Emily Goodson, IBM Strategic Communications Summer Intern
As Sue mentioned in her previous post on Collaborating to Monitor our Personal Health Information, there is a growing range of products available to monitor anything you would want to know concerning your personal health and fitness. With these devices, however, comes more responsibility for the individual. One may have to input data, plug in devices, or describe to a computer what she ate that day.
That is where companies such as Omron Healthcare, GE Healthcare, and Polar Electro step in. Their goal is to make patient responsibility as minimal as possible, or at least seem minimal, and still provide results.
We know that this the combination of improved health and greater patient responsibility is central to the emerging idea of "patient-centric healthcare," as well as the intention behind the Continua Heath Alliance. The spotlight on personal health today makes me certain that the future of healthcare is headed in a new direction and that personal health devices will play a large role. I can see how Continua will help with this endeavor.
Stacy Lawrence’s article on Continua outlines their intended approach to tackle this dilemma:
“The group plans to deliver guidelines within the next 18 months for networked personal health care products based on existing connectivity standards like USB and Wi-Fi. Continua also plans to establish a product certification program with a consumer recognizable logo signifying the promise of interoperability with other certified products.”
After reading Lawrence's article and Sue Green’s post, I started researching just what kinds of remote monitoring devices and opportunities are available to patients. Weight-management devices will surely will be one of the most popular gadgets for consumers. BodyMedia, for example, offers the BodyBugg, an armband that tracks your calories burned throughout the day. Data from your armband can be uploaded to the Web wirelessly.
While you begin to get a true picture of the energy you're expending each day, you can also log the food you eat or get custom menus of what you should be eating in order to balance that personal equation.
Beyond the BodyBugg, there are many other fat trackers and body fat calculators an individual could use to help control weight. Linear Software manufactures calipers and tape measures, which help calculate fat. After you get the measurement from the device you input it into a computer database, which then tracks your Body Fat Composition, your Body Mass Index, your tape measurements etc... You can then analyze your progress over time.
Other devices entering the market enable patients to exchange information with their healthcare providers. For example, BodyMedia markets an armband that delivers patient information to doctors. The SenseWear Pro2 armband can track data such as number of steps, energy expenditure, duration of physical activity, and sleep/wake states.
Researchers then use a program that is able to retrieve the data from the armband and analyze it. Similar products are available from Omron Healthcare, a founding member of the Continua Health Alliance. They sell blood pressure, weight management, thermometry, and respiratory tools to both patients and doctors. LifeSensor is yet another option. Individuals enter data, records, medications etc... online and only selected doctors and physicians are allowed to access the data. As well, the company certifies several blood pressure devices and glucometers, which will transfer your data directly into your electronic health record.
On the wearable computing front, Wealthy, pictured to the left, is a sort of "smart bodysuit" that continuously monitors your vitals signs, transmits data, and alerts emergency help via Bluetooth or the GSM network if necessary. Wealthy is aimed at helping patients in rehabilitation states or risk activities.
Smart pill boxes, another emerging trend, are designed to remind you to take your pills and simultaneously record the date and time. That information is then transmitted to a database where it is monitored to prevent overdoses and mistakes. One example is the pill pet. (click below to see a picture) Developed by MIT's AgeLab, it uses emotion to remind older adults to take their medications. View this photo
In fact, it seems that technology is everywhere in healthcare, and remote healthcare monitoring is not a distant dream. Products are available on the Internet at places like the soon-to-be Ecare website, LifeSync, or Cardiocom, and technology has made much of this innovation possible.
Clearly there are plenty of opportunities available to personalize healthcare and give patients more awareness of their own health. I’m interested to know your thoughts. How big a deal is remote healthcare monitoring going to become? What are the drawbacks or caveats we should be addressing? Will advances and more availability of remote healthcare monitoring counterbalance the predicted future shortage of doctors in the U.S.? Finally, would you wear or use a personal electronic health device, and what would you most want your "personal dashboard" to measure?
IBM HealthNex Continua Health Alliance BodyBugg personal health devices
Something that struck me reading your post is the "equal opportunity" vs. "equal outcome" debate that is raging over healthcare. These personal health tools will surely help a greater number of people achieve and maintain better health. But, you can't make folks use them - I would guess that many, if not most people who could benefit from these products will not use them. The parallel is health insurance; many of those without health insurance are not covered by choice - not necessarily a good choice, but a choice none the less. A single payer health care system removes personal responsibility and choice for coverage by providing everyone with poorer coverage.
People who don't want to take responsibility or an active role in their own health represent a huge market opportunity. The challenge here will be to make remote health systems automatic and transparent to the user. With these systems, perhaps all they receive is a phone call from a nurse practitioner about a change in their health status, or poor therapy compliance. Patients who actively embrace products like the bodybugg will be the early innovators, less involved people will represent the early majority, and the most passive patients will be the late majority adopters. And those who just can't be bothered will represent a tragic resource drain on society and those who love them.
The easier to use and better designed remote monitoring products become, the greater the adoption. Progress in usability will be required to move through the adoption curve and grow the market. Costs must also fall considerably. The bodybugg looks like a great product, but at $500 for 3 months is waaay to expensive. The participation of consumer electronics companies in Continua is encouraging.
One thing that could improve reimbursement for remote monitoring would be for payors to have exposure to patient's long term health costs - then they would have a greater incentive to promote remote monitoring to minimize acute care costs. This is a pretty big structural change better suited for lobbyists not some to base business models on.
Remote monitoring could be a huge market. Continua is bringing a business model to health care that has driven vigorous growth in numerous consumer and high tech markets. If left to medical device vendors (and their traditional business models and strategies) the remote monitoring market might never take off.
Success will require remote monitoring vendors to create hybridized business models based on both health care, consumer and high tech markets. The former will be required to overcome barriers to adoption (see this on health care innovation), and the latter will fuel growth and commoditization.
Posted by: Tim Gee | June 14, 2006 at 01:07 PM
Technology can help us. I used healthia.com to get the best health insurance policy for my family. They came back with multiple offers that I would not have received using an old fashion system. They are like a lending tree.com for health savings accounts
Posted by: James | June 15, 2006 at 06:27 AM
Another monitoring service I just saw on the Medical Connectivity Counseling blog is Impulse Monitoring (www.impulsemonitoring.com). This monitoring is extremely interesting and different from the remote monitoring described in the post. Impulse monitoring is also proactive and provides monitoring to patients who are undergoing surgery. The monitoring allows doctors to constantly be aware of their patient's neural status.
Posted by: Emily Goodson | June 16, 2006 at 12:24 PM
To add some context to my comments, you might want to take a look at an advanced automated wireless monitoring device and system for people with diabetes at Diabetech.net and a few of my blog comments at challengediabetes.com Admittedly, my team haven't spent time at trade shows and we're terrible with PR but we are good at designing devices, systems and methods for interventional monitoring including automated feedback for managing a patient-centric team.
Our upcoming Intensive Management Protocol rolling out in the near future will be used to support islet cell transplant patients for compliance monitoring and simplicity for the patient. We have been leading this segment of the industry (diabetes) since 2002 with our first trial in the pediatric outpatient setting.
I guess my contribution to this thread of ideas is that we need to be much more focused than 'wireless monitoring' in order to generate successful outcomes. The nuances of each patient scenario including their interaction with specific clinicians have to be taken into account in order to deliver effective monitoring. Simply applying our system used to streamline insulin pump starts at TJU would not be as effective as a specific protocol for the islet transplant scenario.
- from the trenches
Posted by: Kevin McMahon | August 17, 2006 at 10:05 PM