rapid aging of the population, the methods of managing health will need to
shift from traditional institutional settings to peoples everyday
environments, including the home. To enable this shift, a group of
technology, healthcare and fitness companies have formed the Continua Health
Alliance, an open industry group that will establish an ecosystem of
connected personal health and fitness products and services, making it
possible for patients, caregivers and healthcare providers to more
proactively address ongoing healthcare needs.
Between the inexorable grind of demographics - the aging baby boomers and increases in chronic disease, and the shortage of nurses and physicians, our acute care focused health care delivery system will be running out of capacity in the foreseeable future. The solution is widely recognized - provide care outside of acute settings that emphasizes prevention and chronic disease management in order to minimize the burden on acute care.
The challenge is getting our quirky little health care industry to, you know, change the way we do things. Needed changes include reimbursement and the adoption of "new" technologies like email and the Internet by providers to better manage patients. The market opportunity is huge: 1 billion obese adults, 860 chronic disease patients, and 600 million people aged 60 or older. Currently 75-85% of health care spending goes to chronic disease management, and with 200,000 hospitals and 18 million acute care beds, this capacity gap can only grow.
There's a technology gap that exists as well. Current remote monitoring technology is too proprietary and too expensive, and the absence of open systems and interoperability aims to keep it that way. A while back, I met with Dave Whitlinger, director of health care device standards at Intel. We talked about the health care industry and how
dysfunctional "unique" it is (I usually don't hold out much hope for outsiders trying to enter the health care market). Dave was particularly frustrated at the lack of open standards that could growth the market for all health care vendors. These standards exist in many other markets - manufacturing, automotive, aviation, telecommunications, the computer industry - but with the exception of DICOM, have been successfully resisted in health care. Also from yesterdays press announcement:
The alliance's members acknowledged they face plenty of hurdles. One
is the current "dog's breakfast" of technology interfaces on existing
devices, said Dave Watson, chief technology officer at Kaiser
Permanente, the country's largest health management organization.
Watson said it has been a slow and expensive process to connect to
Kaiser's network just some of the 300,000 biomedical devices it has in
its doctors' offices and hospitals.
"To place appropriate devices
in our members' homes takes us into billions of devices that are
outside our network," said Watson. "If this is going to work, the
care-system people are going to have to put terms and conditions in our
contract. [They] must deliver a product that meets Continua input and
be a Continua-branded product."
The Continua Health Alliance aims to close this technology gap by selecting existing industry standards and defining specific implementations of those standards to provide interoperability between vendors' products to create an end to end remote monitoring solution. Continua will not be creating standards; their role will be similar to the IHE developing guidelines for the implementation of standards that ensure interoperability. Continua will also certify compliant products and anoint them with a "consumer recognized" logo. Continua will also work with the world's major regulatory agencies to facilitate regulatory approvals (talk about a hybrid device classification) and the harmonization of regulations. Finally, the group will also work to extend reimbursement to this alternative health care model.
The alliance is targeting three initial market segments: health and fitness, chronic disease management, and elderly monitoring. The members of the Continua Health Alliance are an interesting bunch. I was struck by many non health care companies. Motorola, Sharp, Panasonic, Samsung - their strengths are consumer electronics and could contribute gateway devices like smart phones and PDAs, along with possibly commoditizing some sensors like NIBP and weight scales. It is nice to see Kaiser and Partners in the alliance representing providers. Medical device vendors were noticeable in their absence. Philips is in there based on their Motiva business. A cynic might think GE Healthcare is there because they can afford to be, and want to keep an eye on things. Welch Allyn is also a surprise since they currently don't target the remote monitoring market (although they have some great technology that could be used in that market). A number of companies with remote monitoring business round out the alliance roster.
Back to yesterday's event - during the Q&A, Matthew Holt brought up the elephant in the living room when he asked what role HIT vendors and payors might play in the alliance. Dave Whitlinger, who's also Continua's president and chair, said he expected them to be among the 100+ additional members he expects will join the alliance of the next several months.
Continua expects to have commercially available products some time in 2008. This will be a fun group to watch, and I'm expecting big things from the alliance and their member companies.
UPDATE: You can catch alliance member IBMer Sue Green's perspective on Continua Health Alliance on the HealthNex blog. IBM looking to advance remote monitoring with their "experience in helping to establish and leverage
standards, open systems and tools for interoperability between
communication devices and servers, as well as server to server and