Guidant-Contak-Renewal

Nice story in the St Louis Business Journal on Guidant's ICD and wireless connectivity:

Increasingly, cardiac rhythm management -- the electrical -- is aided
by wireless technology that can connect patients over the Internet to
their doctors, who can then manage their care and possibly help them
avoid heart failure, in many cases without a visit to the doctor's
office or hospital.

Many
implantable cardiac defibrillators (ICDs) already on the market allow
doctors to capture real-time data on physiological conditions of the
heart, which are downloaded by the patient with a simple wave of a
computerized wand over the chest area. A radio frequency device in the
home then transmits health data through the Internet to the server when
it's time for a patient's checkup or if the patient is in distress. The
main difference in the wireless Guidant model is there is no need for
the wand.

Replacing the wand with a wireless RF link comes at a price.

Guidant's new wireless product costs about $2,500 more than previously
existing models. That difference is not yet covered by insurance, nor
is the online monitoring. Nobody has quite figured out who will monitor
the data, how often or how it will be billed, said Barnes-Jewish
Hospital's Lindsay.

"It's a practical business problem," Lindsay said. "If we save a lot of
money by keeping people out of the hospital, that's great. But if it
takes a lot of nurses engaged in tracking, how do we bill for their
services?"

"As with any new technology, buyers will be behind the curve as far as
reimbursement," said Steve Conway, administrative director for clinical
services at SSM St. Joseph Health Center. "Physicians will have to
really screen applicants for the right ones. At this point, the
clinical decision is more like rural outreach."

Hogarth in Elsberry had his wireless defibrillator implanted Jan. 13.
He looks forward to making the hour-and-a-half drive to St. Charles
only once a year, rather than four times.

The bane of remote monitoring for years has been reimbursement, or lack thereof. Vendors will need to deliver more value that replacing a wand with a radio before payors pony up. The biggest benefit of early RF units is the elimination of the wand from the sterile field during implantation - while physicians love it, there is no clear clinical benefit.

There are two most obvious directions for future wireless enhancements of implantable devices. First is the integration of the device with a broader remote monitoring system and disease management system. The second application entails extending the monitoring potential of implanted devices with near real time data acquisition (transmitted to the hospital for analysis and diagnosis) and remote alarm notification (with sample waveforms and patient positioning data). Both potential roadmaps take implantable device companies beyond their core competencies, although one takes them much farther than the other.
 
UPDATE: Jack Mason from IBM relates his personal experience with remote monitoring and wireless ICDs here.