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Engineering a Paradigm Shift in At-Home Monitoring Devices

Semiconductor vendors are constantly on the lookout for the market dislocations that will provide the opportunity for product innovation and subsequent sales and revenue growth. Market dislocations tend to be anticipated and debated long before they come to fruition — echoing the old adage that invention is 10 percent innovation and 90 percent perspiration. Today, the healthcare industry is on the cusp of a market dislocation that promises to change the way healthcare is administered.

The pressures to reduce medical costs are driving the need for devices that provide healthcare in the home. These devices provide 24/7 real-time monitoring of:

  • Vital signs (outpatient ECG monitoring, temperature, blood pressure, etc.);
  • Physical well being (fall prevention and detection, weight, and calorie control); and
  • Cognitive behavior (to aid in diagnosis of the onset of a medical condition)

altThis is just a very short list of home-based devices, but it gives an idea of how out-of-hospital patient monitoring can help reduce healthcare costs and improve personal health. Reducing the time a patient stays in the hospital for “observation” by transitioning to effective remote “observation” will inevitably reduce costs. Employing these devices to aid in the area of preventative healthcare will also make a significant contribution.

These motivations are driving companies — both traditional manufacturers of healthcare equipment as well as those not familiar with this market — to focus attention on developing devices for this emerging space. However, as with most market dislocations, there are a number of challenges that need to be addressed before a ubiquitous out-of-hospital patient care program can be fully realized. Geoffrey Moore’s bestselling book, Crossing the Chasm, aptly describes the situation in which the healthcare industry will soon find itself.

Moore suggests that the diffusion of innovation is precipitated by the use of that innovative technology by early adopters. Therefore, it is of vital importance that there is a strong acceptance of out-of-hospital medical devices in the early stages of their introduction. Currently, home monitoring and diagnostic devices (Fig. 1) are successful at monitoring vital signs (such as blood pressure and temperature) and testing for glucose levels, but have still not created the paradigm shift in healthcare that is necessary to take us across the chasm.

How Do We “Cross the Chasm”?

Notwithstanding all the other factors that will influence change in the future of healthcare (government programs, insurance, economic climate, regulatory rules, etc.) the product challenges for companies targeting this market are quite significant. These include trying to develop products that are:

  • Able to provide the level of patient monitoring that will have the desired effect (outlined above) and prove to be useful to the patient and the healthcare system;
  • Low enough in power that they operate for long periods without needing to be charged;
  • Low enough in price for mass adoption;
  • Able to communicate with remote servers;
  • Ergonomically acceptable to be part of our everyday lives; and
  • Designed to be error-free even for untrained users

This is no easy task, especially since the business models behind these products are still being defined. Ultimately, those driving this change in paradigm should not lose sight of the problem by becoming obsessed with one or two of the elements listed above. For example, fixating on “low cost” while neglecting “effective monitoring” runs the risk that the product never moves past the gadget category. Of course, there is no question that product affordability is vitally important, but it should never compromise the fundamental reason why out-of-hospital monitoring devices are needed. Credible solutions that address the critical need for patient monitoring outside of the clinical environment are one of the key factors that will enable the healthcare industry to evolve. Achieving the ultimate goal requires acknowledging the key role technology plays in securing the support of not only the early adopters but also the early majority that will take healthcare across the chasm.

For out-of-hospital monitoring to become part of everyday life, an effective return on investment (ROI) must be achieved — that is, there must be assurance that a tangible benefit is gained from being monitored. In the clinical environment, ROI is pretty evident. Being monitored while in the hospital is accepted as a matter of course and gives patients peace of mind throughout the duration of their stay. People tend to take for granted that hospital monitoring equipment is of high quality, comprehensive, and expensive. As such, should it not also be expected that out-of-hospital monitoring devices need to carry the same level of expectation? Once again, advanced technology is the key to achieving this.