With the convergence of key technologies such as IT software, telecommunications, data processing power and low-power technology, we can empower patients.
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| || ||Stephen Oesterle, MD |
| ||Medtronic, Inc., |
Senior Vice President for Medicine and Technology
Sensors and connectivity
Over its 62-year history, Medtronic has largely developed implantable and other devices to treat patients with chronic degenerative diseases. This will remain a high-growth market — chronic diseases are becoming increasingly important because of demographic shifts. But I think the biggest opportunities for medical device companies such as ours are to enhance our support for patients across the continuum of care — not just treatment, but also prevention, diagnosis and disease management — and to expand our business models into patient-centric services that provide clear customer economic value.
With the convergence of key technologies such as IT software, telecommunications, data processing power and low-power technology, we can empower patients across the continuum of care to remotely manage their devices and health. For instance, we plan to develop implanted sensors to track blood pressure data for patients with heart failure and warn patients that are on harmful trajectories.
We can use mobile phone technology to monitor the blood sugar of diabetics, notify them of significant changes and educate them on choices and implications. We are setting up an OnStar-type call center for patients with heart failure or diabetes where relatives or caregivers could be notified if a patient's condition deteriorates.
These technologies provide patients more control and autonomy in managing their devices. Patients will probably never reprogram certain implanted devices, such as pacemakers and ICDs, but they are already managing and adjusting their own spinal pain stimulators. And we are pursuing a closed-loop system whereby our sensors will drive an insulin pump and turn it off when a patient's blood sugar is falling.
This isn't just about technology. It's also good economics — these approaches will allow us to manage health care in more efficient and cost-effective ways. Continuous data from wearable and implantable sensors could improve drug adherence. It could keep people out of hospitals by identifying patients who are trending toward hospitalization several days in advance — truly significant when you consider that a major consumption of health care dollars in the US ($40 billion annually) is for hospitalized patients with heart failure.
It's not just the system that would save money. Hospitals would benefit, since they are penalized for readmissions within 30 days under the new US health care reform legislation. And manufacturers could lower the cost of servicing devices, since programming in numerous situations — new implants, pacer revisions, operating rooms — could be done remotely instead of requiring site visits by service reps.
In many ways, emerging markets are leading the way. Since insurance is not very prevalent in these markets and patients typically pay for health care themselves, we are finely attuned to educating patients, understanding their needs and giving them the most relevant features at an affordable price. In Beijing, we have set up our first patient education center — a high-end, high-touch facility, somewhat like an Apple Store, where patients can walk in off the street and ask questions about diabetes or heart failure.
The paucity of providers is similarly driving patient empowerment. India has 1.3 billion people, but only 90 electrophysiologists. So we simply cannot employ the Western model of using electrophysiology clinics to manage implanted pacemakers and ICDs. Instead, we are making the programming, reprogramming and follow-up of these devices much simpler, through new systems of data transfer and analytics — providing both clinical and economic value.
Looking ahead: empowered patients
We are only getting started down this path. Over the next decade, we will likely see increasingly powerful and ubiquitous mobile phones further extending a physician's reach for people in many parts of the world. Mobile phones will give patients more control over programming and running implanted devices.
We are moving toward a future with smaller implantable sensors, patient-controlled mobile devices, real-time data, remote services that assist patients and caregivers, and more. These trends will give forward-looking companies new opportunities and revenue streams. And most important, they will make health care more transparent and effective for patients and more efficient and cost-effective for the system.
This article was featured in our report Progressions 2012 - the third place: health care everywhere.