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mHealth and Home Monitoring – 7th Edition

  • December 2015
  • -
  • Berg Insight AB

Executive summary
The number of remotely monitored patients grew by 51 percent to 4.9 million in 2015 as the market entered a growth phase fuelled by rising market acceptance in several key verticals. This number includes all patients enrolled in mHealth care programs in which connected medical devices are used as a part of the care regimen. Connected medical devices used for various forms of personal health tracking are not included in this figure. Berg Insight estimates that the number of remotely monitored patients will grow at a compound annual growth rate (CAGR) of 48.9 percent to reach 36.1 million by 2020. Cellular connectivity has already replaced PSTN and LAN as the de-facto standard communication technology for most types of connected home medical monitoring devices and will account for 19.2 million connections in 2020. Using patients’ own mobile devices as health hubs is now becoming a viable alternative for remote patient monitoring. BYOD connectivity will be preferred by select patient groups and will be used for the remote monitoring of 15.2 million patients in 2020.

Berg Insight estimates that revenues for remote patient monitoring (RPM) solutions reached €_6.2 billion in 2015, including revenues from medical monitoring devices, mHealth connectivity solutions, care delivery platforms and mHealth care programs. RPM revenues are expected to grow at a CAGR of 32.1 percent between 2015 and 2020 to reach € 25.0 billion at the end of the forecast period. Connected medical devices accounted for 71.0 percent of total RPM revenues in 2015. However, revenues for mHealth connectivity solutions, care delivery platforms and mHealth care programs are growing at a faster rate and will
account for 46.3 percent of total revenues in 2020, up from just 29.0 percent in 2015. There is a strong trend towards incorporating more connectivity in medical devices and pharmaceuticals in order to enable new services and value propositions. Implantable cardiac rhythm management (CRM) has traditionally been the largest market segment, led by companies such as Medtronic, Biotronik and St Jude Medical that included connectivity in CRM solutions more than a decade ago. However, the sleep therapy segment is growing at the fastest rate and will surpass CRM in 2016. The number of remotely monitored sleep therapy patients grew by 170 percent in 2015, with market growth mainly driven by the vendor ResMed that has made connected healthcare a cornerstone of its strategy. Berg Insight predicts that three of the fastest growing market segments in the next five years will be glucose monitoring, air flow monitoring and connected pharmaceuticals. Today, the leading connected healthcare players in these segments include forward-thinking incumbents as well as innovative new entrants such as AstraZeneca, Dexcom, Merck, Novartis, Propeller Health, Proteus Digital Health, Roche, Sanofi, Voluntis and WellDoc.

Care delivery platforms and mHealth connectivity solutions are two of the most rapidly developing parts of the mHealth technology value chain. Care delivery platforms are software solutions that enable the remote delivery of healthcare services and allow care efforts to be coordinated between patients, various professional caregivers and other stakeholders such as the patient’s family. Care delivery platforms will be instrumental for engaging patients in their own care and delivering remote monitoring services to a large number of people in a cost efficient way. There are various types of care delivery platforms available on the market. General-purpose platforms can be adapted to a wide variety of use cases and are often used as the foundation for developing therapeutic area specific mHealth products. Companies that specialize in this area include BePatient, Exco InTouch, Medixine, OpenTeleHealth and Vivify Health. mHealth connectivity solutions include products and services that are used for collecting data from medical monitoring devices, transmitting this data to caregivers and enabling the data to be used by care delivery platforms. The leading players include Qualcomm Life, eDevice, Tactio Health, Validic and MedM.

The adoption of remote patient monitoring solutions is driven by a wide range of incentives, related to everything from demographics and technology development to new advancements in medical treatment. However, there are a number of barriers, including resistance to change among healthcare organizations and clinicians, misaligned incentive structures and the financing of wireless solutions by what is at large an underfunded healthcare sector. Several catalysts are nevertheless speeding up the rate of adoption – in particular incentives from payers and insurance companies, national health systems that support remote monitoring and a shift to performance-based payment models.

Table Of Contents

mHealth and Home Monitoring - 7th Edition
Table of Contents . i
List of Figures .. ix
Executive summary 1
1 The challenge from welfare diseases . 3
1.1 Introduction 3
1.1.1 The ageing world population .. 4
1.1.2 Metabolic syndrome and lifestyle related diseases . 5
1.2 Common chronic diseases 5
1.2.1 Cardiac arrhythmia 7
1.2.2 Ischemic diseases . 7
1.2.3 Hypertension 8
1.2.4 Sleep apnea . 9
1.2.5 Chronic respiratory diseases 10
1.2.6 Diabetes .. 13
1.2.7 Hyperlipidemia . 14
1.3 Healthcare providers and reimbursement systems .. 14
1.3.1 Healthcare in Asia-Pacific 18
1.3.2 Healthcare in Europe 19
1.3.3 Healthcare in North America . 20
1.4 Regulatory environment .. 22
1.4.1 Regulatory environment in Europe 23
1.4.2 Regulatory environment in the US . 24
1.4.3 Regulatory environment in other major markets . 27
1.4.4 International standardisation . 27
2 mHealth platforms . 29
2.1 Overview of the mHealth market . 29
2.1.1 mHealth market segments . 30
2.1.2 Connectivity options for medical devices .. 32
2.1.3 The mHealth technology value chain 34
2.2 mHealth connectivity solutions . 37
2.2.1 Apple HealthKit . 39
2.2.2 PTC . 41
2.2.3 eDevice . 41
2.2.4 Ericsson 43
2.2.5 KORE . 44
2.2.6 Microsoft HealthVault 46
2.2.7 Orange Healthcare . 47
2.2.8 Qualcomm Life . 48
2.2.9 MedM . 50
2.2.10 Telenor Connexion . 52
2.2.11 Vodafone . 53
2.3 mHealth care delivery platforms .. 54
2.3.1 ATandT .. 55
2.3.2 BePatient . 57
2.3.3 Domicalis . 58
2.3.4 Exco InTouch 59
2.3.5 Get Real Health 60
2.3.6 HealthyCircles .. 61
2.3.7 Medixine .. 62
2.3.8 OpenTeleHealth .. 64
2.3.9 S3 Group . 65
2.3.10 Tactio Health . 66
2.3.11 Verklizan .. 68
3 Physiological monitoring solution providers 71
3.1 Medical devices and remote monitoring . 71
3.1.1 Medical device revenues by market segment . 71
3.1.2 Overview of the remote patient monitoring market 73
3.2 Cardiac rhythm management 74
3.2.1 Overview of the CRM device market . 74
3.2.2 Use cases for CRM monitoring 75
3.2.3 Remote monitoring solution providers . 78
3.2.4 Biotronik .. 79
3.2.5 Boston Scientific .. 81
3.2.6 Medtronic 83
3.2.7 LivaNova .. 85
3.2.8 St. Jude Medical .. 86
3.3 Remote ECG monitoring . 89
3.3.1 Overview of the remote ECG monitoring device market. 89
3.3.2 Use cases for remote ECG monitoring 89
3.3.3 Remote monitoring solution providers . 92
3.3.4 Aerotel Medical Systems . 93
3.3.5 AliveCor 93
3.3.6 BioTelemetry . 95
3.3.7 CardioComm Solutions 97
3.3.8 LifeWatch . 99
3.3.9 ScottCare .. 100
3.3.10 TZ Medical 100
3.3.11 Zenicor .. 101
3.4 Blood pressure monitoring .. 102
3.4.1 Overview of the blood pressure monitoring device market 102
3.4.2 Use cases for blood pressure monitoring 103
3.4.3 Remote monitoring solution providers .. 104
3.4.4 Omron Healthcare 105
3.4.5 AandD Medical 106
3.4.6 Microlife . 107
3.4.7 Rossmax 108
3.4.8 Sotera Wireless . 108
3.5 Coagulation monitoring . 109
3.5.1 Overview of the coagulation monitoring device market 109
3.5.2 Use cases for blood coagulation monitoring . 110
3.5.3 Remote monitoring solution providers .. 110
3.5.4 Accriva Diagnostics . 111
3.5.5 Alere 111
3.5.6 CoaguSense 112
3.5.7 Helena Laboratories 112
3.5.8 iLine Microsystems .. 112
3.5.9 Siemens Healthcare Diagnostics . 113
3.5.10 Roche Diagnostics .. 113
3.6 Sleep therapy monitoring . 113
3.6.1 Overview of the sleep therapy device market 114
3.6.2 Use cases for sleep therapy monitoring .. 115
3.6.3 Remote monitoring solution providers .. 117
3.6.4 Fisher and Paykel Healthcare . 118
3.6.5 Philips Respironics .. 119
3.6.6 ResMed . 122
3.6.7 SRETT 124
3.6.8 SomnoMed .. 125
3.6.9 Weinmann 126
3.7 Home sleep diagnostics 127
3.7.1 Overview of the home sleep diagnostics market . 128
3.7.2 Use cases for home sleep diagnostics . 129
3.7.3 Remote monitoring solution providers .. 129
3.7.4 Cadwell Laboratories . 130
3.7.5 CareFusion .. 130
3.7.6 Compumedics 131
3.7.7 Infoscan . 131
3.7.8 Natus Medical . 132
3.7.9 NovaSom .. 132
3.7.10 SleepMed . 133
3.8 Blood oxygen monitoring . 133
3.8.1 Overview of the blood oxygen monitoring device market .. 133
3.8.2 Use cases for blood oxygen monitoring .. 134
3.8.3 Remote monitoring solution providers .. 134
3.8.4 ChoiceMMed .. 135
3.8.5 Masimo .. 135
3.8.6 Nonin Medical 137
3.9 Air flow monitoring 137
3.9.1 Overview of the air flow monitoring device market . 138
3.9.2 Use cases for air flow monitoring . 138
3.9.3 Remote monitoring solution providers .. 139
3.9.4 Aerocrine .. 139
3.9.5 AstraZeneca 140
3.9.6 Clement Clarke International .. 142
3.9.7 iSonea 142
3.9.8 Medical International Research . 144
3.9.9 Ndd Medizintechnik. 144
3.9.10 nSpire Health .. 145
3.9.11 Propeller Health . 145
3.9.12 Sibelmed .. 147
3.9.13 Vitalograph .. 147
3.10 Glucose level monitoring .. 148
3.10.1 Overview of the glucose monitoring device market 148
3.10.2 Use cases for glucose monitoring .. 150
3.10.3 Remote monitoring solution providers .. 153
3.10.4 Abbott . 155
3.10.5 Bayer Healthcare .. 157
3.10.6 BodyTel . 158
3.10.7 Johnson and Johnson 159
3.10.8 Roche Diabetes Care . 160
3.10.9 Dexcom . 163
3.10.10 Voluntis .. 165
3.10.11 Telcare 166
3.10.12 WellDoc . 167
3.11 Other 170
3.11.1 Implantable medical devices .. 170
3.11.2 Home hemodialysis . 170
3.11.3 Telerehabilitation .. 171
4 Medication and integrated monitoring solution providers .. 173
4.1 Telehealth and multiparameter monitoring solutions . 173
4.1.1 Overview of the telehealth solutions market .. 173
4.1.2 Use cases for telehealth solutions .. 175
4.1.3 Telehealth solution providers . 175
4.1.4 Optum . 177
4.1.5 AuthentiDate 177
4.1.6 Bosch Healthcare . 178
4.1.7 Cardiocom 179
4.1.8 Care Innovations .. 181
4.1.9 H2AD .. 182
4.1.10 Honeywell Life Care Solutions .. 184
4.1.11 Ideal Life 186
4.1.12 Medvivo . 187
4.1.13 Philips Hospital to Home .. 187
4.1.14 SHL Telemedicine 190
4.1.15 Telefónica . 192
4.1.16 Tunstall Healthcare Group .. 194
4.1.17 Vitaphone . 195
4.2 Medication compliance monitoring . 197
4.2.1 Overview of the medication compliance monitoring market . 197
4.2.2 Use cases for medication compliance monitoring .. 198
4.2.3 Compliance monitoring solution providers . 198
4.2.4 DayaMed .. 199
4.2.5 Evondos 200
4.2.6 InRange Systems . 203
4.2.7 Medicpen .. 205
4.2.8 Merck .. 205
4.2.9 Compliance Meds Technologies . 207
4.2.10 MedSignals .. 208
4.2.11 Philips Medido 208
4.2.12 Proteus Digital Health . 209
5 Market analysis and forecasts .. 211
5.1 Market forecasts 211
5.1.1 Cardiac rhythm management 214
5.1.2 Sleep therapy . 215
5.1.3 Telehealth and multiparameter monitoring . 216
5.1.4 ECG monitoring . 218
5.1.5 Glucose level monitoring . 219
5.1.6 Medication compliance monitoring . 221
5.1.7 Other medical devices 222
5.2 Revenue forecasts 223
5.2.1 Medical monitoring devices 224
5.2.2 mHealth connectivity solutions . 225
5.2.3 Care delivery platforms . 226
5.2.4 mHealth care programs 227
5.3 Industry trends and analysis 228
5.3.1 New players enter the market 228
5.3.2 Pharmaceutical companies prepare large-scale rollouts 231
5.3.3 Consumerisation of medical-grade mHealth devices and apps .. 232
5.3.4 BYOD is becoming a viable option . 234
5.3.5 Digitalisation of PSTN networks 235
5.3.6 Modularization of the value chain 236
5.4 Market drivers and barriers .. 237
5.4.1 An ageing population . 237
5.4.2 Increasing welfare disease prevalence . 238
5.4.3 Focus on disease prevention . 238
5.4.4 Substitutes to medical monitoring .. 239
5.4.5 Resistance to change . 240
5.4.6 Alignment of financial incentives .. 240
5.5 Potential market catalysts . 242
5.5.1 Increased monitoring during clinical trials .. 242
5.5.2 Incentives from insurance companies and payers . 242
5.5.3 National health systems support remote monitoring . 243
5.5.4 New clinical evidence on cost effectiveness .. 243
5.5.5 Non-prescribed monitoring and healthcare consumerism . 244
Glossary . 245

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