Remote and Wireless PM Markets

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August 2012

CHAPTER ONE: EXECUTIVE SUMMARY .........................................................1

Introduction ......................................................................................................................... 1
Scope and Methodology ...................................................................................................... 2
Product Segments .............................................................................................................. 2
Product Details .................................................................................................................. 3
End-Users .......................................................................................................................... 4
Issues and Trends ................................................................................................................ 6
Size and Growth of the Market .......................................................................................... 8
Competitors ........................................................................................................................ 11
Forecast .............................................................................................................................. 12

CHAPTER TWO: INTRODUCTION .....................................................................13

Overview............................................................................................................................. 13
Aging of the Population..................................................................................................... 14
Population Statistics .......................................................................................................... 15
U.S. Population Totals .................................................................................................... 16
Life Expectancy ..............................................................................................................19
Economic Trends ............................................................................................................... 22
U.S. Healthcare Challenges ............................................................................................. 23
Barriers to Use of New Technologies in Patient Monitoring ......................................... 24
Emerging Trends ............................................................................................................... 27
Cloud-Based Mobile Healthcare ..................................................................................... 28
Healthcare Establishments .............................................................................................. 30
Hospitals.......................................................................................................................... 31
Physicians ........................................................................................................................ 35
Nursing Homes................................................................................................................37
Proven Cost Effectiveness ................................................................................................. 38

CHAPTER THREE: PRODUCTS...........................................................................40

Overview............................................................................................................................. 40
New Technologies .............................................................................................................. 42
Wireless Technologies .................................................................................................... 42
Smartphones in Healthcare.............................................................................................. 42
Remote Monitoring ......................................................................................................... 43
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Table of Contents
Telemedicine ...................................................................................................................44
Applications by Disease State .........................................................................................45
EMR (EHR) Data Transfer Applications and Equipment ...............................................45
Technology Achievements ..............................................................................................46
Established Product Segments with Improved Technologies ........................................48
Multiparameter Monitoring Devices ...............................................................................48
Ultrasound .......................................................................................................................49
Fetal Heart Monitors .......................................................................................................51
Diabetes Monitors ...........................................................................................................51
Prothrombin Time Monitors ............................................................................................52
Offerings .............................................................................................................................54
SPECIFIC COMPANY OFFERINGS ............................................................................62
Abbott ..............................................................................................................................62
American Medical Development (AMD) Telemedicine Products ..................................62
American TeleCare..........................................................................................................63
Cardiocom .......................................................................................................................64
Carematix ........................................................................................................................65
Cybernet Medical Corporation ........................................................................................65
Draeger Medical ..............................................................................................................66
GE Healthcare .................................................................................................................67
GlobalMedia Group .........................................................................................................68
Honeywell HomMed .......................................................................................................69
Intel..................................................................................................................................70
InTouch Health ................................................................................................................70
LifeWatch Technologies .................................................................................................71
MedApps .........................................................................................................................72
Medtronic ........................................................................................................................72
Philips Medical Systems .................................................................................................73
Roche ...............................................................................................................................73
St. Jude Medical ..............................................................................................................74
Second Opinion Telemedicine Solutions, Inc. ................................................................74
Welch Allyn ....................................................................................................................75
New Monitoring Development ........................................................................................77

CHAPTER FOUR: ISSUES AND TRENDS .......................................................... 79

Introduction .......................................................................................................................79
Issues and Trends Driving the Market ............................................................................80
Aging of the Population ..................................................................................................80
New Wireless Technologies ............................................................................................85
Health Information Technology and American Reinvestment and Recovery Act of 2009
(ARRA) ...........................................................................................................................86
Medicine-At-Work ..........................................................................................................89
Healthcare Efficiency ........................................................................................................89
Are Electronic Healthcare Systems More Efficient?.......................................................90
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Table of Contents
Emphasis on Reducing Hospital Days ............................................................................ 95
Decreasing Healthcare Resources ................................................................................... 96
Nursing Shortage ............................................................................................................. 96
National Health Expenditures ......................................................................................... 97
eICU .............................................................................................................................. 100
EMR Adoption .............................................................................................................. 101
Opportunities in TeleHealth/TeleMedicine ................................................................... 106
Development of Patient Monitoring Technologies........................................................ 107
Audio and Video ........................................................................................................... 108
Algorithms to Sort Data or Trigger Alarms ............................................................... 108
Alarm Fatigue................................................................................................................ 109
Off-site Access to Data ................................................................................................. 109
Full-service Outsourcing ............................................................................................... 109
Converged Wireless Networks ...................................................................................... 109
Data Management and the Electronic Medical Record ................................................. 110
Turnkey Systems ........................................................................................................... 112
Disease Management Kits ............................................................................................. 113
HIPAA........................................................................................................................... 113
FCC Rules for Medical Wireless Communication ........................................................ 114
System Compatibility .................................................................................................... 114

CHAPTER FIVE: TOTAL MARKET SIZE AND FORECAST........................117

Overview........................................................................................................................... 117
Total Market Size and Forecast ..................................................................................... 117
Technologies ..................................................................................................................... 121
Wireless and Remote Monitors and Devices ................................................................ 121
Patient Data Processing Applications and Equipment .................................................. 121
Equipment and Applications to Transfer Data to EMRs ............................................... 122
End-User Markets ........................................................................................................... 126
Hospitals........................................................................................................................ 131
Home Healthcare ........................................................................................................... 132
Nursing Homes.............................................................................................................. 135
Disease States ................................................................................................................... 139
Asthma .......................................................................................................................... 146
Cancer ........................................................................................................................... 146
CHF ............................................................................................................................... 146
COPD ............................................................................................................................ 147
CAD .............................................................................................................................. 147
Diabetes ......................................................................................................................... 147
Other.............................................................................................................................. 148
International Markets: Brief Overview ......................................................................... 149
International Developments .......................................................................................... 149
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Table of Contents
World Population ..........................................................................................................152
Healthcare Spending Trends: A Global Overview ........................................................156
Patient Monitoring Global Market Summery ................................................................160
Market Drivers and Inhibitors .......................................................................................163
Growth Drivers ..............................................................................................................163
Growth Inhibitors ..........................................................................................................163
Emerging Trends .............................................................................................................164

CHAPTER SIX: CORPORATE PROFILES ....................................................... 167

Introduction .....................................................................................................................167
Abbott Laboratories, Inc ................................................................................................169
Aerotel Medical Systems .................................................................................................171
Draeger Medical, Inc. ......................................................................................................173
GE Healthcare..................................................................................................................175
Honeywell HomMed LLC ...............................................................................................178
Intel Corporation .............................................................................................................180
LifeWatch AG ..................................................................................................................182
Medtronic, Inc. .................................................................................................................184
Philips Healthcare............................................................................................................186
St. Jude Medical ...............................................................................................................189

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Table of Contents
L

CHAPTER ONE: EXECUTIVE SUMMARY

The U.S. Market for Advanced Patient Monitoring Systems 2007-2016........................ 9
The U.S. Market for Advanced Patient Monitoring Systems 2007-2016...................... 10

CHAPTER TWO: INTRODUCTION

Table 2-1: The U.S. Population, 1980-2050 ..................................................................... 16
Figure 2-1: The U.S. Population, 1980-2050 ................................................................... 17
Tabel 2-2: Percent U.S. Population Over Age 65 by Year, 2000-2050 .......................... 17
Figure 2-2: Estimated Population by Age Group, 2000 and 2050 ................................. 18
Table 2-3: Average Life Expectancy in Years by Country 1980, 2004 and 2011 ......... 20
Figure 2-3: Average Life Expectancy in Years by Country 1980 and 2011 ................. 21
Table 2-4: National Healthcare Expenditures in the United States 1960-2015 ............ 22
Figure 2-4: Healthcare Spending as a Percent of GDP in the
United States, 1980-2020 .................................................................................................. 23
Figure 2-5: Most Significant Barriers to Implementing IT, 2011 ................................. 27
Table 2-5: U.S. Registered Hospitals by Type, 2010....................................................... 32
Figure 2-6: Number of Hospitals in the US, 1975-2005, Estimated 2015 ..................... 33
Select For-Profit U.S. Hospital Chains, 2010 Data ......................................................... 34
Number of Hospital Mergers in the US, 1998-2007 ........................................................ 35
Number of Physician Offices, 2000-2009 ......................................................................... 36
Number of Nursing Homes, 2000-2010 ............................................................................ 38

CHAPTER THREE: PRODUCTS

Table 3-1: Select Patient Monitoring Systems May 2012............................................... 56

CHAPTER FOUR: ISSUES AND TRENDS

Table 4-1: United States Population Trend Age 65+, 2000-2050 .................................. 82
Figure 4-1: United States Population Trend Age 65+, 2000-2050 ................................. 83
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Table of Contents
Table 4-2: Stages of Meaningful Use ................................................................................88
Figure 4-2: Percent of U.S. Hospitals Reporting ED Capacity Issues by Type of
Hospital, Current Survey March 2010 ............................................................................93
Figure 4-3: Percent of U.S. Hospitals Reporting ED Diversion in Last 12 Months by
Type of Hospital, Current Survey March 2010 ..............................................................94
Figure 4-4: Percent of U.S. Hospitals Citing Factor as Number One Reasons for ED
Diversion, Current Survey March 2010 ..........................................................................95
Table 4-3: National Health Expenditure Amounts, by Type of Expenditure:
Calendar Years 2005-2019 1..............................................................................................98
Table 4-4: Percent of Office-based Physicians Using EMRs, 2001-2010 ....................102
Table 4-5: Percent of Office-based Physicians Using EMRs, by Level of
EMR System, 2006-2010 ...................................................................................................103
Figure 4-5: State Data: Percent of Office-based Physicians Using EMRs,
Preliminary 2010 ..............................................................................................................105

CHAPTER FIVE: TOTAL MARKET SIZE AND FORECAST

Table 5-1: The U.S. Market for Advanced Patient Monitoring Systems 2007-2016 .119
Figure 5-1: The U.S. Market for Advanced Patient Monitoring Systems 2007-2016 120
Figure 5-2: The U.S. Market for Advanced Patient Monitoring Systems, by
Technology Type, 2007 ....................................................................................................123
Figure 5-3: The U.S. Market for Advanced Patient Monitoring Systems, by
Technology Type, 2011 ....................................................................................................124
Figure 5-4: The U.S. Market for Advanced Patient Monitoring Systems, by
Technology Type, 2016 ....................................................................................................125
Table 5-2: The U.S. Market for Advanced Patient Monitoring Systems, by End User
(Hospitals, Home Healthcare, Nursing Homes, Other) 2007-2016 .............................127
Figure 5-5: The U.S. Market for Advanced Patient Monitoring Systems, by End User
(Hospitals, Home Healthcare, Nursing Homes, Other) 2007-2016 .............................128
Figure 5-6: The U.S. Market for Advanced Patient Monitoring Systems, by End User
Type (Hospitals, Home Healthcare, Nursing Homes, Other) 2011 ............................129
Figure 5-7: The U.S. Market for Advanced Patient Monitoring Systems, by End User
Type (Hospitals, Home Healthcare, Nursing Homes, Other) 2016 ............................130
Figure 5-8: Number of Hospitals in the US, 1975-2005, Estimated 2015....................132
Table 5-3: Home Health Statistics, 2010 Estimates ......................................................134
Table 5-4: Hospice Cases by Diagnosis, 2010 Estimates ..............................................134
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Table of Contents
Table 5-5: U.S. Nursing Homes, Beds, Residents and Occupancy Rate, 2010 ........... 136
Figure 5-9: Number of Nursing Homes, 2000-2010 ...................................................... 137
Table 5-6:U.S. Prevalence of Selected Medical Conditions ......................................... 140
Figure 5-10:U.S. Prevalence of Selected Medical Conditions ...................................... 141
Figure 5-11: The U.S. Market for Advanced Patient Monitoring
Systems, by Disease, 2007 .............................................................................................. 143
Figure 5-12: The U.S. Market for Advanced Patient Monitoring
Systems, by Disease, 2011 .............................................................................................. 144
Figure 5-13: The U.S. Market for Advanced Patient Monitoring
Systems, by Disease, 2016 .............................................................................................. 145
Table 5-7: The World Population, 1980-2050 ............................................................... 153
Figure 5-14: The World Population, 1980-2050 ........................................................... 154
Table 5-8: International Population Trend Age 65+, 2000-2050................................. 155
Figure 5-15: International Population Trend Age 65+, 2000-2050 ............................. 156
Table 5-9: Total Healthcare Expenditures as a Percent of GDP
by Country 1990, 2000 and 2009 ................................................................................... 158
Figure 5-16: Total Healthcare Expenditures as a Percent of GDP by
Country 1990, 2000, and 2009 ....................................................................................... 159
Table 5-10: International Market for Advanced Patient Monitoring, 2011 .............. 161
Figure 5-17: International Market for Advanced Patient Monitoring, 2011 ............. 162

CHAPTER SIX: CORPORATE PROFILES

Table 6-1: Abbott Revenues ........................................................................................... 170
Table 6-2: Draeger Revenues ......................................................................................... 174
Table 6-3: GE Revenues .................................................................................................. 177
Table 6-4: Honeywell Revenues ..................................................................................... 179
Table 6-5: Intel Revenues ............................................................................................... 181
Table 6-6: LifeWatch Technologies Revenues .............................................................. 183
Table 6-7: Medtronic Revenues ..................................................................................... 185
Table 6-8: Philips Revenues ............................................................................................ 188
Table 6-9: St. Jude Revenues .......................................................................................... 190

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Three: Products
41

Nursing homes

Other, including first responders, institutional, and military.

Hospitals are concerned with being able to access patient monitoring data within
the hospital, regardless of whether the patient is being transported; having the data sorted
so a clinician does not have to pour through it; and having access to data from all
departments. Use of electronic medical records is more prevalent within hospitals than in
the other markets, but remote patient monitoring usually pertains to monitoring within
the hospital. Hospitals frequently use intranets for data storage, rather than web-based
systems.
Home health care can be ordered by hospitals or physicians and can range from
monitoring basic temperature, weight, and vital signs, to specific disease state
management of conditions such as chronic obstructive pulmonary disorder (COPD),
asthma, cardiovascular conditions, respiratory conditions, perinatal monitoring, sleep
apnea, or diabetes. In these cases, patient monitors are user-friendly, often connect to a
central hub, and often transmit data via telephone lines. Newer developments use wireless
technologies, transmit data using Bluetooth or mobile phones, sort the data with
algorithms specific to the disease state, and use customizable alarms and patient surveys.
Few of the systems used in the home healthcare market will transfer data to an electronic
medical record (EMR), although this is likely to become a more important component in
the future. A concern with remote patient monitoring systems used in homecare is
compatibility of devices and software. There are vendors that manufacture peripherals,
vendors that manufacture hubs and software that only support select brands of peripherals,
and applications for managing data that are not compatible with other technologies.
Nursing homes, including skilled nursing homes, rehabilitation nursing homes, and
assisted living facilities, have needs somewhere between those of hospitals and home
healthcare. Patient monitoring needs can range from basic monitoring of vital signs for
rehabilitative patients or relatively mobile patients to monitoring of chronic conditions.
Patients range from short-term rehabilitative patients to long-term residents, with all
ranges of patient mobility. A useful technology for nursing homes is the health kiosk. A
patient can sign in with a password, have various measurements taken, and then upload
data into a patient record that can be accessed by the patient, his or her family, and the
patients healthcare providers. This is a cost-effective means for taking various
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Four: Issues & Trends

102

Only physicians who said they used all four of these features were deemed to be
using comprehensive EMR systems. Use of the EMRs by office-based physicians has
xxxxxx relatively steadily since 2001, from XX% in 2001 to XX% in 2010.

Table 4-4

Percent of Office-based Physicians Using EMRs, 2001-2010

Year

Any EMR

Fully Functional
System

Basic System

2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
Source: CDC/NCHS, National Ambulatory Medical Care Survey, 2010.

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Five: Markets
149

Hypertension
Monitoring and managing hypertension at home is becoming a trend device
manufacturers are unable to ignore. The more than XX xxxx Americans battling some
degree of hypertension is increasing the need for portable, home monitoring systems.
Several new, advanced blood pressure monitors have Bluetooth capabilities to upload data
and track trends easily; come in very small, handheld versions; are Multiparameter and are
priced affordability to home users. This market is continuing to advance and will likely
see moderate double-digit growth during the forecast period.

Myocardial Infarction
The continuous cardiac monitoring in myocardial infarction patients has improved
mortality rates for patients. Ambulatory and critical care monitoring of these patients is an
essential measure in providing quality care with the most optimal outcomes.

Osteoarthritis
New technologies are emerging for the monitoring of osteoarthritis (OA)
particularly in home environments. Many monitoring devices are used in rehabilitation
labs and onsite physician offices. However, there are new advances in using small,
portable monitors which strap to specific body locations (the knee in particular) which
record and measure body movement and relay that data to a wireless device for
transmitting to the patients record. These advances are newer and may take some time to
evolve. Today the market for wireless and remote OA monitoring is only worth xxxxx
xxxxx. However, growth is expected in this segment as a growing number of people are
facing OA diagnoseswith an aging population contributing to this figure.

INTERNATIONAL MARKETS: BRIEF OVERVIEW

International Developments
Internationally, the advanced patient monitoring market has seen some recent
growth with many European countries at the forefront of implementation. Countries with
a growing demand for high-tech monitoring devices include:
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