Life Sciences Report

Digital disruption of the healthcare sector will drive the medical wearables market to $19.7 billion

Remote Patient Monitoring 2019-2029

Trends, opportunities and outlook for the use of wearables and connected medical devices in the monitoring of patients outside of traditional clinical settings

Brand new for June 2019

By Dr Nadia Tsao and James Hayward

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As healthcare spending around the world increases, innovative methods of delivering cost-effective healthcare must be developed. Remote patient monitoring (RPM), referring to the measurement and analysis of a patient's health status without needing to be physically present at a medical facility or in the presence of a medical professional, has emerged as a promising technology to drive down healthcare costs while maintaining a high standard of care for patients.

While traditional RPM technologies has involved connected blood pressure cuffs, heart rate monitors, scales, etc., innovations in RPM bring increasing patient convenience. At the forefront is the drive to bring continuous monitoring to wearable devices. Recent activities from technology giants such as Apple, Google and Amazon seeking to disrupt the healthcare space, combined with increasing interest in and reimbursement of RPM, will bring about drastic changes to how patients will be cared for in the future.

At its core, RPM technologies and services enable healthcare providers to care for their patients outside of their regularly scheduled visits and follows the global trend in the healthcare industry of decentralization to alleviate overburdened hospitals and clinics. RPM provides healthcare providers and carers with time-sensitive medical information which can be used to optimize the allocation of healthcare resources while simultaneously improving patient health outcomes.

For patients, the benefits of RPM include increased quality of life, reduced hospitalizations and emergency room visits, and reduced hospital stay times. By tracking a patient's health status, early warning signs may be detected and even allow for preventative healthcare to be administered. This provides both patients and their carers with a peace of mind.

A key market for RPM technologies and services is in the care of chronic diseases, particularly in the elderly population. The world's elderly population are responsible for a large portion of healthcare spending due to the high prevalence of chronic diseases in this group, and the high cost of managing chronic diseases. Management of chronic diseases involve high levels of care (regular check-ups and good adherence to medication regimen) over the long term. With the increase in the world's elderly population predicted, even small cost reductions in this space will have drastic impact for healthcare systems around the world.

In this report, IDTechEx leverages our existing coverage of wearable technology to bring you the latest in technologies, applications, and opportunities for RPM. The report takes a deep dive into a spectrum of RPM approaches in the following high impact applications:

In-hospital monitoring
Cardiovascular disease monitoring
Diabetes monitoring
Respiratory disease monitoring
Monitoring of infants and the elderly
Monitoring of medical adherence
Monitoring for wellness

Examples of technologies covered in the report include electronic skin patches, smart mattresses, smart shirts, smart watches, connected inhalers and digital pills. This report cuts across IDTechEx's expert analysis of wearable technology, wearable sensors, electronic textiles, electronic skin patches, and digital health, to bring to the reader the most relevant insights on the exciting innovations in RPM.

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Table of Contents

1.	EXECUTIVE SUMMARY
1.1.	Global Healthcare Spending is Rising
1.2.	Factors Encouraging the Rise of Digital Health
1.3.	Remote Patient Monitoring is Changing the Face of Healthcare
1.4.	The Benefits of Remote Patient Monitoring for Payers
1.5.	Remote Patient Monitoring: Measurements and Applications
1.6.	Market Outlook: Medical Devices
1.7.	RPM in the Hospital
1.8.	RPM in the Hospital: Conclusions and Outlook
1.9.	RPM for Cardiovascular Diseases
1.10.	RPM for Cardiovascular Diseases: Conclusions and Outlook
1.11.	Diabetes management process
1.12.	RPM for Diabetes: Conclusions and Outlook
1.13.	Respiratory diseases are leading causes of death
1.14.	RPM for Respiratory Diseases: Conclusions and Outlook
1.15.	Remote Monitoring Benefits Carers of the Young and the Old
1.16.	Monitoring for the Young and Elderly: Conclusions and Outlook
1.17.	Medical Adherence is a Billion-Dollar Opportunity
1.18.	Medical Adherence: Conclusions and Outlook
1.19.	Wearables for the insurance sector: people and pets
1.20.	Wellness: Conclusions and Outlook
1.21.	The Outlook for Remote Patient Monitoring
2.	INTRODUCTION
2.1.	Scope of Report
2.2.	Changing Demographics Require Healthcare Reforms
2.3.	Global Healthcare Spending is Rising
2.4.	Factors Encouraging the Rise of Digital Health
2.5.	Consumer-Driven, Patient Centered Healthcare
2.6.	Telehealth and Telemedicine are Poised for Take-Off
2.7.	Remote Patient Monitoring is Changing the Face of Healthcare
2.8.	Driving the Uptake of Telemedicine
2.9.	Changes to Reimbursement of Telehealth
2.10.	Reimbursement of Remote Patient Monitoring
2.11.	The Benefits of Remote Patient Monitoring for Payers
2.12.	Remote Patient Monitoring: Measurements and Applications
2.13.	Components of a Remote Monitoring System
2.14.	Remote Patient Monitoring in Hospitals and the Home
2.15.	RPM: From Connected to Wearable
3.	TECHNOLOGIES
3.1.	The Role of Wearables
3.1.1.	Introduction
3.1.2.	Wearable Sensors in Three Waves
3.1.3.	The First Wave: "The Originals"
3.1.4.	The Second Wave: "Made-Wearable" Sensors
3.1.5.	The Third Wave: "Made-for-Wearable" Sensors
3.1.6.	Wearables 2016-2018: Commoditisation, Shakeout, Maturity
3.1.7.	Wearables as a Sum of its Parts
3.1.8.	Wearables 2018-Onwards: Core Value Shines Through
3.1.9.	Wearables - technology hype and drivers
3.1.10.	Integration into clothing
3.1.11.	Examples E-Textiles in RPM
3.1.12.	Skin Patches - A True Wearable
3.1.13.	Skin patches competing with established products
3.1.14.	New market creation around skin patches
3.1.15.	Applications, market sizes and outlook
3.1.16.	Market Outlook: Medical Devices
3.2.	Wearable Sensor Technologies
3.2.1.	Sensors in Wearable Medical Devices
3.2.2.	Common Wearable Sensors Deployed Today
3.2.3.	Sensors on the Body: What do we want to Measure?
3.2.4.	Appropriate Data for the Desired Outcome
3.2.5.	Example: Effort and Reward in Heart Monitoring
3.2.6.	Example: Useful Data at Different Levels of Inference
3.2.7.	Sensor Fusion is Essential and Expected
3.2.8.	Sensor Fusion is Essential and Expected
3.2.9.	Different Product Types from the Same Sensors
3.2.10.	Photoplethysmography (PPG)
3.2.11.	Transmission-mode PPG
3.2.12.	Reflectance-mode PPG
3.2.13.	Measuring Electrical Properties of the Body
3.2.14.	Measuring Biopotential
3.2.15.	Biopotential: Signal Frequency and Amplitude
3.2.16.	ECG
3.2.17.	EEG
3.2.18.	EMG
3.2.19.	Circuit Construction for Measuring Biopotential
3.2.20.	Properties of Wearable Electrodes
3.2.21.	Dry electrodes: Challenges and Solutions
3.2.22.	Optical Chemical Sensors
3.2.23.	Selectivity and Signal transduction in Chemical Sensors
3.2.24.	Stretch / Pressure Sensors
3.2.25.	Stretch / Pressure Sensors - Respiration Rate
3.2.26.	Types of Temperature Sensor
3.2.27.	Approaches and Standards for Medical Temperature Sensors
3.2.28.	Core Body Temperature
4.	APPLICATIONS
4.1.	Monitoring in the Hospital
4.1.1.	Remote Patient Monitoring in the Hospital Setting
4.1.2.	Medtronic - Vital Sync
4.1.3.	EarlySense
4.1.4.	VitalConnect
4.1.5.	Sensium (Surgical Company Group)
4.1.6.	Capsule Technologies
4.1.7.	LifeSignals
4.1.8.	MC10
4.1.9.	Inpatient monitoring: The case for removing the wires
4.1.10.	Hospital-acquired pressure ulcers
4.1.11.	Medicus Tek: Sensable Care
4.1.12.	Sensing Tex
4.1.13.	Leaf Healthcare
4.1.14.	Conclusions and Outlook
4.2.	Cardiovascular
4.2.1.	RPM improves cardiovascular disease outcomes
4.2.2.	Heart monitoring
4.2.3.	Select History of Wearable Medical Devices - Cardiac
4.2.4.	Wearable, ambulatory cardiac monitoring: Comparison of over 30 players
4.2.5.	Progress towards ambulatory cardiac monitoring
4.2.6.	Differentiation between ambulatory cardiac monitors
4.2.7.	iRhythm: ZIO
4.2.8.	VivaLNK
4.2.9.	Wearable vs implantable monitoring
4.2.10.	Pacemakers and other cardiac rhythm implants
4.2.11.	Medtronic - CareLink
4.2.12.	Boston Scientific - Latitude
4.2.13.	Comparison: Apparel
4.2.14.	ChronoLife
4.2.15.	@-Health - CardioNexion®
4.2.16.	Comparison: Consumer Portable Devices
4.2.17.	AliveCor
4.2.18.	Comparison: Smartwatch optical HRM
4.2.19.	Valencell
4.2.20.	Cosinuss
4.2.21.	toSense
4.2.22.	Select History of Wearable Medical Devices - Blood Pressure
4.2.23.	Omron
4.2.24.	Blood pressure from other heart biometrics
4.2.25.	TLT & ViCardio
4.2.26.	Conclusions and Outlook
4.3.	Diabetes
4.3.1.	Diabetes on the rise
4.3.2.	Managing side effects accounts for 90% of the total cost of diabetes
4.3.3.	Diabetes management process
4.3.4.	Diabetes management device roadmap: Glucose sensors
4.3.5.	Connected and Smartphone-based Glucometers
4.3.6.	The case for CGM
4.3.7.	Skin patches are the form factor of choice
4.3.8.	CGM: Overview of key players
4.3.9.	Implantable glucose sensors: Introduction
4.3.10.	Key Players in Implantable Glucose Monitoring
4.3.11.	Focus shifts from test strips to CGM
4.3.12.	Strategy comparison amongst the largest players
4.3.13.	CGM options are expanding
4.3.14.	Diabetes management device roadmap: Insulin delivery
4.3.15.	Diabetes Monitoring: Closing the feedback loop?
4.3.16.	Diabetes Monitoring: Current commercial situation
4.3.17.	Diabetes is an Early Adopter of Digital Healthcare Initiatives
4.3.18.	Diabetes apps
4.3.19.	Smarter insulin delivery informing decisions
4.3.20.	Smart Pen Platform Preventing Missed Doses
4.3.21.	Smart insulin delivery device manufacturers
4.3.22.	Monitoring Adherence to Therapy
4.3.23.	Connected Devices for DFU Prevention
4.3.24.	Amazon Tackles Diabetes Care
4.3.25.	Conclusions and Outlook
4.4.	Respiratory
4.4.1.	Respiratory diseases are leading causes of death
4.4.2.	COPD and Asthma
4.4.3.	Smart Inhalers
4.4.4.	Smart Inhalers: Companies
4.4.5.	Propeller Health
4.4.6.	Propeller - Novartis in Asthma Care
4.4.7.	Real-time air quality data - BreezoMeter
4.4.8.	Smart Spirometer
4.4.9.	Microphones and AI for respiratory diagnostics
4.4.10.	Respiri
4.4.11.	Spire Health
4.4.12.	Smoking Cessation: Carrot / Pivot
4.4.13.	RPM in Tuberculosis Treatment
4.4.14.	Conclusions and Outlook
4.5.	Monitoring of Infants and the Elderly
4.5.1.	Remote Monitoring Benefits Carers of the Young and the Old
4.5.2.	Baby Monitoring - Addressing SIDS
4.5.3.	Smart Socks
4.5.4.	Owlet
4.5.5.	Smart Baby Cameras
4.5.6.	Temperature and Moisture Sensors
4.5.7.	Diaper Monitoring
4.5.8.	Blue Spark
4.5.9.	VivaLNK
4.5.10.	Rest Devices
4.5.11.	Elder Care - Detecting and Preventing Falls
4.5.12.	Abeye
4.5.13.	CarePredict
4.5.14.	E-Vone
4.5.15.	Philips
4.5.16.	Welt
4.5.17.	Xandar Kardian
4.5.18.	Conclusions and Outlook
4.6.	Medical Adherence
4.6.1.	Medical Adherence is a Billion-Dollar Opportunity
4.6.2.	Digital Pill - Proteus Digital Health
4.6.3.	As Directed Plus
4.6.4.	Cardinal Health
4.6.5.	Corbit
4.6.6.	Stanley Black & Decker and Pillo Health
4.6.7.	Smart Pill Boxes
4.6.8.	Connected Pill Bottle Caps
4.6.9.	Conclusions and Outlook
4.7.	Wellness
4.7.1.	Fitness and Wellness
4.7.2.	Corporate Wellness
4.7.3.	Wearables for the insurance sector: people and pets
4.7.4.	UnitedHealthcare Motion: US
4.7.5.	Momentum Multiple: South Africa
4.7.6.	Vitality: UK
4.7.7.	Vitality and Apple Watch
4.7.8.	Fitbit
4.7.9.	Conclusions and Outlook
5.	CONCLUSIONS
5.1.	Is Remote Patient Monitoring Really Helpful?
5.2.	The Outlook for Remote Patient Monitoring
6.	APPENDIX
6.1.	List of Company Profiles
6.2.	List of Abbreviations