Spyglass Consulting has released a new market study on remote monitoring called, Trends in Remote Patient Monitoring. Spyglass creates great market studies that illuminate markets just as they're getting hot. It seems that so many market reports either focus on markets that are too early and undeveloped or markets that are mature and well, boring. Director, Gregg Malkary, is lucky; as a boutique consulting firm, he can select dynamic topics and do them when his report will have the greatest value for both vendors and early adoptors.

I talked with Gregg a while ago to get some of the high points from this latest study. This assessment of remote patient monitoring really highlighted for Gregg how our health care system is optimized for complex acute care rather than preventive or chronic care. Hospital frequent flyer patients (those patients who are repeatedly admitted for poorly managed chronic diseases) are one of the most expensive patient types in health care today. Gregg found that providers are most interested in applying remote monitoring to patients with congestive heart failure, diabetes, chronic obstructive pulmonary disease, and asthma.

One of the biggest barriers to broad remote patient monitoring adoption are state licensure laws. Think Kansas City, St Louis, Spokane/Coeur D'Alene, Duluth/Superior - there are lots of metro areas that straddle state lines. Without a common set of federal requirements or reciprocity (and data reporting) between states, much of the location independence provided by remote monitoring will go to waste. Pricing is another huge barrier to adoption - remote monitoring products currently run from $3,000 to $5,000, yet you can bluy a personal computer for $500. In Gregg's research most organizations felt that sub $1,000 pricing was neccessary to spur adoption. Other key barriers to adoption were connectivity to elderly patient's homes, the current lack of reimbursement, and (surprisingly) physicians who can't imagine remote monitoring as a duty on par with office visits.

Here's more from a Healthcare IT News story:

Malkary expects the use of remote monitoring - especially of chronic
diseases, such as coronary heart disease and diabetes - will become
widespread over the next four to five years, especially after Medicare
adopts telemedicine as a way to provide better care and reduce costs.

“This will take place much quicker than we think,” Malkary said.

Spyglass interviewed more than 100 healthcare
organizations involved in telehealth including home health agencies,
academic medical centers, regional hospitals, government agencies and
disease management companies.

Sixty-five percent of organizations interviewed
were making limited investments in remote patient monitoring solutions
focusing on high-risk, high-cost patients with multiple chronic
diseases. Organizations are resistant to further investments until RPM
[remote patient monitoring] solutions can be proven clinically and financially effective, the study

Boomers aside, the major impetus for physicians,
hospitals and home health organizations to focus on monitoring their
patients is cost. They need to keep patients out of the emergency room
and out of the hospitals.

Reimbursement for remote monitoring is slowly becoming a reality.

Among organizations using remote patient monitoring, 71 percent used
government grants to subsidize deployments, and most interviewees said
their organizations would probably not recoup money spent to install
remote patient monitoring.

Though patients like the remote monitoring systems, they are
unwilling to pay the estimated $150-per-month for them. Nor, for the
most part, are Medicare or health insurance companies willing to pay.

Extrapolating from observed results with a telehealth network
in Tennessee, Burgiss, a professor at the University of Tennessee
Graduate School of Medicine, published estimates
that remote monitoring could bring national costs of caring for
congestive heart failure patients down from $8 billion a year to $4.2
billion, including costs of providing remote monitoring.

There seems to be a fundimental disconnect between providers, payors and patients.

Though companies like Health Hero
have services that both collect information and professionals that
monitor it, patients' personal doctors are often not part of the
monitoring system.

Doctors and nurses need to be able to use the information to
help patients take better care of themselves and avoid trips to the
hospital, said Malkary.

But until the service is covered, clinicians are reluctant to
participate. Doctors usually don't get paid for interpreting data
collected remotely, but they can still get sued if they make a mistake,
said Malkary.

Pictured right is Cardiocom's Carestar chronic disease telemonitoring device.