Part of An introduction to Internet of Things in health

Appendix A: IoT connectivity considerations

See An introduction to wireless technologies in health for more on the capabilities of these technologies and their broader health care applications.

Wi-Fi considerations

Wi-Fi is the most common wireless connectivity, and Wi-Fi infrastructure is in place with coverage at almost all NHS sites. Below are some key points to consider when planning to implement an IoT solution over a Wi-Fi network.

Wi-Fi bandwidth/speed

Newer generations of Wi-Fi offer significantly faster speeds. Connection speeds for an IoT device will be affected by other factors including physical structures and distance from the access point (AP).

Wi-Fi frequency band

Wi-Fi operates over the 2.4GHz, 5GHz and 6GHz radio frequency bands. Ensure that the Wi-Fi network is configured to support the IoT solution and that the IoT devices can connect to it, particularly if deploying a newer generation such as Wi-Fi 6, 6E or 7.

Range and penetration

Whilst newer generations of Wi-Fi offer improved performance and capabilities over previous versions, it is important to consider the frequency bands the Wi-Fi APs support and how best to configure these for optimal IoT device connectivity. Physical obstacles such as walls and other structures can reflect or absorb Wi-Fi signals and degrade the quality of a connection. Consider the placement of IoT devices in relation to Wi-Fi access points and the frequency band in use.

Interference

Other electronic devices and radio frequency signals operate in the same frequency band as Wi-Fi and can degrade or disrupt the signal. This is of particular concern where a large number of IoT devices connect to a Wi-Fi network that is already highly utilised for other services. Configure other Wi-Fi networks and IoT devices (for example, Bluetooth) operating in the same vicinity for optimal performance and availability.

Energy/power usage

While wireless network access points are often more energy efficient than wired network hardware, Wi-Fi networks can require many such devices within a single location.

Wi-Fi generations

Newer Wi-Fi generations (Wi-Fi 6, 6e, 7) generally support more devices than older generations (Wi-Fi 5, 4, 3) and IoT solutions may employ many (more than 100) devices. Adding a significant number of IoT devices to a Wi-Fi network may cause congestion and impact network performance so it is important to consider the anticipated bandwidth demand of the new IoT devices and ensure that they are compatible with the Wi-Fi generation you are using.

For more on Wi-Fi see An introduction to Wi-Fi guidance (FutureNHS account required).

Bluetooth and Bluetooth Low Energy (BLE) considerations

Bluetooth is a short-range wireless technology standard that is used for exchanging data between fixed and mobile devices over short distances.

BLE is a wireless personal area network technology aimed at novel applications in the healthcare, fitness, beacons, security and home entertainment industries. It is independent of classic Bluetooth and has no compatibility.

The range that Bluetooth can connect devices at has increased over time but is still limited to approximately 10 meters. Developments have improved the number of devices that can concurrently connect to a single Bluetooth service, but again it is still common for connection to allow just one device.
BLE is typically capable of around 50 metres though again can reach greater distances. In both cases, typical implementations see power consumption limited so that range is generally much shorter, depending upon the requirements of the application.
Most modern Wi-Fi access points have built-in BLE radio capabilities. This enables the device to provide connectivity for IoT devices that use BLE, as well as providing the Wi-Fi network, which enables:
- simplified management - the Wi-Fi access point and BLE device can be configured and managed using the same management platform
- reuse existing infrastructure and devices, supporting value for money
Be aware that to use the BLE capabilities you may need to subscribe to or activate a license with the supplier.
Bluetooth Low Energy (BLE) operates within the same frequency range as standard Bluetooth (2.4GHz) but is defined by its minimal power consumption and energy-efficient sleep modes, making it more suitable for communicating with IoT devices.
While standard Bluetooth is very power efficient compared to other wireless standards, BLE cuts power consumption further. BLE devices can run for years on a single coin cell battery.
In terms of data transfer capabilities, standard Bluetooth has a greater maximum speed of approx. 3Mbps compared to BLE which is around 1 Mbps. BLE’s lower data rate supports many IoT use cases where only periodic and/or small amounts of data transmission are required.
For critical and real-time applications, BLE can achieve lower latency (the time delay for a data packet to be transmitted successfully) than standard Bluetooth, enabling more responsive device communication.

These capabilities make Bluetooth and BLE useful connectivity protocols for a number of healthcare applications such as RTLS asset tags, patient monitoring, fitness trackers and health monitors.

Other technologies

Implementing IoT devices leads to an increasing demand on ways to connect to the network. Most of these devices don't need to transfer a lot of information but are expected to be in an 'always on' mode or can 'wake up' when sent a control signal. There are a range of connectivity technologies that can support connecting IoT devices into your wider network.

There are a number of competing connectivity standards that are used for IoT devices, with the most common ones outlined below. As these technologies evolve it is anticipated that the number of competing options will decrease, as the technology moves towards standardisation of capability for the most common use cases and connectivity requirements.

However new technologies may also emerge and supersede the examples listed, so it is recommended to undertake a review of these available technologies and capabilities prior to selecting and implementing any new connectivity.

5G is the fifth-generation standard for cellular network communications. 5G offers much higher bandwidth and lower latency than previous generations and has and has been deployed by mobile phone manufacturers since 2019. Typical range is up to 10 kilometres, with transmission rates of up to 10Gbps.

6LoWPAN

6LoWPAN stands for 'IPv6 over Low-Power Wireless Personal Area Networks'. It is a communication protocol designed to enable a large number of small, low-power devices to connect over wireless networks. 6LoWPAN is capable of an outdoor range of approximately 200 metres and a data rate of up to 200Kbps. Because this uses the IPv6 protocol it can communicate with devices connected to a Wi-Fi network using this protocol.

EnOcean

EnOcean is a wireless standard which operates in the unlicensed 860Mhz range, giving it good in building penetration. One of the benefits of this standard is the way that connected devices are powered. For devices to connect to any wireless network they will need power, and this usually comes in the form of a battery. EnOcean is designed to draw power by 'energy harvesting', where a device can be powered wirelessly or 'harvested' from the EnOcean system. This removes the need for some IoT devices using EnOcean to have their own battery.

However, at present only small amounts of power can be harvested, limiting the complexity and number of devices that can connect without a battery, and limiting the applications of the technology for large scale deployments.

Long Term Evolution - Machine connection (LTE-M)

LTE-M is a type of 4G cellular network specifically designed for IoT. This standard aims to provide low power consumption over a long range, but as an emerging standard there is little consistent information about its exact capabilities.

LTE-M aims to provide a high data transfer rate at the expense of greater power consumption, meaning connected devices can send more complex and greater volumes of data but will use more power. As such, they may need larger batteries or more frequent charging leading to greater costs and maintenance considerations.

Long-Range Wide Area Network (LoRa or LoRaWan)

A type of Low Power Wide Area Network (LPWAN) that uses open-source technology and transmits over unlicensed frequency bands. Designed for IoT, LoRaWAN technology provides a longer range than Wi-Fi or BLE connections, can work indoors and outdoors, and is supports applications in remote or rural areas where mobile networks have poor coverage.

LoRaWan can connect over distances of up to 15 kilometres and uses the unlicensed 868Mhz range in the UK. Its low power consumption means that battery life on devices can be good. LoRaWan’s primary market to date has been for outdoor 'smart' or IoT devices such as smart street lighting and pollution monitoring.

Learn more about the most common applications and use cases for LoRaWan.

Narrow Band Internet of Things (NB-IoT)

A low power wide area network standard designed for IoT devices.

This standard is part of LTE, but works in a very limited, narrow bandwidth range, designed to bridge the gap between mobile data and Wi-Fi. It was designed to be a low-cost solution suitable for inbuilding coverage, with comparably lower power consumption and the ability to connect many devices.

Devices are typically battery powered and have lifespans of up to 10 years. This is enabled by low throughput and devices powering down when not in use. As such this is less suitable for devices that are required to send and receive lots of data frequently.

NB-IoT devices can communicate over distances of up to 10 kilometres with a data transmission rate of up to 250 Kbps. Typical use cases for healthcare include remote and mobile health monitors, and wide geographic asset tracking.

Near Field Communication (NFC)

NFC is a wireless PAN technology that connects 2 compatible devices in very close proximity, to enable slow but reliable data transfer. The technology behind NFC is similar to RFID described earlier.

NFC typically does not require manual pairing or device discovery steps or passwords to connect with a compatible device. Close proximity of around 4 inches or less should allow one NFC device to connect with another. Typical uses of NFC are contactless payments and access control, and in healthcare could be used for authentication.

Radio-frequency identification (RFID)

RFID uses electromagnetic waves to identify and track tags attached to objects. The attached tags, called RFID tags, store digitally encoded data that can be read by an RFID reader.

Passive RFID

Passive RFID is commonly used for such consumer systems as contactless bank cards and door security systems. For RTLS, unpowered tags, usually presented as stickers, are placed on the assets. Auditor users then use handheld recording devices to register the presence of the tag and asset. This requires manual effort to keep the presence and location information up to date and as such does not track asset location in real time. The tags themselves have no power, so do not require batteries, and they operate by RF induction from a reader device, which is powered.

Active RFID

Active RFID is generally held as a more flexible version of passive that provides the same solution. The active asset tags used contain batteries and respond to readers from a longer distance than passive tags (as the reader does not have to power the tag). This reduces the admin overhead and manual scanning to keep the asset information up to date.

The greater scanning distance and the active nature of the tags means that active RFID can be implemented to be part of a mobile asset tracking solution. It is possible to have active RFID readers placed in fixed locations and linked to the wider IT network to supplement a Wi-Fi or BLE based RTLS solution.

SigFox

SigFox is an LPWAN standard designed to support connection of a very high number of devices over long range, up to several miles. SigFox can be seen as a competitor to LoRaWan, with similar design goals but differs in capabilities, availability and bandwidth.

Devices can transmit data over distances of up to 10 kilometres with a data rate of 100bps. Potential use cases for healthcare include asset tracking and environmental sensors.

Thread

Thread is an IPv6-based, low-power mesh networking technology. This standard is for the connection of devices, especially for smart home devices or building management. It is a competitor of ZigBee and is built around Internet Protocol (IP) standards making it easier for device manufacturers to connect than some of the other similar technologies.

As with all privately owned protocols consideration must be given to licensing agreements and interoperability. Devices can transmit over distances of up to 100 feet with a data rate of 250Kbps.

Ultra-wideband (UWB)

UWB is a short-range wireless communication technology that enables extremely precise location tracking. A UWB-enabled device can send and receive data across short distances at very high speeds.

One of the limitations of using radio to transmit data is having to adhere to regulations and standards around use of radio frequency bands. UWB is a newer technology that can use a much wider part of its allocated radio band, and as such suffers less from congestion and interference.

UWB can only be used for short range communications, but it is ideally suited for certain applications, such as asset tracking.

Some modern Wi-Fi access points include UWB capabilities.

Zigbee

Zigbee is a product name for a type of short-range radio network, similar to Bluetooth Low Energy (BLE).

Zigbee has been developed mainly for the connection of 'smart'/IoT devices and as such can support around 65,000 devices, significantly more than the current capability of BLE. It is most commonly seen within home automation networks that smart lights and heating (and other sensors) use, as well as some smart meters.

Last edited: 26 February 2025 10:33 am