Abstract
The market could exceed revenues of US$1 billion by 2015 - but user and patient concerns must be overcome
Telemonitoring technology has been hailed as a major breakthrough in changing
the operating dynamic of health provision. Patient monitoring, observation and
diagnosis, no longer rooted in the consulting room, provides 24- hour
surveillance and timely clinical interventions when conditions deteriorate.
And telemonitoring products are delivering these services across a range of
chronic conditions such as asthma, diabetes and heart disease.
So, what are the issues....?
Telemonitoring is a fledgling market. Most widely adopted in the US and some
European countries, it is still in pilot stage development in the majority of
markets. As with all new technologies, there is a time for bedding in and
evaluating effectiveness in large scale patient populations. While
telemonitoring has been shown from a technical perspective to work, the sector
is dogged by a number of issues which will need resolution if the market is to
fully develop.
This new report from Espicom examines the sector in depth. It looks at the
companies and technologies involved and examines the topical issues such as
cost-effectiveness, patient compliance, technical standards and the need for
more clinical evidence, which are impacting its development.
The report answers key questions
- Which companies have developed multi-functional telemonitoring products
and where are they best applied?
- To what extent is the lack of clinical evidence from trials affecting the
sector?
- To what extent are health providers' concerns for the cost-effectiveness
of telemonitoring true?
- Poor patient compliance: how might this be overcome?
- Who is the leading provider of telemonitoring services to the US Dept of
Veteran Affairs?
- With whom did IDEAL LIFE form an agreement in May 2011 to extend its
product portfolio to include embedded wireless devices?
- What is the role and position of service providers such as AT&T, Google
and Microsoft?
- Which companies are adapting their technologies for viewing through
smartphones and pads?
A complete analysis for evaluating this key emerging medical technology area
The cost-effectiveness claim: a two edged sword
The global economic downturn presents its own challenges and opportunities for
the telemonitoring industry. With the need to address deficits, most countries
have reduced spending on new healthcare projects and healthcare capital
expenditure, meaning there is less money available for the implementation of
new technology. However, at the same time there is a long-term pressure on
healthcare providers to find new, cost-effective ways to manage their patients
and reduce the burden of potentially preventable diseases - two areas where
telemonitoring can help considerably. The key focus is on chronic disease, the
progression of which can often be slowed or even reversed with proper care and
management, before the patient requires more expensive medical care.
Claim and counter claim - the debate develops
In September 2011, an article, entitled “Integrated Telehealth and Care
Management Program for Medicare Beneficiaries with Chronic Disease Linked to
Savings”, was published in the healthcare policy journal, Health
Affairs. The study looked at the economic impact of using remote patient
monitoring for high-cost Medicare beneficiaries with CHF, COPD and/or
diabetes. Bosch's Health Buddy telemonitoring programme was associated with
spending reductions of approximately 7.7 to 13.3% (US$312 to US$542) per
intervention patient per quarter over the two-year period studied.
Conversely, two larger, randomised studies of telemonitoring for HF patients
published in 2010 did not show clinical or cost-effectiveness for
telemonitoring over their entire study groups, while a 2011 study of children
with asthma found no improvement in their clinical outcomes with
telemonitoring.
The Role of Patients
Current telemonitoring technology is reliant on the patient's ability to use
the technology and discipline to take the home measurements. Poor patient
compliance is not a telemonitoring issue - it affects many areas of health
care - but the selection of patients for whom the technology is suitable may,
in the short-term, limit the patient population for whom it will be effective.
Easy-to-use technology which includes motivational tools and feeds back
information to the patient are valuable to the technology adopters. In the
future, the automation of monitoring through implants, for example, will
remove the inconvenience factor and improve compliance.
Emerging markets - leap-frogging the technology gap?
Chronic disease may be seen as mainly a problem for developed countries, but
the WHO estimates that only 20% of cases of chronic disease occur in high
income countries. In most countries, the poorest people are the most at risk
of developing chronic respiratory diseases and are also most likely to die
prematurely from these diseases because of their greater exposure to risks and
decreased access to health services.
Telemonitoring may help to enable providers to offer remote healthcare to
patients living in rural areas or where there is little healthcare
infrastructure. This is particularly the case with mHealth, as the use of
mobile communications is ncreasing rapidly in the developing world and
emerging markets, although not all have access to the advanced technology
required for telemonitoring.
Indeed, some observers argue that for regions with poor terrain or limited
health infrastructure, telemonitoring may find a niche as the principal means
of practically managing patients.
Unintended consequences...
There are clinical concerns that in some situations the analysis of
telemonitoring results meant that some patients were being over-treated for
their condition.
For example, a 2008 pilot study of the telemonitoring of 27 COPD patients by
NHS Lothian in Scotland, UK, found that, while patients were generally
positive about the technology, clinicians had concerns about false positive
symptom scores and difficulty in interpreting physiological data. It was noted
that costly, and potentially harmful, over-treatment (reflected in a large
increase in antibiotics and steroid prescribing) could be seen along with the
cost of increased staff workload.
A larger 256-patient randomised, controlled clinical study of COPD
telemonitoring is now taking place at NHS Lothian, but this example
illustrates the need for robust clinical data to support wider adoption of the
technology.
About Espicom
Espicom Business Intelligence is a highly-regarded and established provider of
business intelligence services. Founded in 1982 as MDIS Publications Ltd, the
company changed its name to Espicom in 1997. Initially a publisher in a wide
range of industries such as power generation and telecommunications, we now
focus on the global pharmaceutical and medical device sectors.
Table of Contents
EXECUTIVE SUMMARY
- BACKGROUND
- The Uses of Telemonitoring
- CURRENT MARKET DYNAMICS
- Fig.1: Global Telemonitoring Market by Region, 2010
- Competitive Environment
- Industry Collaboration
- Mergers & Acquisitions
- Service Provision
- Regulatory Approval and Reimbursement
- Connectivity, Integration and Healthcare IT Standards
- Data Transmission
- Data Integration and Security
- Connectivity Standards and the Continua Health Alliance
- GLOBAL IMPLEMENTATION PROJECTS
- United States
- Europe
- Asia-Pacific
- Australia
- China
- South Korea
- GROWTH DRIVERS, RESTRAINTS AND FUTURE OPPORTUNITIES
- Demographics and the Rising Burden of Chronic Diseases
- Telemonitoring and the Economy
- Reducing Hospital Readmissions
- Patient Satisfaction and Compliance
- Telemonitoring as a Disruptive Technology
- Healthcare Provider Acceptance
- Establishing Clinical and Cost-Effectiveness
- Developing and Emerging Regions
- Emerging Technologies
- Summary - Growth Drivers, Restraints and Opportunities
- MARKET EXPECTATIONS
- Fig.2: The Global Telemonitoring Market, 2010-2016E (US$ million)*
- Fig.3: The Global Telemonitoring Market Growth, 2010-2016E (%)*
PRODUCTS AND APPLICATIONS
- MULTI-FUNCTIONAL TELEMONITORING PRODUCTS
- Currently-Available Products
- Key Products
- American TeleCare's Advanced Care Management Solution
- Bosch Healthcare's Products
- Cardiocom's Telehealth Systems
- ExpressMD's Electronic House Call
- Honeywell HomMed's Products
- IDEAL LIFE's IDEAL LIFE Managers
- Intel-GE Care Innovations Guide and Intel Health Guide
- Microsoft HealthVault
- Philips' Remote Patient Monitoring Solution
- Tunstall Healthcare's mymedic, mymedic plus and myclinic
- Other New Products and Product Developments
- Aerotel Medical Systems' e-CliniQ
- ALR Technologies' ALRT Health-e-Connect System
- AT&T ForHealth
- ConnectedHealth's eHealth Platform
- CJPS Medical Systems' Remote Patient Monitor
- CSC's CSC eMEDlink
- Ericsson Mobile Health
- Health Net Connect's HNC VideoDoc
- Infopia's Eocene System
- MedApps' HealthPAL, HealthAir and HealthCOM
- SAP Collaborative E-Care Management
- SHL Telemedicine's Products
- Vignet Connected Health Services
- Waldo Health's Waldo Health System
- Zephyr Technology's BioHarness
- Products in Development
- BlueLibris' BlueLibris Mobile Monitoring Device
- Cambridge Consultants' Minder and Vena Technology
- Deep Breeze's Breeze@home
- iMPak Health
- Telefónica
- Toumaz' Sensium Digital Plaster
- CARDIOLOGY
- Heart Failure
- The Role of Telemonitoring
- Getemed's Cardiac Telemonitoring System
- Advancing HF Telemonitoring
- Implantable Cardiac Device Monitoring
- Fig.4: Sales for CRM Market Leaders, 2005-2010 (US$ million)*
- BIOTRONIK Home Monitoring
- Boston Scientific's LATITUDE Patient Management System
- Medtronic's CareLink
- St Jude Medical's Merlin.net Patient Care Network and Merlin@home
Transmitter
- Remote ECG Monitoring
- Aerotel Medical Systems' Heartline ECG Monitoring Products
- Cardiac Network's Cardiac Monitoring Products
- CardioComm Solutions' GEMS
- CardioNet Mobile Cardiac Outpatient Telemetry
- Corscience's TE-SYS
- Corventis' NUVANT and AVIVO Systems
- eCardio Diagnostics' Verite Mobile Cardiac Telemetry Device
- IntriCon's Centauri Ambulatory Patient ECG
- Vitaphone Products
- Products in Development
- Home Coagulation Monitoring
- Market Dynamics
- Fig.5: Global Self-Testing Coagulation Market, 2007-2016E (US$
million
- Self-Testing and Telemonitoring Products
- DIABETES TELEMONITORING
- Diabetes Self-Testing
- Blood Glucose Testing Market
- Fig.6: Global Blood Glucose Testing Market, 2005-2016E (US$ billion)
- Fig.7: Blood Glucose Testing Market by Customer Type, 2010
- Leading Companies' Diabetes Care Sales, 2004-2010 (US$ million)
- Market-Leading Self-Testing Blood Glucose Meters
- The Role of Telemonitoring in Diabetes Care
- Clinical Studies of Diabetes Telemonitoring
- DiaTel Study
- IDEATel Study
- Current Telemonitoring Initiatives
- Available Products
- ALR Technologies' ALRT Health-e-Connect System
- Arkray's ARK Care
- Bayer's Contour USB
- Cardiocom's Glucocom-Autolink Diabetes Management System
- ConnectedHealth's eDiabetes Platform
- Entra Medical Systems' MyGlucoHealth Network
- Infopia's Blood Glucose Products
- Medtronic's CareLink Pro
- Vodafone
- WellDoc's DiabetesManager
- New Products in Development
- AiMedics' HypoMon
- Biovotion's Multisensor Glucose Monitoring System
- MicroCHIPS
- mobiLIFE's GlucoReader
- Pepex Biomedical's Trio
- REACTION Project
- Aipermon's Active Body Control Programme and AiperMotion Device
- RESPIRATORY DISEASES
- Chronic Obstructive Pulmonary Disease
- Asthma
- Telemonitoring and Asthma
- New Products and Products in Development
- Nonin Medical's Onyx II Model 9560
- Applied Nanodetectors' Sensor Array Platform
- Aipermon's Telemonitoring Solution for Cystic Fibrosis and COPD
- Deep Breeze's Breeze@home
- HYPERTENSION
- The Role of Telemonitoring
- New Products
- A&D Medical's Blood Pressure Monitors
- HP's Mobile Health Monitoring Solution and HealthSTATS' BPro Device
- Withings' Blood Pressure Monitor
- Hypertension Clinical Studies
- TASMINH2 Study
- IDEAL LIFE Study
- Hypertension Intervention Nurse Telemedicine (HINTS) Study
- Ongoing Initiatives
- OBESITY
- The Role of Telemonitoring
- New Products
- A&D Medical's Tri-axial Activity Monitor and the Precision Personal
Health Scale
- Aipermon's Active Body Control Programme, AiperMotion and AiperSunny
Devices
- Withings' WiFi Body Scale
- Clinical Trials
- Smart-OB
- The Weigh by Day Trial
- RENAL DISEASE
- The Role of Telemonitoring
- Minneapolis Veterans Affairs Medical Center Study
- MEDICATION MANAGEMENT
- AARDEX' MEMS
- American Medical Alert's MedSmart
- Evalan's Products
- Leap of Faith Technologies' eMedonline
- MedMinder's Maya
- Philips' Medication Dispensing Service
- Vitaphone's Pico Dispenser
- Vitality's GlowCaps
- In Development - Aipermon's Telemonitoring Solution for Cystic Fibrosis
Patients
COMPANIES DIRECTORY
APPENDICES
- APPENDIX 1 - LIST OF ABBREVIATIONS
- APPENDIX 2 - REPORT METHODOLOGY
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