By Andy Castonguay, Principal Analyst, Machina Research
While the US government continues to suffer political apoplexy when it comes to creating efficient national healthcare policies, the venture capital and angel investor communities in the United States have seized on the market’s potential and have been aggressively funding health-focused companies so far in 2014. Recent investment tracking reports from Rock Health and Mercom Capital Group show that investments in health-focused companies totaled between USD700m and USD848m in the first quarter of 2014 alone. While the range of these investments includes companies focused on clinical management, consumer mHealth, and health IT companies, among others areas, the size of the overall investment activity highlights the growing significance and market potential that technology holds in reshaping the delivery of healthcare services. In the US, where healthcare spending is expected to grow from 18.3% in 2014 to 19.9% of national GDP by 2022, high spending has not necessary resulted in improved outcomes. In fact, that rate of US spending is nearly double the average among OECD countries, of which several offer better healthcare access and clinical outcomes. Even though the US is certainly not alone in facing increasing healthcare costs, the size of the market, expenditure trends and an aging population with significant chronic disease profiles make for a dynamic opportunity for advances in digital health services, remote monitoring and connected health devices to potentially offer a path towards better, more efficient healthcare.
Among the most prominent connected devices in digital health are those solutions targeting the consumer-focused “worried well” health monitoring. Machina Research estimates that the broader worried well category will account for 61.8m connected devices in 2014 globally, increasing to more than 477m in 2023. The range of these devices, which are typically purchased by the individual consumer and are generally not certified by regulators such as the FDA, is expanding quickly to include devices such as connected heart rate monitors, blood pressure monitors, weight scales, wearable activity monitors, sleep monitors and even devices designed to predict optimum fertility cycles for couples looking to conceive. While these consumer focused devices and solutions are gaining significant traction in the marketplace, advances in worried well device and application design are also influencing clinical remote monitoring of chronic diseases like diabetes and asthma, creating a trend of consumerization of clinical health devices.
The blending of consumer-friendly technology with clinically relevant monitoring is driving a new generation of health monitor devices aimed predominantly at chronic disease patients, and raising expectations for better adherence to monitoring regimen and lowering the likelihood of acute events associated with poor disease management. The introduction of wirelessly connected glucose meters in recent years and associated smartphone applications is helping create a more integrated approach to helping patients adhere to their care regimens while facilitating a better record of their daily glucose readings and insulin usage. For many years the primary business model for diabetes monitoring has revolved around the selling of testing strips. As a result, the testing device, into which the strips are inserted for analysis, has generally been sold at low cost or even given to consumers for free in order to encourage their use of a particular brand of strips. With the introduction of connected blood glucose monitors such as Telcare’s cellularly connected model launched in 2010, the field of connected glucose strip readers is quickly evolving to include new models and formats, but just as importantly, creating a more dynamic platform for patient education and engagement. Newer designs such as Sanofi’s iBGStar have begun to blur the lines between a stand alone device and a smartphone accessory. The tiny iBGStar device clicks into the bottom of the iPhone or iPod, analyzes a user’s blood strips then displays the results through an associated iPhone application. The application allows users to view and analyse their glucose readings history, to track eating behaviour and to share that history with care providers.
Aiming for better engagement and disease control for asthma sufferers, Propeller Health, has developed an inhaler-based solution that that houses an FDA-approved sensor to monitor the frequency and level of usage of the inhaler, and then uses that data in its smartphone application to guide and educate asthma and COPD patients to maintain better health. The product is designed to fit onto a medicated inhaler and capture usage behaviour data so that every time the inhaler is used the Propeller sensor records date, time and location data and then syncs that data wirelessly with the Propeller smartphone app or data hub. This process creates a detailed compliance record of the patient’s actual medication usage that can be shared with medical personnel, eliminating the need for manual keeping of asthma treatment logs typically requested by physicians and frequently ignored by patients. Additionally, the usage patterns of the inhaled applications are also used to predict a patient’s worsening condition and likely need of emergency room visits or interventions and therefore establish a 4-5 day lead for the patient and his/her clinician to address the problem. For asthma patients the solution appears to be effective in raising medication adherence as much as 80%, according to the company. This represents a significant improvement among asthma patients as studies indicate that as many as 55% of asthma patients do not have their condition under control.
These examples of the consumerization of clinical remote monitoring devices offer some insight into the potential for future health care monitoring as well as hope to improve the level of patient health through a consumer friendly, cost-efficient means. Similar hybrids of clinical devices with consumer technology are being introduced for cardio monitoring (ECGs), vital fluids analysis and other clinical areas. The combination of clinical accuracy, better patient engagement and management, and significantly lower device costs in many cases, presents a unique opportunity for new investment in companies focused on this space as well as a potential path to making a dent in the rise of healthcare costs overall, which will be crucial for countries like the US where such costs have reached the level of strategic imperative.
