Sunday, May 8, 2011

Remote Patient Monitoring

Building on top of the topic from the last post, in this post I would like to further talk about remote patient monitoring (RPM), a term and field that is extending the boarder of telemedicine.
The fall detector discussed in the previous post belongs to the group of wireless remote patient monitoring devices, which is expected to grow at the compounded annual growth rate (CAGR) of 77%, leading to a global market size of $950 million by 20141. The larger category, the entire RPM industry, is also experiencing a high CAGR of 56% leading a total market of $8 billion by 20122.
An example is that in 2008 Bayada Nursing home partnered up with Ideal Life to send out internet-connected remote monitoring systems to more than 200 U.S. patients with limited mobility and chronic diseases such as congestive heart failure (CHF) and hypertension3. The benefit was tremendous – the hospitalization was reduced by 54% for these patients. It means huge savings for both the patients and the hospitals and at the same time without reducing the quality of care. These devices could send real time information to patients’ nurses and doctors to tell them the health condition of their patients. It is meaningful because for chronic diseases, many key symptoms will develop unnoticed. For example, if a patient with CHF gained more than 3 pounds over the last 24 hours, it could mean there is a fluid retention in the patient’s body3. Then the wireless body weight scale could transfer this data to the patient’ doctors and nurses, which allows the care givers to either visit the patient or make necessary adjustment in the treatment and medication3.
Besides Ideal Life, other companies, such as Philips or GE, have also developed similar products or systems to detect and transfer real time patient data from patient’s home to the care givers. The following videos are some examples.
Products from Ideal Life:


Products from Philips
Products from GE


Reference:

1.       Roy Mark, Remote Patient Monitoring Set for Explosive Growth, August 2009, http://www.eweek.com/c/a/Health-Care-IT/Remote-Patient-Monitoring-Set-for-Explosive-Growth-144720/

2.       DATAMONITOR, Homecare telehealth expected to grow despite current barriers to adoption, August 2007, http://callcenterinfo.tmcnet.com/news/2007/08/30/2897900.htm

3.       Marianne Kolbasuk McGee, Remote Monitoring Yields Healthier Patients, November 2009, http://www.informationweek.com/news/healthcare/mobile-wireless/221900414?pgno=1

Saturday, May 7, 2011

Fall Detectors - Improving Senior Home Care

In this post I would like to talk about a specific technology that would significantly improve the senior home care and at the same time present a potential business opportunity in telemedicine.

The technology is a Fall Detector that is a watch-like mini size device (Figure 1). It could be attached on the wrist of a senior person or patient. The device is capable of measuring unusual pulse rate and detecting free falling1. When there is a case of abnormal pulse or free falling motion detected by the device, it would play an alarm sound1. If the alarm were not turned off in a pre-set time interval, a signal recording the pulse or free falling information would be sent to a GSM modem previously set up in the room where the patient was in1. The modem after collecting and receiving the information would send a signal to the care center, ambulance, or the patient’s relative’s house wirelessly linked with the GSM modem1. In this way medical professionals would receive the real time alerts from the device attached to the patient and would be able to respond at the earliest possible time. The implication is that for seniors living by themselves, this device could safe many lives by asking for medical services in the shortest possible time interval.

Figure 1.


The potential market for this telemedicine application is promising. The total number of older persons worldwide over 60 years old has almost tripled from 1950 to 2000 from 205 million to 606 million2. In the coming 50 years this number will be tripled again to about 2 billion in 20502. The number of countries with more than 10 million people over 60 will increase from 10 in 2000 to 33 countries in 20502. In the U.S., the number of people over 60 will increase from 46 million to 107 million by 20502.  



I think it is safe to say that, according to the social structure, most of these senior people would either live by themselves or with other seniors who will be facing the similar challenge to seek for help whenever there is an emergency. This Fall Detector would become a must-have device for senior people to avoid delayed medical care and improve their life quality.

References:
1. http://www.owentix.com/en/ow_telemed_operator.php
2. United Nations, World Population Aging, 2002, http://www.un.org/esa/population/publications/worldageing19502050/pdf/80chapterii.pdf

Friday, May 6, 2011

Overview of Telemedicine in Europe

In this post I would like to briefly talk about the recent development of telemedicine in Europe. The telemedicine market in Europe is a fragmented and it grows at a slower rate than that of the U.S. market1. The major hurdle of the development of telemedicine in Europe is the lack of standard regulation – each member country has its own laws and regulations regarding the practice of telemedicine1. Some of the major restraints to the growth of telehealth markets in Europe include lack of concrete laws and regulations1.

However, recently EU members have been striving to cooperate and collaborate to establish unified and efficient telemedicine services, aiming to deploy telehealth in every home in Europe by 20121. One attempt was the formation of European Patient Smart Open Services (epSOS)1. It is a cross boarder telehealth project that linked 27 beneficiaries from 12 EU member countries1. The goal was to build an infrastructure and framework through which patients’ health information, medical history, and prescription from different EU member states could be shared1.

Another recent project was called the Renewing Health, a large-scale pilot project that involved nine European regions2. This project was launched on February 1, 2011, with the goal to make telemedicine as a routine care for patients with chronic disease by generating data for European healthcare systems2. There are 8,000 patients involved in this project including intervention groups such as cardiovascular disease (CVD), chronic obstructive pulmonary disease, and diabetes2. The nine regions are Veneto region in Italy, South Karelia in Finland, Southern Denmark, Northern Norway, Catalonia in Spain, central Greece, Norrbotten in Sweden, Carinthia in Austria and Berlin in Germany2.

There are more initiatives of telemedicine development in EU and the following videos illustrate these ideas and projects.
USACE Renovates Hospitals for Unique Telemedicine Program in Albania

Telemedicine Clinic in UK

eHealth - Better Health for All in Europe


References:

1.      S.Priyan, Increasing scope of Telehealth markets in Europe - A Concise Analysis, May 2009, http://www.frost.com/prod/servlet/market-insight-top.pag?docid=168892280

2.      Renewing Health, EU, http://www.renewinghealth.eu/

Wednesday, May 4, 2011

Progress of Telemedicine in China

Although China is growing fast in many areas, however, in the field telemedicine, it still is in its infant stage. Nonetheless, by establishing an extensive network Community Health Centers (CHC), China is building a foundation for telemedicine and telehealth, an extension of telemedicine.

With the release of the Healthcare Reform Plan in 2009, China underwent a high growth period of building CHC, each covering population between 30,000 and 100,0001. Every CHC is created by transforming existing level I public hospitals that is designed to serve multiple communities or regions. Under each CHC, there are more Community Health Stations (CHS) 1, which are incorporated into each community and each serves about 10,000 people1. As of 2011, there are 8859 CHS in 36 major cities in China2. The goal of this CHC system is to reduce the number of visits to the major hospitals to reduce cost to both patients and the social healthcare system. Now it usually takes 5 to 10 minute walk for a patient to visit the CHS or CHC. CHS is capable of providing primary care but more complicated cases would be transferred to its associated CHC or specialized hospitals.

Given this network of CHC and CHS, it provides the basis for implementation of telemedicine applications and technologies. If each CHS could be linked with other CHS and its associated CHC, then there would be no need for transferring patients from CHS to CHC for severe diseases, because patients could access to doctors and specialists and even perform remote operations from their CHS.

In February 2011, Ideal Life from Canada is signing a contract with Novatech Biological Pharmaceuticals in China to build a telemedicine network that provides remote monitoring healthcare to 100,000 patients, the largest in the world to date3. Ideal Life would provide wireless sensor devices that would be installed at CHS and could detect and transmit real time patients’ data to their health providers for instant feedback and consultation3.

Although this project would start at Shandong Province, with the infrastructure in other major cities in China, I believe it is scalable to the 36 cities where CHS and CHC are already in place.

Reference:

1.      Ruth Woodrow, An in – depth look at Community Healthcare Centers in Beijing, http://www.pharmachinaonline.com/admin/eWebEditor/UploadFile/2009624193513456.pdf

2.      Xinhua News, China boosts community health service, March 201, http://www.chinadaily.com.cn/bizchina/2011-03/12/content_12160857.htm

3.      Close-Up Media via COMTEX, Ideal Life and Shandong NovaTech Biological Pharmaceutical Enter into Pact, December 2010, http://medhealth.tmcnet.com/news/2010/12/03/5172811.htm