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Digital Health 2019: Trends, Opportunities and Outlook

Telehealth, telemedicine, remote patient monitoring, digital therapeutics, analytics, genetic testing and smart home as a carer

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Digital health promises to change the face of healthcare. Reflecting this is growing interest in the digital health space, as evidenced by a substantial growth in investment over the 5 years. Digital health continues to take prominence at healthcare conferences such as the JP Morgan Healthcare Conference in January 2019, illustrating its growing importance - but it is not limited to strictly the healthcare space.
 
Digital health is a convoluted and complex field, much of which is made up of technologies and services that enable healthcare outside of traditional clinical settings. It follows a global trend in the healthcare industry of decentralization to alleviate overburdened hospitals and clinics. Coupled with escalating healthcare costs, shrinking profit margins and ageing populations suffering with chronic conditions, digital health offers a solution to these problems for all players in the space including patients, providers and payers. In fact, it presents such an alluring and lucrative opportunity that companies not previously in the healthcare space are making significant investments and moves to do so. Big tech companies such as Amazon, Apple and Alphabet have made significant strides into the healthcare space since their announcements in January 2018.
 
The time is ripe for digital health due to the combination of a number of factors. These include changing population demographics, such as ageing populations with increasing prevalence of chronic diseases, as well as current and upcoming changes to regulations and reimbursements which mean that the route to market and take-up of digital health services and technologies is more likely in 2019 and beyond.
 
By whichever name it comes under, whether that's digiceuticals, digital therapeutics or software-as-a-drug, this idea of software replacing drugs is a worry for large, established pharmaceutical companies. Coupled with the changing landscape of healthcare which is moving away from treating patients and towards a model of preventative care and a move from fee-based to value-based services, big pharma is being disrupted and digital health threatens to cause even more turbulence.
 
This report acts as a primer to the digital health space, providing a detailed overview of the ecosystem and offering insights into the key trends, opportunities and outlooks for all aspects of digital health, including:
  • Telehealth and telemedicine
  • Remote patient monitoring
  • Digital therapeutics / digiceuticals / software-as-a-drug
  • Consumer genetic testing
  • Diabetes management
  • Smart home as a carer
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Table of Contents
1.EXECUTIVE SUMMARY & CONCLUSIONS
1.1.The Scope of Digital Health
1.2.Changing Demographics Require Healthcare Reforms
1.3.Factors Encouraging the Rise of Digital Health
1.4.Enabling Technologies for Digital Health
1.5.Effective Use of Resources Enabling Cost Efficiency
1.6.The Future of Healthcare is Consumer-Led
1.7.Big Tech Players are Moving into Healthcare
1.8.Towards a Model of Value-Based Healthcare
1.9.Big Pharma is Struggling, Disruption is Inevitable
1.10.Consolidating and Collaborating to Survive and Thrive
1.11.Regulation of Digital Health: Wanting the Best of Both Worlds
1.12.Telehealth and Telemedicine are Poised for Take-Off
1.13.The Future for Telehealth and Telemedicine
1.14.Remote Patient Monitoring is Changing the Face of Healthcare
1.15.The Outlook for Remote Patient Monitoring
1.16.Digital Therapeutics - The Next Step for mHealth?
1.17.The Outlook for Digital Therapeutics
1.18.The Rise of Direct-to-Consumer Genetic Testing
1.19.Sensors in Smart Homes: Decentralization of Healthcare
1.20.Outlook: Investment Continues to Break Records
1.21.Market Outlook: Wearable Medical Devices
1.22.Outlook for Digital Health: Quality, Outcomes, and Value are Key
2.INTRODUCTION
2.1.The Scope of Digital Health
2.2.Digital Health Definitions
2.3.Changing Demographics Require Healthcare Reforms
2.4.Global Healthcare Spending is Rising
2.5.Margins are Being Squeezed in Healthcare
2.6.Trouble for Traditional Healthcare?
2.7.Mergers and Acquisitions: Vertical Integration
2.8.Big Tech Players are Moving into Healthcare
2.9.Apple
2.10.Amazon
2.11.Alphabet
2.12.Tencent
2.13.From Fee-for-Service to Value-Based Purchasing
2.14.Towards a Model of Value-Based Healthcare
2.15.Big Pharma is Struggling
2.16.Digital Disruptors & Big Pharma: A Match Made in Heaven?
2.17.Big Pharma: Competitions and Digital Hubs
2.18.The Future for Pharma
2.19.Rising Role of Venture Capital
2.20.Mobile Health is Becoming the Norm
2.21.Apple Enters the Electronic Health Record Market
2.22.The Future of Healthcare is Consumer-Led
2.23.Apps are Moving Towards Voice
2.24.A Move to Precision/Personalized Medicine
2.25.Biosensors are Moving to the Point-of-Care
2.26.Consumer-Driven, Patient Centered Healthcare
2.27.Global Challenges in Implementing Digital Health
2.28.The P4 Healthcare Model
2.29.The Emergence of a P4 Healthcare System
2.30.Wellness and Prevention
2.31.Outlook: Investment Continues to Break Records
2.32.Market Outlook: Wearable Medical Devices
3.ENABLING TECHNOLOGIES
3.1.Enabling Technologies for Digital Health
3.2.IoT
3.3.5G
3.4.Access to High Quality Broadband
3.5.Artificial Intelligence and Machine Learning
3.6.VR, AR and MR
4.REGULATIONS AND SECURITY
4.1.Digital vs Traditional Healthcare
4.2.Medical Device Pathways
4.3.Regulation of Digital Therapeutics
4.4.FDA Pre-Cert Program
4.5.Pre-Cert 1.0
4.6.Digital Tools Not Under FDA Review
4.7.Regulation of Direct-to-Consumer Genetic Testing
4.8.Genetic Data, Privacy Concerns and a Lack of Trust
4.9.Unanswered questions about device security
4.10.Security Risks for Medical Devices
4.11.The Security of Data is a Critical Issue
4.12.National Systems at Risk of Large Scale Cyber Attacks
5.TELEHEALTH & TELEMEDICINE
5.1.Defining Telehealth and Telemedicine
5.2.The History of Telehealth and Telemedicine
5.3.Telehealth Encompasses a Range of Services
5.4.There are Numerous Types of Telemedicine
5.5.The Key Services Models for Telehealth
5.6.Use Cases for Telehealth and Telemedicine
5.7.Benefits of Telehealth and Telemedicine
5.8.Challenges in Telehealth and Telemedicine
5.9.Is Telehealth a Cost-Effective Solution?
5.10.Telehealth and Telemedicine are Poised for Take-Off
5.11.The Growing Network of Care
5.12.Doctors Require Better Ways of Communication
5.13.Nomadeec
5.14.Smartphones Become the Tool for Doctors
5.15.Driving the Uptake of Telemedicine
5.16.Changes to Reimbursement of Telehealth
5.17.Reimbursement of Remote Patient Monitoring
5.18.Room to Improve and Mature
5.19.The Next-Generation of Telemedicine
5.20.Babylon Health
5.21.TytoCare
5.22.American Well
5.23.Key American Well Partnerships
5.24.The Future for Telehealth and Telemedicine
6.REMOTE PATIENT MONITORING
6.1.Remote Patient Monitoring: Measurements and Applications
6.2.Components of a Remote Monitoring System
6.3.Remote Patient Monitoring is Changing the Face of Healthcare
6.4.Remote Patient Monitoring in Hospitals and the Home
6.5.Remote Patient Monitoring Solutions in the Home
6.6.Omron
6.7.Owlet
6.8.toSense
6.9.Biotricity
6.10.Remote Patient Monitoring Solutions in Hospitals
6.11.Evolution of the Stethoscope into the Digital Realm
6.12.Remote Patient Monitoring in Clinical Trials
6.13.The Benefits of Remote Patient Monitoring for Payers
6.14.UnitedHealthcare Motion: US
6.15.Momentum Multiple: South Africa
6.16.Vitality: UK
6.17.Vitality and Apple Watch
6.18.Fitbit
6.19.Elder Care
6.20.Elder Care: Fall Detection
6.21.Elder Care: Medical Adherence
6.22.Is Remote Patient Monitoring Really Helpful?
6.23.Skin Patches Emerging as a Key Form Factor
6.24.Contactless/Invisible RPM
6.25.Xandar Kardian
6.26.The Outlook for Remote Patient Monitoring
7.DIGITAL THERAPEUTICS
7.1.Digital Therapeutics: App-Based Healthcare
7.2.Digital Therapeutics - The Next Step for mHealth?
7.3.The Rationale Behind Digital Therapeutics (DTx)
7.4.Digital Therapeutics for Chronic Conditions Poised for Success
7.5.Tracking and Monitoring Adherence
7.6.Proteus Digital Health
7.7.Propeller Health
7.8.Mental Health is a Key Focus for DTx
7.9.PEAR Therapeutics
7.10.Carrot
7.11.Akili Interactive
7.12.Insurers are Investing in Digital Therapeutics
7.13.Difficulties in Realising the Potential of Digital Therapeutics
7.14.Digital Therapeutics Alliance
7.15.Diabetes Partnerships are Proliferating
7.16.The Outlook for Digital Therapeutics
8.CASE STUDY: DIABETES MANAGEMENT
8.1.Diabetes is an Early Adopter of Digital Healthcare Initiatives
8.2.The cost of diabetes
8.3.Managing side effects accounts for 90% of the total cost of diabetes
8.4.Diabetes management device roadmap: Summary
8.5.Strategy comparison amongst the largest players
8.6.New directions with glucometers: Connectivity
8.7.The case for CGM
8.8.CGM: Overview of key players
8.9.Skin patches are the form factor of choice
8.10.Smarter insulin delivery informing decisions
8.11.Smart Pen Platform Preventing Missed Doses
8.12.Smart insulin delivery device manufacturers
8.13.Diabetes apps
8.14.Growing ecosystem via acquisitions and partnerships
8.15.Roche & mySugr
8.16.Lilly & Rimidi, Lilly & Livongo
8.17.Blue Mesa Health & Merck
8.18.Glooko-Novo Nordisk in Diabetes Care
8.19.Other case studies: Digital diabetes management
8.20.BlueStar
8.21.Voluntis
8.22.DIABNEXT
8.23.Better Therapeutics
8.24.Amazon Tackle Diabetes Care
8.25.Alexa Diabetes Challenge Finalists
8.26.Sugarpod Champions Diabetes Care
9.CONSUMER GENETIC TESTING
9.1.The Central Dogma: DNA, RNA and Proteins
9.2.What is Direct-to-Consumer Genetic Testing?
9.3.Genetic Variations: What Are We Testing For?
9.4.The Rise of Direct-to-Consumer Genetic Testing
9.5.Monetizing Genomic Testing
9.6.The Emergence of Genomics Analysis Companies
9.7.Rent-Out Your DNA Data
9.8.Not All Data is Created Equal
9.9.AI Driven Genomics and Drug Development
9.10.Alexa-Powered AI Genomics Platform
9.11.Using Genomics to Diagnose NHS Patients
9.12.AncestryDNA
9.13.23andme
9.14.Foundation Medicine
9.15.Atlas Biomed Group
9.16.Orig3n
10.SMART HOME AS A CARER
10.1.Smart Home as a Carer Becomes Increasingly Important with Ageing Populations
10.2.Sensors in Smart Homes: Decentralization of Healthcare
10.3.Bringing Healthcare into the Home by Fitting Sensors
10.4.Medical Asset Tracking Allows for More Productive Refilling of Medicines and Vital Equipment in the Home
10.5.Philips Smart Home as a Carer Ecosystem is Able to Alert Carers in Case of an Emergency
10.6.Home Asthma Care
10.7.Dr Alexa
10.8.Health Information at Home Through Voice Technology
10.9.Digital Health Apps Using Amazon Alexa
10.10.3rings
 

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