Health Monitoring is a market that is growing at an exponential pace and the demand for health monitoring worldwide is exploding. Today, there are 52,000 pharmaceutical clinical trials and each of them require participants to be monitored throughout the duration of the trial. There are over 860 Million chronic disease patients worldwide today, and this number is growing rapidly. Many of the chronic diseases require patients to be monitored regularly for vital signs, etc. Caring for patients with chronic disease accounts for 4/5th of the health care expenditure in the US, and accounts for over $1.5 trillion annually. This puts a heavy load on the already overworked health care system. If this work can be reduced or eliminated, the health care system will be freed up to provide other services to patients. Another population segment that needs constant health monitoring is the elderly (60+ years). There are over 600 Million people worldwide who are over 60 years or older. This number continues to increase, and is creating further strain on the health care system. Another market that is interested in health monitoring is the Health and Wellness market. Weight Loss and Diet services and Personal Fitness services fall in this category.
Current health monitoring methods are largely manual, and are slow and labor intensive. They are unable to meet the exploding market demands for health monitoring, including clinical trials. As the demand increases, the gap between supply and demand grows wider in the health monitoring market. For example, it is estimated that there will be shortage of over 1million nurses for the monitoring of elderly patients in the next decade or so.
A second issue is the rising cost of delivering health care and monitoring patients. This is particularly true for clinical trials. Tufts Center for the Study of Drug Development has been tracking drug development costs -- providing some of the most closely watched and influential findings in the country on the pharmaceutical industry. The Tufts experts released their newest research on development costs -- a meteoric $802 million per drug -- almost triple the $231 million estimate Tufts released in 1987 -- stunned many experts on the industry. But the Tufts researchers said rising costs throughout the process -- from initial research to clinical trials -- have pushed development costs ever higher. "Tufts' Center Director Dr. Kenneth Kaitin attributes the staggering increase... to the soaring costs of human clinical testing," reported the Boston Globe. "The size of clinical trials has steadily increased in the past two decades at the same time that volunteers have become more scarce. As researchers learn more about the potential hazards posed by drugs, companies are also required to run a growing battery of safety tests."
The solution to this problem is to automate and streamline the health monitoring process as much as possible. Mobile technology is seen as a key enabler to extending health monitoring outside the health care provider’s office to a home setting. There are over 3 billion mobile phones in the world, and this number is increasing exponentially every year. In some countries, mobile users have surpassed regular landline telephone users. For many segments of the population, a mobile phone is the only phone that they own. This trend is happening in both underdeveloped countries such as China and India where the cost of deploying landline telephone networks is cumbersome and costly, as well as in developed countries such as the US. As the popularity of the mobile phones has increased, so has their functionality. Mobile phones have become a platform for delivering a growing variety of applications and services. Mobile phones have some attributes that make them particularly well suited for delivering health care applications. They are (a) Personal, (b) Ubiquitous, (c) Connected and (d) Increasingly Intelligent. Therefore, mobile technology is the ideal vehicle for creating a remote home based personal health monitoring/delivery solution. Mobile technology enables health providers to monitor patients remotely and to extend the reach of health care, ultimately making it available anytime anywhere.
Recently, the California HealthCare Foundation conducted an extensive study on the role of wireless in health care. Some observations from their report are worth reproducing here:
- As mobile devices and networks become more versatile and capable, they offer expanded opportunities to link patients continuously to the health care system. Remote monitoring enables providers to rapidly identify signs of abnormal function and provide timely intervention to avoid larger problems. Mobile applications may be the most cost-effective way to manage millions of chronically ill patients.
- Because mobile phones are personal and ubiquitous, they offer the ability to deliver health-related information whenever and wherever it can be most effective.
- A world of pervasive mobile networks and remote sensors could make it possible to move from a health care system that primarily provides episodic treatment of acute problems to one that is better able to manage chronic conditions continuously. As remote delivery of health care services becomes more feasible, the locus of diagnosis and treatment of medical conditions will shift from traditional settings such as clinics and hospitals to the patient’s location.
Key stakeholders from various industries formed an alliance called the Continua Alliance to address the health monitoring problem and to create guidelines for an open and interoperable remote personal health monitoring system. Some of the leaders from various markets such as Mobile Devices (Nokia, Samsung, Motorola), Mobile Operators (Orange, AT&T, Sprint, etc), Pharmaceutical Companies (Baxter, Pfizer, etc), medical insurance companies, telecom vendors (Cisco, Siemens, etc). New England based Harvard Medical School plays an important role in the Continua Alliance and hosted one of the summit meetings. The deliberation within the Continua Alliance confirms the interest within the industry to utilize mobile technology for remote health monitoring and delivery.
A Mobile Health Monitoring Solution should consist of a Client Software running on standard smartphones based on Windows Mobile, Symbian, Android and Linux operating systems, a Monitoring software running on standard server platforms, and a real time Reporting System. The solution architecture should also allow for the introduction of new applications and services in a modular fashion.
The Client software running on the smartphone should interact with Bluetooth or Zigbee enabled medical sensors using a secure protocol to obtain health related readings, which are then transmitted to a centralized Server using a secure link. Detailed real time and trending reports can be produced on the Server using this data. The Server should also support automatic real time health care provider alert capability either through SMS or by dialing a call center attendant. The Server should provide interfaces to the hospital or health care provide backend systems. A Care Give Web Portal allows authorized individuals to view specific health monitoring data that is relevant to them. This, for example, allows elderly health monitoring data to be viewed by the monitored person’s spouse/child. The Server can also be connected to Social Networking Sites that allow monitored patients (such as participants in a clinical trial) to set up community groups to share information with each other.
The Solution should also take advantage of inherent capabilities of a mobile phone, such as camera and the ability to record videos, by allowing pictures and video clips to be included as part of the health monitoring data sent to the Server. For example, during clinical trials, a participant can send photo of a specific skin reaction that he/she may be experiencing as a result of taking the drug. Location information can also be incorporated in the health monitoring data sent to the Server by utilizing the GPS/location capabilities of today’s smartphones. The Solution can also interface with a Health Advertising Application to deliver targeted advertisements to smartphones.
Features supported by the client software should include:
- Downloadable Java ME Client that supports multiple monitoring applications
- Medication & Monitoring Alerts
- Data Collection and transmission to server
- Bluetooth/Zigbee interface to measuring devices
- Soft “Hot Button” for emergency purposes
- Location support
- Interface with Community Groups (Social Networking Sites)
- Local backup of measurement data storage
- Support for AES encryption with 256-bit key
Features supported by the Server should include:
- Monitoring Patient Enrollment & Provisioning System
- Client Configuration & OTA download
- Software upgrade, sensor setting, data collection interval, etc
- Image/Video Monitoring
- Reporting System
- Configurable reports based on the monitoring data collected from clients
- Real Time Plotting of monitoring data
- Message Alert System (SMS Alert and Call Center Alert)
- Consumer medical information to client
- interface with third party content sources (such as WebMD)
- API/Interface to EMR/PMR systems
- Community Group interface
- Example: Participants share information during a clinical trial
- Integrate with third party social networking sites
- Push based Appointment scheduling
- Web based Consumer Portal
- For access to monitoring data and reports for Care Givers and Self
- Location tracking (interface with location services)
- Location tracking data received from clients
The Client software should also run on a PC, with connectivity to the Server through PC supported mechanisms (DSL, WiFi, etc).
