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Telemedicine and Remote Patient Monitoring Rely on Wireless, Business and Industry Trends Analysis

The healthcare products business of electronics giant Royal Philips Electronics offers an ICU (intensive care unit) remote monitoring system called eICU.  Originally developed by Visicu, Inc., a Baltimore, Maryland medical information technology company that is now part of Phillips, eICU is a combination of software, video and audio feeds and real-time patient vital statistics that hooks patients in ICUs in multiple hospitals to central monitoring facilities manned by ICU specialists.  A specialist at the central location mans a standing desk outfitted with a cutting edge graphical dashboard called orb that displays patient data, including real-time video and audio for up to 150 ICU beds at a time.  The system ranks patients according to their conditions and flags gravely ill patients in red so that their progress can be more easily monitored.  Indications such as changes in blood pressure alert the specialist who then contacts the nurse or physician on duty to treat the patient accordingly.  As of mid-2015, eICU was in use in more than 350 hospitals across more than 40 health systems around the world.

Hospitals that have eICU have experienced significant cost savings since the system cuts the average ICU stay from 4.4 days to 3.6 by lowering the instances of complications such as pneumonia and infections (these conditions generally occur when patients are not closely monitored by ICU specialists).  The Leapfrog Group estimates that 54,000 patients per year could be saved if every U.S. ICU were monitored by specialists.

Other remote monitoring systems are allowing patients to be monitored at home or at out-of-the-way care facilities.  For example, American Telecare, Inc.’s CareTone Telephonic Stethoscope checks for heart, lung and bowel sounds using a small stethoscope, a phone line and two-way video stations.  Cardiocom LLC’s Telescale is a telemonitoring device integrated with an electronic scale.  The patient steps onto the scale and answers questions using a touch pad about his or her symptoms.  The answers and the patient’s weight are communicated via two-way messaging to the consulting physician, who is alerted if there is any deterioration in the patient’s health.  The system also sends alerts back to the patient for follow-up visits or care plan adjustments.  Other remote monitoring systems track cardiac patients’ vital signs and links them via video chat to a nurse when necessary.

Many of the world’s leading technology companies see immense potential in remote home monitoring of elderly and chronically ill patients.  One example is the “Health Buddy” from Bosch, which can utilize home monitors for weight, glucose, blood pressure and blood oxygen.  Philips, Honeywell and Intel are also developing products.  Intel’s design includes two-way video between the patient at home and caregivers.  A noteworthy startup is Scanadu, , a Silicon Valley firm that raised $1.7 million in crowdfunding to develop Scout, its hockey-puck sized unit that measures body temperature, heart rate and blood pressure when held to the forehead (pricing starts at $199).  The firm is also working on a urine test kit.

Another slant on telemonitoring is the growing practice of patients connecting with physicians via laptop webcams, video-enabled tablets or smartphones.  Rather than an expensive doctor visit, some patients are opting for virtual consultations that cost about $40 to $45.  Insurers including WellPoint, Aetna and United Health are offering virtual visit options in several U.S. states that do not require a face to face meeting before a doctor can prescribe medication.  A large number of companies have launched telehealth services, with many of them aimed at saving costs for employee health plans.

Thomas Jefferson University Hospital is investing in video apps that enable physicians to consult with patients from their homes.  The hospital began testing video consultations in late 2014, with primary care physicians following up with patients after they went home.  The facility hopes to eventually perform triage via video for many of the patients who visit its Emergency Room each year.  Video assessments may enable doctors to assess who needs emergency treatment and who would be better served at an urgent care clinic or by calling a regular doctor.

A new player in the wearable sensor arena is Apple’s smartwatch which is basically a wearable computer that is part watch, part iPhone, part iPod and much more.  With regard to health care, users can download apps to the watch that track readings from external monitors such as those used to measure glucose.  DexCom, Inc. has designed just such an app to go with its glucose monitor that displays blood sugar data in a simple, easy to read graph.  Watch for apps and sensors that track other medical data to hit the market in the near term such as electrocardiograms (EKGs), blood oxygen levels and respiratory rates, pending FDA approval.

PricewaterhouseCoopers (in partnership with GSM Association) forecasted that global mobile health revenue would reach $23 billion by 2017.  Grand View Research projected that the worldwide market would total $49 billion by 2020.  This includes mobile operators, device vendors, health-care providers and content makers.

Mobile health apps are extremely popular with consumers, and are adding features and capabilities on a continual basis.  Examples include MyFitnessPal, which was acquired by Under Armour, and Runkeeper.  Apple released the HealthKit and ResearchKit (in addition to its Health tracking and fitness app) that enable physicians search for health apps according to their medical specialty and leverage health resources.  Stanford University found that 11,000 people signed up for a cardiovascular study using ResearchKit less than 24 hours after its release.

In the Finnish city of Oulu, a telemonitoring system called Self Care has users who login to their computers to make appointments, refill prescriptions and exchange messages with doctors.  People who test blood pressure or blood sugar levels at home can enter the results online for doctors to view.  Lab results are posted within hours.  Self Care costs the city $390,000 each year, but has saved millions in reducing expensive, face-to-face doctor’s visits.



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