The converging face of healthcare
This article has been taken from The Gen newsletter - Summer 2009.
Click here to download the pdf.
Over the next ten years, across the developed world, there will be dramatic changes in the way national healthcare systems operate. During the same period we will alsosee the relationship between patient and healthcare professional redefined.
At the very centre of this healthcare ‘revolution’ lies the convergence of medical and consumer technologies. Healthcare technology convergence will be as fundamental and far reaching as the convergence we are witnessing in the telecommunications area, where the mobile handset is playing such a pivotal role.
While lay people have always had access to basic medical devices – for instance thermometers, stethoscopes and blood pressure units – it is only very recently that more advanced technologies such as glucose monitors, insulin pumps and home diagnostic kits have become available. As convergence between professional and consumer technology gathers pace, a multi-billion dollar market will present itself. What we have seen so far is the merest tip of the iceberg.
Factors driving convergence
Convergence of professional and consumer medical technology is being driven by a variety of factors, the most important being the consumer population itself:
The baby boomer generation – those born between 1946 and 1964 – are more knowledgeable and more interested in their own health than previous generations. Baby boomers are also more mobile, more affluent, better educated and better insured, and they were the first generation to feel at home with technology.
Better paid, better educated
In the US between 1970 and 1998 the percentage of the 65+ population to complete high school rose from 28 to 67 per cent. Improved education has led to increased affluence. This, in conjunction with increased life expectancy, has in turn led to a greater interest in the benefits of medical technology.
Rapid access to detailed health information on the internet, coupled to the emergence of online medical message boards, self-help groups and chat rooms, allows consumers to learn about their health and the treatments and/or technologies available to treat specific conditions. Healthcare specialists are no longer the only source of medical information. The availability of information has its pros and cons but undoubtedly has led to a change in the doctor/patient relationship. Healthcare professionals will, in the future, be viewed more as experts who can help people manage their own health and less as authoritative and unquestioned decision makers.
Shift away from acute care facilities
Over the past 20 years there has been a marked shift away from hospitals to long term care facilities, outpatient clinics and the home. The primary reason has been the imperative to reduce costs but the desire to improve patient comfort and convenience has also played a part, supported by improvements in medication and technology. In less than 30 years the percentage of outpatient procedures in the US has risen from 31 to 70 per cent, according to a recent American Hospital Association survey.
The prevention and management of chronic disease and conditions is the primary target area for convergence. In the US, statistics paint a sombre picture for the nation’s finances. It is estimated that 125 million Americans have chronic health conditions such as cardiovascular disease, diabetes, asthma and Parkinson’s disease.
The care of these patients costs in the region of $510 billion. This number will likely grow to about 175 million patients by 2020 with a corresponding increase in costs beyond $1 trillion. Through technology convergence, there is a corresponding opportunity for industry and service providers to respond with a variety of solutions including, but not restricted to, areas noted above.
One area of considerable interest is the electronic transmission of health information for remote patient monitoring (RPM). Here, convergence includes the sensors of regulated medical devices, the user-friendliness and ease of use of consumer electronics, secure and flexible telecommunications connections, and a support service to monitor the data transmitted. Publicly funded pilot studies are already being undertaken in the US. Considerable commercial interest is also being shown and, despite still being in its infancy, some estimates forecast that RPM will have grown to $260 million by next year.
The field of diagnostics is also a vast market for convergence – and with blood glucose monitoring for diabetics already an established market in the US and elsewhere, the opportunities for future growth are evident. Firstly diagnostics can lay the path for therapy – interpreting symptoms in an unambiguous way (personalised medicine being the holy grail). Diagnostics also play a significant role in reinforcing patient compliance with either a therapy or a behaviour change. By offering immediate and personal feedback they motivate consumers to ‘stick with the plan’. Compared to therapeutic devices, diagnostic technology is often simpler to develop and get approved by the US FDA (Food and Drugs Administration). Additionally, there is broad acceptance that diagnostic devices are easier for consumers to understand compared to therapeutic devices.
Opportunities for technology convergence are almost unlimited. While we have noted some of the ‘front runners’ above, there are equally big markets to be developed in the areas of wellness, nutrition, weight loss, medication compliance and pain management.
Challenges to overcome
While the opportunity for technology convergence is real and growing, there are challenges still to be overcome. Significant among these include a thorough understanding of consumer psychology by manufacturers. Whereas clinicians adopt a utilitarian and functional view of medical technology, consumers’ buying decisions will be based on a wider range of criteria many of which will be distinctly non-medical!
In the US reimbursement for medical technology continues to remain a significant barrier to adoption. Doctors’ notes are required for insurance company reimbursement and where these do not exist, the consumer will have to pay out of pocket. The value of the device will need to be clearly demonstrated and understood before wide scale take up occurs. The move towards remote monitoring raises a number of payment issues that the US reimbursement model (for instance) is not yet set to deal with.
The role of regulatory bodies will also come under the spotlight as convergence gathers pace. In the US for example, the FDA is responsible for the approval of professional and consumer medical devices. Allowing patient populations to self diagnose for life- threatening viruses such as HIV, without appropriate back up counselling services, raises a number of ethical issues.
And finally, there will be understandable deep rooted resistance from healthcare professionals who have been trained to be cautious in the adoption of new technology and will have genuine concerns about the consequences of putting more knowledge and empowerment at the door of the patient.
Notwithstanding the challenges yet to be overcome, there is growing recognition that convergence involving professional and consumer technology will grow dramatically over the next ten years.
The newness and nature of the opportunity means that very few companies – even those acknowledged as ‘leaders’ in their particular fields of operation – will have the in-house expertise across the board to undertake opportunity discovery, market and voice of the customer research, patent landscaping, technology innovation and product development.
At Sagentia, we are well placed to work with customers in this field. We have experience in both consumer product and medical device development over many years, including remote monitoring in cardiology, through to consumer products such as a mobile child monitoring unit for parents and carers. Through our work in both areas, we are able to bridge the gap between consumer aspiration and real medical technology.