Advanced Planning Strategies for Telehealth

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What Healthcare Organizations Must Know to Reduce Costs and Improve Patient Outcomes

Advanced Planning Strategies for Telehealth

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Machina Research is a research and consulting firm focussed on M2M

Machina Research

Market side Provider side• Quantifying the opportunity for

M2M – Forecast Database providing 10

year forecasts across 201 countries for 61 application groups

– Sector Reports annually updated reports on our 13 sectors (including Automotive, Healthcare and Utilities)

• Addressing the issues that determine success– Research Notes - 3 per month on

major qualitative issues such as platforms, value chain roles, big data, NFC, and security

– Strategy Reports - 4 in 2013 covering four areas: Big Data, platforms, modules/devices and our CSP Benchmarking Report

M2M Leaderboard

Custom Research

Consumer and clinical healthcare markets work in very different ways

Machina Research

Criteria Consumer applications Non-consumer applicationsDrivers

Barriers

Channels

Addressable market

Application functionality

Risks

Available margins

Attractiveness to a new entrant service provider: Low High

Consumer vs non-consumer applications in the Healthcare segmentSource: Machina Research 2013

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883 million M2M healthcare connections by 2022, USD 115bn revenue

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Machina Research

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M2M connections, Healthcare 2022Source: Machina Research 2013

M2M revenue, Healthcare 2022Source: Machina Research 2013

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Regional market differences

• Investing in connected solutions and generating returnso US: can impact the same P&Lo Europe: often fall on different P&Ls

• Routes to marketo US: more autonomous decision makers, but a fragmented

environmento Europe: more central decision making, often less fragmented

environment• Benefits of datamining

o US: can become a competitive differentiatoro Europe: more likely to be shared to save national healthcare

costsMachina Research

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Agenda

• Multi-Tech Systems• About the company

• M2M and the Healthcare Industry• Applications and Case Studies

• Deployment of cellular connectivity from a product perspective

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Agenda

• Multi-Tech Systems• About the company

• M2M and the Healthcare Industry• Applications and Case Studies

• Deployment of cellular connectivity from a product perspective

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Healthcare Industry Key Drivers– Industry Growth

• Number of companies has grown by just under 10% in the last 10 years• Revenue growth of over 35% in the same time period

Home Healthcare Monitoring Revenue Forecast (No. America)1

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• The population is aging worldwide

• Patient behaviors are changing• Patients are becoming more

comfortable with technology• People are unhealthier than

ever

Healthcare Industry Key Drivers

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Agenda

• Multi-Tech Systems• About the company

• M2M and the Healthcare Industry• Applications and Case Studies

• Deployment of cellular connectivity from a product perspective

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Successful development relies on multiple business disciplines:Hardware – Software – Certifications – Carrier Approvals – Manufacturing

• Organizational Considerations:• Organizational Capabilities• Development Budget and Timeline• Volume Expectations• Total Cost of Ownership/ROI Expectations• Application Flexibility/Roadmap• Network Coverage Requirements• Regulatory Considerations

Enabling Cellular Connectivity

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4. STAND-ALONE Certified communications

equipment

3. EMBEDDED MODEMPre-certified carrier cards

(SocketModem)

2. MODULE Pre-certified module

1. CHIPSET

LEVEL OF INTEGRATION

TIME TO MARKET

4 Months

18-24 Months

17 Months

8 Months

Enabling Cellular Connectivity– Integration and Design Levels - Hardware

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Customer Life Cycle

External Modem

Embedded Modem

Module

Initial M2M Solution/Upgrade Existing

Embed into New Designs

Original Design Manufacturing

Life Cycle Management: Professional Services | Manufacturing Services | Support Services

• Quickest• Lowest out of

pocket cost• Minimal risk• For lower

volumes

• Quick• Lower out of

pocket cost• Minimal risk• For medium

volumes

• Longest development cycle

• More risk• For higher

volume

Build a custom solution

Buy an embedded device

Buy an existing device

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Build vs. Buy

Reduce time to revenue with Approved Devices

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Healthcare Case Studies

M2M has had a significant impact in two segments of Healthcare

Emergency data transmissionRemote patient monitoring

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Remote Patient Monitoring– What can technology do?

• Measurement of activity and/or movement• Wellness monitoring

• Sharing information with those who matter most in their lives

• Messaging based on data collected• Care facility proactively reaching out to a patient

• Trend and timely data availableWeight ActivityBlood sugar Pain levelsVitals signs Sleep patterns

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• Challenges• Disappearance of analog connectivity options• Improving care while managing costs • Ability of elderly patients to handle

technology and its challenges

• SolutionMultiModem® rCell Intelligent Wireless Router• Applied when cellular communications is the

only or best connectivity option• Simple installation• Home monitoring equipment with large

display, large buttons, and simple user interface

Home Healthcare– Case Study

In home device interface collects and transmits vital health

data

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Emergency Data Transmission– What can technology do?

• Subset of Emergency Patient Tracking System• Frequently involving a mass event• A fairly new segment with tremendous growth potential• Financed heavily through government grants

• Life critical health care situation• Requires a moment-to-moment analysis and real-time

information• Frequently from the incident site to the care facility

• Provides better care via increasedcommunication and knowledge• Bridges field and hospital care teams to reduce

the time to treatment

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• Challenges• Cellular infrastructure changes from city to city

and around the globe• New cellular technologies being introduced• Company needed to upgrade software to

accommodate faster, more reliable data transfer, yet preserve usability of deployed units

• SolutionMultiConnect® OCG Open Communications Gateway• 3G enables more patient data to be transmitted

faster to improve patient care• Allowed the ability to control software engineering

and legacy quality system• Future-proofs designs

Emergency Data Transmission – Case Study

Portable monitor/defibrillator sends remote patient

data to hospital to improve time to

treatment.

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Agenda

• Aeris• About the company

• Selecting Partners• Telehealth Product Needs & Life Cycle

• Certification & Approvals• GSM & CDMA

• Future Trends• Telehealth Products

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About Aeris

• Cellular services for Machine to Machine (M2M)• Industry pioneer that began service in mid-1990’s

Company

• Platform built from the ground up to only support M2M• Network infrastructure, management portal, and API’s

designed for automation, performance, and scalability• We apply Silicon Valley Innovation to M2M services

Solution

Customers

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Agenda

• Aeris• About the company

• Selecting Partners• Telehealth Product Needs & Life Cycle

• Certification & Approvals• GSM & CDMA

• Future Trends• Telehealth Products

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Data Need is Simple

Medical Monitors

PatientData

Sensor Information

Remote Control

StorageServers

DataAnalytics

Transport

Reliably, quickly and inexpensively

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But … Deployment Can Be Complex!Who Makes Devices

for my needs?

Who are the Radio suppliers?

Do I develop my App Firmware?

Will it work where I put my Device?

How do I remotely “touch” my Device?

Should I use Cellular transport services?

Or do I need Satellite services?

Do I need short-range wireless?

What is the latency?How do I certify my completed Device?

What antenna do I use?

Can I shoulder tap my Device?

What is my Device location?

Is SMS too expensive/slow?

How do I scale the number of units?

What does my service really cost?

Cellular 3G? 4G? Which “G” is right?

Is there an M2M Family Plan?

Can this Device work on batteries?

Why did my data not come through?

Is the network down?

What network stats do I get?

How secure is my data transport?

How many times should I retry?

What data do I store and keep?

Do I need to encrypt my data?

Do I send TCP or UDP packets?

Can I get a Public Static IP?

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Using M2M Platforms

Medical Monitors

PatientData

Sensor Information

Remote Control

Servers

Analytics

Provisioning & Billing

Transport

Support

Por t a l

Cloud-basedBig Data

SDK

Standard Hardware

Optimized Network

Increase performanceIncrease reliabilityStandard protocols

Extensive API’s

Simplify applicationContent correlationLarge-scale analytics

Better decisions

Standardize unitsSimplify certification

Common SDKAvoid duplication

Por tal

API

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Telehealth Products Life Cycle

EOL

• Plan up-front• Remove units• Re-use #’s

Operate

• Manage units• Bill customers• Update app

Scale

• Manufacture• Provision• Test (on-air)

Develop

• Buy vs. Build• Certification• Select network

Successful applications plan for entire life-cycle

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PARTNEROutsource: off-the-shelf solutions

and/or design services

BUYIncorporate pre-certifiedembedded components

BUILDDesign from the ground upA

MO

UN

T O

F R

ES

OU

RC

ES

Buy vs. Build … Data & Systems– Find the right partners

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STAND-ALONE Certified communications

equipment

EMBEDDED MODEMPre-certified carrier cards

MODULE Pre-certified radio modules

CHIPSET Cellular radios and

components

LEV

EL O

F INTE

GR

ATIO

N

TIME TO MARKET

18 - 2

4 Mon

ths 17

Mon

ths 8 M

onth

s 2 - 4

Mon

ths

Hardware Design

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Managing Data Costs

Can standard cellular subscriptions fit needs?• Most operators have monthly recurring charges plus data costs• But, typical handset plans and services don’t fit Telehealth requirements• Asking end-users to maintain cellular service limits deployment

Can operator provide multiple-year pre-paid service?• Bundling transmission into products reduces end-user concerns• Requires good understanding of application data patterns• And careful attention to device design: retries, emergency use, etc.

Can operator provide special plans for M2M devices?• Multiple rate plans for different levels of use in same application • “Pooled” data billing services … across multiple plans

Select an operator who understands M2M services

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Agenda

• Aeris• About the company

• Selecting Partners• Telehealth Product Needs & Life Cycle

• Certification & Approvals• GSM & CDMA

• Future Trends• Telehealth Products

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Certifications & Approvals

• Stand-alone communication products reduce/eliminate requirements• Medical regulations & certifications play a major role

GSMFCC

PTCRB

Operator

CDMAFCC

CDG

Operator

Certification for new products add time & cost

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Agenda

• Aeris• About the company

• Selecting Partners• Telehealth Product Needs & Life Cycle

• Certification & Approvals• GSM & CDMA

• Future Trends• Telehealth Products

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Telehealth Trends

Increased use of Cellular for some applications • Natural transport for wide-area, long-range transmissions• From simple monitoring to mission-critical, emergency care

Expanding information requirements• Increased need for information storage, filtering and analysis• Real-time … sent directly to clinics, doctors and care-givers• Patient privacy and data access/ownership regulations concerns

Product and technology evolution • Deployment of wearable health devices, including aesthetic designs• Hybrid technology transmissions for short-range + long-range wireless• “Continual connection” between patients and their care teams

Increased Patient & Care Team Involvement

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Wearable Telehealth Devices• 100M health-related devices annually by 2016 – ABI Research

• Wireless patches … smart medical clothing … biosensors Body Area Networks

• Projected to reach $6B by 2016 – IMS Research• Explosive growth over the next decade

Sources: medsmagazine.com, ABI Research, IMS Research, Information Week, www.preventice.com, www.imecs.be

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Wearable Telehealth Devices• Fashion and aesthetics are important

• If devices are not actually worn, the purpose may be lost

• Many new technologies in the works• Hidden technology and “smarter” garments • Smart skins, patches, flexible electronics

Sources: Misfit Wearables, Coleman Labs, Idealabs, Univ of Pennsylvania, Isansys

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SummaryTelehealth Market Trends• Telehealth markets, products and services growing dramatically• Standard medical care services not keeping up with population• Patient and care-team communication & involvement increasing• Wearable devices futuristic but key to large-scale deployments• Real-time monitoring needs are increasingly important

Long-range Wireless• Regulations, certifications, technology choices, can slow time to market• Stand-alone communications products minimize cert & cost issues• Development and operation can be complex without the right partners• Understand & manage the costs for wireless implementations• Manage the life-cycle: develop, scale, operate, and end-of-life

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Syed Zaeem Hosain Don MillerSyed.Hosain@aeris.net damiller@multitech.com@AerisCTO @MultiTechSyswww.aeris.com/blog YouTube.com/MultiTechSystems