mHealth and Home Monitoring

• Publication date: September 2009

mHealth and Home Monitoring gives first-hand insights into the adoption of wireless solutions for health monitoring.This strategic research report provides you with a comprehensive analysis of the current trends on the market and offers advice on how to foster further growth. Executive summary The market for home health monitoring of welfare diseases was worth approximately US$ 11 billion in 2008, and is growing with about...

mHealth and Home Monitoring gives first-hand insights into the adoption of wireless solutions for health monitoring.This strategic research report provides you with a comprehensive analysis of the current trends on the market and offers advice on how to foster further growth.

Executive summary

The market for home health monitoring of welfare diseases was worth approximately US$ 11 billion in 2008, and is growing with about 10 percent annually. Among the most common conditions to monitor at home are cardiovascular irregularities, respiratory problems and high levels of metabolic products in the blood. Diabetes testing accounts for the vast majority of the market value. In many cases the monitoring is related to chronic, often welfare-related, conditions. Wireless technologies have only just begun to penetrate the market but have a huge potential. Berg Insight estimates that 300 million people in the EU and the US suffer from one or several diseases where home monitoring can become a treatment option.
Among those, about 25 percent would benefit from existing wireless home monitoring solutions available and another 50 percent who would benefit from handset integration of existing medical devices. Additionally, there are those monitoring their personal health without a strict medical need and those monitoring their medication intake.

The adoption of out-of-hospital wireless monitoring in healthcare is driven by a wide range of incentives, related to everything from demographics and technology development to new advancements in medical treatment. There are however also challenges such as the financing of wireless solutions by what is at large an underfunded healthcare sector. In order to receive reimbursement, suppliers of medical products not only have to prove their worth in a clinical perspective, but also in a health economical one. With rising healthcare costs there is an increasing focus on early diagnosis and home treatment – potentially enabled by new technology. There are several potential catalysts that could speed up the adoption of cellular communication for healthcare monitoring purposes. These include increasing monitoring during clinical trials, insurance company requirements and growing popularity for non-prescribed medical monitoring. When it comes to consumer-oriented propositions it is vital that they in an easy way offer integration of personal medical devices and popular handsets. mHealth has already attracted the interest of many of the leading players in the telecom and IT industries. Business opportunities exist related to both offering home medical monitoring services directly to patients or caregivers and the surrounding infrastructure of devices, networks and data centres. Currently, the wireless medical monitoring services generate only neglectable revenue, but the field shows great potential. The volume of traffic related to medical monitors will increase sharply in the next few years, as new web based services are being established. Also, in the last year, health related applications, for smartphones have become a factor in marketing, and certain services actually generate some direct revenue.
This is especially true with Apple’s iPhone, which has provided a burst in smartphone medical apps. Apple and other companies are also actively working to make health monitoring companies provide smartphone integration. The telecom operator community is more cautious in its attitude to wireless home medical monitoring and existing solutions still tend to rely on fixed line networks. Initiatives such as Verizon Wireless' partnership with LifeWatch may however signify a change in the market. Another interesting group to watch are IT companies such as Google and Microsoft who are positioning themselves in the health and medical data space.

The author is convinced that wireless monitoring in home healthcare represents an important and compelling business opportunity for the mobile industry. Presently, the market is in an early phase and in need of coordinated efforts to take off. Even if the situation is starting to change, there is currently a wide gap in the adoption of new technology in the healthcare sector, compared to other industries. When it comes to communication technologies, healthcare applications are sometimes several generations behind the latest advances in telecom, but again, the situation is now starting to change. Mobile communication is only now being adopted, while the number of mobile subscribers worldwide is exceeding 4 billion. In order to pave the way for a wider use of wireless solutions in healthcare, the mobile industry will need to explain that they fulfil all requirements on safety, data security and reliability in the healthcare sector while at the same time delivering better performance at lower cost compared to legacy systems. Mobile industry players must reach out to medical device manufacturers and caregivers to present solutions that allow them to take full advantage of the latest communication technology. They will also have to offer interfaces, making the technology accessible and the data interpretable.

This report answers the following questions:

- How can the mobile industry contribute to the adoption of wireless technology in healthcare?
- Which medical conditions offer the best potential for wireless health monitoring solutions?
- Who are the leading providers of medical devices for home monitoring?
- Which are the general technology trends for home health monitoring equipment?
- Why has it taken so long for the healthcare sector to adopt wireless technology?
- What initiatives have been taken by the leading players in the telecom and IT industries?
- Why are smartphone applications so significant for the mHealth market?
- How will standardisation facilitate the integration of medical devices and mobile handsets?

This report will allow you to:

- Understand the dynamics of the health monitoring market in Europe and North America.
- Comprehend how wireless technology can become seamlessly integrated with medical devices.
- Evaluate the business opportunities in the emerging mHealth segment.
- Identify potential partners in the healthcare monitoring ecosystem.
- Predict future market and technology developments.

Global Wireless Technology Industry

Table of Contents

1 The challenge from welfare diseases 3

1.1 Introduction..3
1.2 Common chronic diseases4
1.2.1 Cardiac arrhythmia6
1.2.2 Hypertension.6
1.2.3 Ischemic diseases.8
1.2.4 Sleep apnea..9
1.2.5 Chronic respiratory diseases....9
1.2.6 Diabetes11
1.2.7 Hyperlipidemia..12
1.3 Healthcare providers and reimbursement systems by market.....13
1.3.1 Healthcare in Europe 16
1.3.2 Healthcare in the US and Canada 17
1.3.3 Healthcare in Asia and Australia...19

2 Home healthcare monitoring...21

2.1 Medical monitoring..22
2.1.1 Cardiac monitoring....22
2.1.2 Blood pressure monitoring .....25
2.1.3 Blood coagulation monitoring.27
2.1.4 Sleep monitoring.27
2.1.5 Blood oxygen level monitoring .....28
2.1.6 Breath monitoring28
2.1.7 Glucose monitoring...29
2.1.8 Lipid monitoring31
2.2 Technology trends in health monitoring33
2.2.1 Going digital, going wireless...33
2.2.2 Dedicated PDAs vs general devices.....36
2.2.3 Outsourcing of health monitoring.38
2.2.4 Distance disease management.....39
2.2.5 Frequency and volume of data to transfer..42
2.2.6 eHealth, mHealth and telemedicine43
2.3 Regulatory environment..44
2.3.1 Regulatory environment in Europe.45
2.3.2 Regulatory environment in the US45
2.3.3 Regulatory environment on other major markets.....47
2.3.4 International standardization...48

3 Physiological monitoring solution providers.49

3.1 Cardiac monitoring..51
3.1.1 CardioNet....51
3.1.2 LifeWatch (formerly Card Guard)..53
3.1.3 Philips Healthcare .....55
3.1.4 Aerotel.56
3.1.5 BioWatch Medical56
3.1.6 Boston Scientific..57
3.1.7 Corventis.57
3.1.8 eCardio.....57
3.1.9 Kiwok58
3.1.10 Medtronic 58
3.1.11 Polar Electro59
3.1.12 SHL Telemedicine60
3.1.13 Sorin Group....61
3.1.14 St Jude.....61
3.1.15 Transoma Medical..61
3.1.16 Vitaphone...63
3.2 Blood pressure monitoring.63
3.2.1 Omron Healthcare....64
3.2.2 A&D Medical.....65
3.6.7nSpire....77
3.6.8 SDI Diagnostics.77
3.6.9 Sibelmed77
3.6.10 Welch Allyn..78
3.7 Glucose level monitoring78
3.7.1 Abbott Laboratories...79
3.7.2 Bayer Healthcare80
3.7.3 Johnson & Johnson.81
3.7.4 Roche.....82
3.7.5 BodyTel...83
3.7.6 Cardiocom.....83
3.7.7 Dexcom84
3.7.8 HealthPia America..85
3.8 Lipid monitoring..85
3.8.1 CardioChek.86
3.8.2 APEX86
3.8.3 Biomedix87

4 Medication and equipment monitoring solution providers.89

4.1 Medication compliance monitoring...89
4.1.1 Aardex Group....90
4.1.2 Bang & Olufsen Medicom....90
4.1.3 Cypak91
4.1.4 Information Mediary Corporation91
4.1.5 InforMedix91
4.1.6 Medic4All/Telcomed...92
4.1.7 M-PLIFY92
4.1.8 Proteus Biomedical.....92
4.1.9 SimPill..93
4.1.10 Vitality..94
4.1.11 Vivatec...94
4.2 Integrated solution providers....94
4.2.1 Arrowhead Electronic Healthcare ..95
4.2.2 GE Healthcare....95
4.2.3 iMetrikus....95
4.2.4 Invivo Data....96
4.2.5 MedApps.96
4.2.6 PHT96
4.2.7 Tunstall Group..97
4.2.8 T+ Medical...97

5 Telecom and IT industry initiatives99

5.1 Handset manufacturers....99
5.1.1 Apple’s iPhone drives development of mHealth apps....100
5.1.2 Lack of mHealth products for Nokia’s smartphones...101
5.1.3 Research in Motion and Palm face challenges101
5.2 Telecom operators..102
5.2.1 Verizon Wireless teams with LifeWatch..102
5.2.2 Qualcomm cancels health-oriented MVNO Lifecomm....103
5.2.3 France Telecom’s Orange Healthcare unit aims for leadership in eHealth103
5.2.4 SaskTel first to launch Alcatel-Lucent’s LifeStat 104
5.2.5 NTT DoCoMo introduces health-oriented handsets....105
5.3 IT companies105
5.3.1 Google Health106
5.3.2 Microsoft HealthVault.107
5.3.3 Intel Health Guide.....108
5.3.4 Dossia employee health records 109
5.4 Industry associations and research institutes...109
5.4.1 Continua Health Alliance.109
5.4.2 The Bluetooth SIG Medical Working Group.110
5.4.3 West Wireless Health Institute....111

6 Market analysis and recommendations113

6.1 Market analysis113
6.2 Market drivers and challenges116
6.2.1 An aging population.....117
6.2.2 Increasing welfare disease prevalence..118
6.2.3Focus on disease prevention.....118
6.2.4 Substitutes to medical monitoring..120
6.3 Potential market catalysts.....121
6.3.1 Increased monitoring during clinical trials...121
6.3.2 Insurance companies demanding monitoring123
6.3.3 Non-prescribed monitoring.123
6.4 Recommendations for mobile industry players....124
Glossary127
Index

List of Figures

Figure 1.1: Percentage of population diagnosed with chronic welfare diseases...5
Figure 1.2: Number of people suffering from chronic welfare diseases (EU/US 2008).7
Figure 1.3: Healthcare expenditure per capita by country (US$, World 2005)....14
Figure 1.4: Share of population covered by private health insurance by country.....19
Figure 2.1: Overview of remote ECG monitoring..23
Figure 2.2: Example of blood pressure monitor from Omron Healthcare....26
Figure 2.3: Example of glucose meters from Lifescan and Roche.30
Figure 2.4: Examples of methods for uploading health monitoring data.....35
Figure 3.1: Major suppliers of physiological monitoring solutions.50
Figure 3.2: Brands used by the major diabetes monitoring companies79
Figure 5.1: Companies offering HealthVault-certified products...107
Figure 5.2: Intel’s Health Guide....108
Figure 5.3: Selected members of the Continua Health Alliance, by industry.....110
Figure 6.1: Home medical monitoring market value by segment (World 2008–2013).....116