TLS certificates are automatically renewed (Let's Encrypt / private AC).

Service Continuity: Medical Criticality​

Dual SIM for Medical Applications​

In a medical setting, a loss of connectivity can affect patient care. The Dual SIM configuration is particularly important:

ConfigurationEstimated AvailabilityRecommended Use
Single SIM99.5%Non-urgent monitoring
Dual SIM (Orange + Bouygues)99.92%Continuous monitoring
Dual SIM + store-and-forward99.99%*Mission-critical applications

*Store-and-forward: Data is stored locally during an outage and transmitted as soon as connectivity is restored. No data is lost, even during a prolonged outage.

Store-and-forward for Data Continuity​

# Configuration store-and-forward Eziwan
buffer:
  local_storage: 72h    # 72 hours of local data
  format: sqlite        # Encrypted local database
  
retry:
  interval: 30s
  max_attempts: unlimited
  on_reconnect: transmit_buffered_first
  
# En cas de coupure 4G :
#   → Locally stored data (encrypted)
#   → Upon reconnection: buffer transmission takes priority
#   → No data loss during a power outage lasting up to 72 hours

Regulatory Compliance: GDPR and Medical Devices​

Software-as-a-Medical-Device (SaMD)​

If your medical IoT solution makes decisions to aid in diagnosis or treatment, it may be classified as a Software as a Medical Device (SaMD) and requires CE marking in accordance with Regulation (EU) 2017/745 (MDR).

An IoT gateway that provides connectivity only (data collection and transmission) is generally not a SaMD—it is an accessory or a component. Check with a notified body based on your specific use case.

Access Logs (GDPR)​

All access to health data must be logged:

GDPR Access Log — Required format:

2025-09-16 14:22:11  Access  Dr. Martin (practitioner)  Patient #4521  SpO2 Data
2025-09-16 14:22:11  Access  Dr. Martin               Patient #4521  History 7d
2025-09-16 15:01:44  Access  Nurse Dupont         Patient #4521  SpO2 alert

Export available for exercising the right of access (GDPR Art. 15)
Retention period: at least 5 years (CNIL health recommendation)

View Eziwan's security certifications → · Discuss your remote monitoring project →

Case Study: Remote Monitoring for Heart Failure​

IC Telemonitoring Program Implemented for 150 Patients:

Equipment: smart scale + low-pressure blood pressure monitor → IoT medical hub (Dual SIM)

Data collected: daily weight, morning and evening blood pressure, heart rate

Alert Rules:

If weight increases by +2 kg in 48 hours → Notify the coordinating physician
If systolic blood pressure > 180 mmHg → Immediately notify the referring cardiologist
If HR > 120 bpm at rest → Notify the coordinating nurse
If data is missing for more than 2 days → Call from the coordinator

12-Month Results:

  • Data collection rate: 97.8%
  • Hospitalizations avoided (vs. historical cohort): 23%
  • Patient satisfaction: 89% "feel safer at home"

Conclusion​

Medical IoT connectivity is not just standard IoT with a "healthcare veneer." It requires carrier-grade reliability (Dual SIM, store-and-forward), enhanced security (HDS, GDPR, end-to-end encryption), and full traceability of access.

The good news is that these requirements can be met technically using industrial LTE gateways configured for the medical sector—without the need for complex dedicated infrastructure.

The stakes are high: for every patient receiving remote care, connectivity is not just an afterthought—it is an integral part of the care continuum.

FAQ​

Is 4G connectivity reliable for medical devices that monitor vital signs? For non-critical telemedicine (home monitoring, teleconsultations, monitoring of vital parameters such as HbA1c or blood pressure), 4G LTE with Dual SIM is sufficient. It is not suitable for life-critical devices requiring action within milliseconds (defibrillators, ventilators in the ICU). The decisive factor is the acceptable delay between an anomaly and an alert: if this delay is a few seconds to a few minutes, 4G is reliable.

What certifications are required for the connectivity of medical equipment? For connected medical devices (MDs) in France: CE-MDR (Medical Device Regulation) certification, HDS certification for health data hosting, and GDPR compliance for personal data. The connectivity gateway itself is generally not a medical device (it transmits data but does not make medical decisions), but its integration into the healthcare chain must be validated in the MD’s technical dossier.

Does store-and-forward work if the 4G connection is down overnight? Yes. The Eziwan gateway stores the data locally on its internal memory (SD card) during the outage and automatically transmits it once connectivity is restored. The local retention period varies by model (from a few hours to several days) and can be configured based on the collection frequency and data size.

Further Reading​

Learn more about Eziwan's medical IoT solution → · Schedule a meeting with our team →

Additional Resources​