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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 [email protected] [email protected]@AerisCTO @MultiTechSyswww.aeris.com/blog YouTube.com/MultiTechSystems