Remote Patient Monitoring: Can it Reduce Healthcare Costs?

EugeneBorukhovichKey Drivers and Technology Paving the Way

By Eugene Borukhovich, SoftServe, Inc.
Twitter: @HealthEugene

According to a recent study by the Berg Insight, the remote patient monitoring market is expected to grow to €19.4B ($24.9 billion) by 2019. It’s an astounding number if you consider that the same report put the current market at €4.3B ($5.5 billion) at the end of 2013.

Telemedicine, which is a portion of the overall estimated market, has been a topic of discussion for years, so what has changed so dramatically?

Traditionally, people think about remote patient monitoring in the context of the elderly and aging, but with the advent of increased connectivity, the explosion of consumer wearable devices and the continued move into connected home market by major players like Samsung, Apple and Google, the contextual definition of remote patient monitoring is evolving. After the recent Apple Watch announcement, few would be surprised to see Apple launching “iCare” in the coming year.

Key drivers

  1. With governments under pressure to reduce costs, aging at home is certainly on top of the agendas across the world. In the EU, during the first two years of the Horizon 2020 program(2014/15), 1.2B will be invested to “keep older people active and independent for longer and support the development of new, safer and more effective interventions.” Concerned caregivers, including those who live hundreds or thousands of miles away, also want to stay connected to loved ones.
  2. Technology advancements, both at the quality and accuracy level, but also from connectivity, reliability and accessibility, have pushed this industry forward. From 2007 through 2013, fixed broadband alone rose from 5.2% to 9.8% and mobile broadband increased from 4% to 29.5%, encompassing the developing and developed worlds (according to ITU). Two billion people are now connected and mHealth is at the forefront of many discussions and investment activities.
  3. Gene sequencing – While this may belong in technology advancements, it stands out on its own, due to the indescribable impact it could make on the lives of our future generations. For a mere $1,000, sequencing of the full genome is almost here. While many companies have tried in the recent past, it appears that Illumina, with their HiSeq X Ten machine, will do the job, at least according to their CEO’s announcement earlier in the year. This means that scientists and doctors can begin improving their patients’ care, understanding how genes influence diseases with a potential for highly personalized and at-home treatments (both proactive and reactive).

There are numerous challenges, from healthcare system reimbursement to cultural changes in patient/practitioner communication, but none of them are insurmountable.

Here’s an outline of a few technologies that are paving the way towards preventative and remote healthcare consumer monitoring:

Medication Adherence

Proteus Health – The company was founded in 2001 and after six rounds of funding totaling $291.5M with major strategic investors such as Novartis, Oracle and SVB, they are finally poised to solve the medication adherence challenge of the industry, both from patient perspective and that of a caregiver. The technology consists of an ingestible sensor that is powered by body fluid, which in turn communicates with a small patch and sends that information to a Bluetooth enabled app. While sensor cost, adoption, distribution are just a few of the many challenges ahead, this technology fundamentally changes the game.

AdhereTech – This young company made significant headway in the same market but with a different approach. After going through the Blue Print Health NYC accelerator and joining the StartupHealth transformer team, they have designed and implemented a patented smart pill bottle. Josh Stein is a passionate entrepreneur with an excellent team behind him who will be able to execute AdhereTech’s vision of patient engagement with the drug regimen by visual on-bottle notifications, SMS or even an automated phone calls.

Wearables and Trackers

My Basis (Intel). I was happy to be a beta tester of the watch from its very early days. Personally I believe this is one of the best and most comprehensive devices on the market in the consumer space. With Apple’s iWatch announcement, the future of other young brands is in question, but I want to point out a specific case that is highly relevant to remote patient monitoring and management. Few weeks back, I met with Keith, a forward-looking UK GP who had a concrete case for this My Basis watch. He has been treating a palliative patient who has been suffering from lack of sleep. After taking sleeping medication, the outcomes had not improved. Keith handed him his watch and asked the patient to leave it on for two days. After the review of the data, Keith realized that the patient had been taking up to four one-hour naps throughout the day, with a total daily sleep pattern of six to eight hours. Without a simple technique like this, the patient would have been prescribed more sleeping medication and the course of the clinical pathway would have been much different.

Virtual Doc in your Pock

Skin Vision – There are dozens upon dozens of companies that are entering the space of virtual doctor visits and early detection, but I purposely picked a Dutch company to showcase that the innovation is not only happening in the US. Both, the healthcare system reimbursements as well as consumer adoption of these services are slowly happening around the world. Skin Vision offers a “lifetime skin companion”: in short, early detection of skin cancer (melanoma) by taking photos of the moles and applying their proprietary algorithms and hard science to analyze and predict changes. Instead of coming in every three months for a single data point in time, patients can continuously record the changes and the specialist has a view and actionable information in his or her pocket.

Babylon, an EU-based company (UK) started by Dr. Ali Parsa, uses the analogy of “booking a Hailo cab” (because the Uber of Healthcare was used too many times already) to hold virtual appointments with GPs or get referrals to specialists within the BUPA network. Capabilities include SMS communication, sending pictures and video (secure) appointments.

We are just at the beginning of the consumer health care revolution. While some people tout the extinction of the profession (physician), I am a big believer that the roles and engagement models with patients will change to provide anytime/ anywhere care with actionable technology-driven tools, but still with the empathy and passion of real human beings – our doctors!

About the Author: Eugene Borukhovich is an international expert on healthcare information technology innovation. He is the founder and organizer of Health 2.0 NYC and Health 2.0 Amsterdam and is a leading advocate in healthcare consumer issues and open health data. He currently serves as VP Healthcare, European Markets at SoftServe, Inc., and can be followed on Twitter at @HealthEugene.