new from kalorama information advanced remote patient

NEW FROM KALORAMA INFORMATION

Advanced Remote Patient Monitoring Systems This white paper provides a brief overview of the topic of high tech patient monitoring. The Kalorama Information report covers three product areas: wireless and remote patient monitors, patient data processing applications and equipment, and EMR data transfer equipment and applications, which coordinate the flow of data to hospital electronic medical record systems. There are two primary markets for these new technologies:

• Hospitals • Home healthcare/telehealth

The report breaks out the 2012 market for high‐tech remote and wireless patient monitoring systems by these usage areas. It also provides a breakdown by disease category for the following areas: This report provides complete market sizes and revenue breakouts for the important segments of the advanced monitoring market. For the purpose of this report, three general areas of advanced patient monitoring are covered. These include:

• Vital Sign Monitoring (Blood Pressure, Pulse Oximeters, Other) • Diagnostic Monitoring (EKG, Other) • Specialized or Disease‐Specific Monitoring (Anesthesia Monitors, Cardiac Rhythm Monitoring, Diabetes ‐

Glucose Monitoring, Respiratory Monitors)

The report details products in the marketplace and the various functions that they complete. Most players in the market are discussed as part of Kalorama's competitive analysis of the remote patient monitoring market. The following companies are also profiled in detail: • Abbott • American Medical Development (AMD) Telemedicine Products • American TeleCare • Cardiocom • Carematix • Cybernet Medical Corporation • Drager Medical • GE Healthcare • GlobalMedia Group • Honeywell HomMed

• Intel • InTouch Health • LifeWatch Technologies • MedApps • Medtronic • Philips Medical Systems • Roche • St. Jude Medical • Second Opinion Telemedicine Solutions, Inc. • Welch Allyn

This report was constructed using both a primary and secondary research approach. Annual reports, trade publications and other sources were thoroughly researched, and interviews were conducted among industry executives and used to make assessments of markets and to discover trends and construct forecasts. For More Information on This Report, Visit Kalorama Information

http://www.kaloramainformation.com/Advanced‐Remote‐Patient‐7450566/

Advanced Remote Patient Monitoring

5th

ADVANCED REMOTE PATIENTMONITORING SYSTEMS

A KALORAMA INFORMATION MARKET INTELLIGENCE REPORT

Advanced Remote Patient Monitoring Systems has been prepared by Kalorama Information. We serve business and industrial clients in the United States and abroad with a complete line of information services and research publications.

Kalorama Information Market Intelligence Reports are specifically designed to aid the action-oriented executive by providing a thorough presentation of essential data and concise analysis.

Author: Melissa Elder Publication Date: March 2013

New York, New York (800) 298-5699 • Outside the U.S. (212) 807-2657

FAX: (212) 807-2676 www.KaloramaInformation.com

E-MAIL: [email protected]

..

T A B L E O F C O N T E N T S

CHAPTER ONE: EXECUTIVE SUMMARY ......................................................... 1Introduction ........................................................................................................................ 1

Scope and Methodology ..................................................................................................... 2Product Details ................................................................................................................. 3End-Users ......................................................................................................................... 5

Hospitals ...................................................................................................................... 5Home Health ................................................................................................................ 5Nursing Homes ............................................................................................................. 6Other Markets .............................................................................................................. 6

Issues and Trends ............................................................................................................... 7

Size and Growth of the Market ......................................................................................... 8

Competitors ........................................................................................................................11

CHAPTER TWO: INTRODUCTION .................................................................... 17Overview .............................................................................................................................17

Aging of the Population .....................................................................................................18

Population Statistics ..........................................................................................................20Global Population Trends ................................................................................................20

Global Population over 65 ..........................................................................................23U.S. Population Trends ...................................................................................................25

U.S. Population over 65 ..............................................................................................26Global Trends in Life Expectancy ...................................................................................29

Barriers to Use of New Technologies in Patient Monitoring .........................................32

Emerging Trends ...............................................................................................................35Cloud-Based Mobile Healthcare .....................................................................................36

Cloud Connectivity and Compatibility ........................................................................37Healthcare Establishments ..............................................................................................38Hospitals ..........................................................................................................................39

U.S. Hospital Segment ................................................................................................39Hospital Systems around the World ............................................................................44

Physicians ........................................................................................................................46Number of Physicians .................................................................................................47

Nursing Homes ................................................................................................................50International Trends in Nursing Facilities .................................................................52

Home Health ...................................................................................................................54

Proven Cost Effectiveness .................................................................................................58

.

CHAPTER THREE: ADVANCED REMOTE PATIENT MONITORING PRODUCTS................................................................................................................60

Overview ............................................................................................................................. 60

New Technologies .............................................................................................................. 62Wireless Technologies .................................................................................................... 62Smartphones in Healthcare .............................................................................................. 62

Benefits of Healthcare Smartphones ........................................................................... 63Challenges in the Implementation of Smartphones in Healthcare Settings ................ 63

Remote Monitoring ......................................................................................................... 63Telemedicine ................................................................................................................... 64Applications by Disease State ......................................................................................... 65Global Cancer Incidence ................................................................................................. 68Global Cardiovascular Disease Rates ............................................................................. 70Global Impact of Diabetes............................................................................................... 70Global Obesity Rates by Population ............................................................................... 70EMR (EHR) Data Transfer Applications and Equipment ............................................... 73Technology Achievements .............................................................................................. 73

Implantable Medical Devices ..................................................................................... 73Technology for Drug Adherence, Targeted Delivery, and Monitoring ...................... 74Mobile Medical Applications and Patient Monitoring ............................................... 75Nanobots ..................................................................................................................... 77

Product Segments with Advanced Technologies ............................................................ 78Vital Signs Monitoring Devices ...................................................................................... 78

Blood Pressure Monitors ............................................................................................ 78Pulse Oximeters .......................................................................................................... 79Temperature ................................................................................................................ 80

Diagnostic Monitoring .................................................................................................... 81ECG/EKG ................................................................................................................... 81Spirometry ................................................................................................................... 81Ultrasound .................................................................................................................. 81

Specialized Monitoring ................................................................................................... 83Anesthesia Monitoring ................................................................................................ 83Cardiovascular Disease Monitoring ........................................................................... 84Cancer Treatment Monitors ........................................................................................ 86Diabetes Monitors ....................................................................................................... 87Fetal Heart Monitors .................................................................................................. 88Osteoarthritis .............................................................................................................. 88Prothrombin Time Monitors ....................................................................................... 89Respiratory Monitors .................................................................................................. 90Sleep Disorder Monitors ............................................................................................. 91

Product Offerings .............................................................................................................. 92

Examples of Company Offerings ................................................................................... 102Abbott ............................................................................................................................ 102American Medical Development (AMD) Telemedicine Products ................................ 103American TeleCare ....................................................................................................... 103

..

Bosch Healthcare ...........................................................................................................104Boston Scientific ...........................................................................................................105Cardiocom .....................................................................................................................106Carematix ......................................................................................................................107Covidien ........................................................................................................................107Cybernet Medical Corporation ......................................................................................108Draeger Medical ............................................................................................................109GE Healthcare ...............................................................................................................110GlobalMed .....................................................................................................................111Honeywell HomMed .....................................................................................................112Intel ................................................................................................................................113InTouch Health ..............................................................................................................113InTechnology ................................................................................................................115Johnson & Johnson ........................................................................................................115LifeWatch Technologies ...............................................................................................115Masimo Corporation ......................................................................................................116MedApps .......................................................................................................................117Medtronic ......................................................................................................................118Mindray .........................................................................................................................119Nihon Kohden ...............................................................................................................121Omron Corporation .......................................................................................................122OSI Systems ..................................................................................................................123Philips Medical Systems ...............................................................................................123Roche .............................................................................................................................124Second Opinion Telehealth Solutions, Inc. ...................................................................125St. Jude Medical ............................................................................................................125Welch Allyn ..................................................................................................................126

CHAPTER FOUR: COMPETITOR TRENDS AND MARKET SHARE ANALYSIS ............................................................................................................... 128

Overview ...........................................................................................................................128

Acquisitions and Agreements .........................................................................................128Abbott Laboratories .......................................................................................................129Alere ..............................................................................................................................129Covidien ........................................................................................................................129GE Healthcare ...............................................................................................................129GlobalMed .....................................................................................................................130Medtronic ......................................................................................................................130Philips Healthcare..........................................................................................................130Welch Allyn ..................................................................................................................131

Competitor Market Analysis ..........................................................................................132Philips Healthcare..........................................................................................................133Medtronic ......................................................................................................................133Covidien ........................................................................................................................133Roche .............................................................................................................................134St. Jude Medical ............................................................................................................134

..

GE Healthcare ............................................................................................................... 134Johnson & Johnson ....................................................................................................... 135Omron ........................................................................................................................... 135Draeger .......................................................................................................................... 135Boston Scientific ........................................................................................................... 135Abbott Laboratories ...................................................................................................... 136Nihon Kohden ............................................................................................................... 136Masimo Corporation ..................................................................................................... 136Mindray ......................................................................................................................... 136OSI Systems .................................................................................................................. 137Other Companies ........................................................................................................... 137

CHAPTER FIVE: ISSUES AND TRENDS ..........................................................139Introduction ..................................................................................................................... 139

Issues and Trends Driving the Market .......................................................................... 141

Aging of the Population ................................................................................................... 142Increasing Life Expectancy and the Demand for Advanced Healthcare Delivery Options .......................................................................................................... 143

Global Healthcare Trends .............................................................................................. 143General Economic Trends by Country .......................................................................... 146

U.S. Health Industry Trends .......................................................................................... 147U.S. Healthcare Challenges ........................................................................................... 149Economic Trends in the U.S. ........................................................................................ 150U.S. Health Expenditures by Type ................................................................................ 151Health Information Technology and American Reinvestment and Recovery Act of 2009 (ARRA) ......................................................................................................................... 153

Meaningful Use Criteria ........................................................................................... 155Stages of Meaningful Use ......................................................................................... 155Qualifying for Stage One Meaningful Use ................................................................ 156

HIPAA........................................................................................................................... 157Medicine-At-Work ........................................................................................................ 160

Healthcare Efficiency ...................................................................................................... 160Electronic Medical Records .......................................................................................... 161

Overview of EMRs .................................................................................................... 161EMR Adoption ........................................................................................................... 162

Are Electronic Healthcare Systems More Efficient? .................................................... 168The EMR and Mobile Apps ....................................................................................... 169Hospital Communications ......................................................................................... 171Remote Monitoring ................................................................................................... 171Capacity Constraints ................................................................................................ 171

Emphasis on Reducing Hospital Days .......................................................................... 174Decreasing Healthcare Resources ................................................................................. 179Nursing Shortage ........................................................................................................... 179eICU .............................................................................................................................. 180

eICU Case Study ....................................................................................................... 180

..

Opportunities in Telemedicine/Telemedicine ................................................................181

Mental Health Assessment Through Telemedicine ......................................................181Post-Traumatic Stress Disorder (PTSD) .......................................................................181Improving the U.S. Mental Care Environment .............................................................183Mental Disorder Statistics .............................................................................................183Suicide ...........................................................................................................................186

Growing Acceptance of Mobile Technologies ...............................................................188North America ...........................................................................................................189Europe .......................................................................................................................190South America ...........................................................................................................190Asia-Pacific ...............................................................................................................190Internet Users and Growing Adoption of Technology ..............................................191

Development of Patient Monitoring Technologies ........................................................193Audio and Video ...........................................................................................................193Algorithms to “Sort” Data or Trigger Alarms ...............................................................194Alarm Fatigue ................................................................................................................194Off-site Access to Data ..................................................................................................194Full-service Outsourcing ...............................................................................................196Converged Wireless Networks ......................................................................................196Data Management and the Electronic Medical Record .................................................197Turnkey Systems ...........................................................................................................199Disease Management Kits .............................................................................................200FCC Rules for Medical Wireless Communication ........................................................200System Compatibility ....................................................................................................200

CHAPTER SIX: GLOBAL MARKET SIZE AND FORECAST ....................... 203Overview ...........................................................................................................................203

Total Global Market Size and Forecast .........................................................................204

Global Markets by Product Type ...................................................................................207Vital Sign Monitoring ...................................................................................................207Diagnostic Monitoring ..................................................................................................211Specialized or Disease-Specific Monitoring .................................................................215

End-User Markets ...........................................................................................................219The Global Telemedicine Market ..................................................................................221Global Hospital and Acute Care Patient Monitoring Market ........................................225

Global Markets by Region ..............................................................................................227

Market Drivers and Inhibitors .......................................................................................229Growth Drivers ..............................................................................................................229Growth Inhibitors ..........................................................................................................229

Emerging Trends .............................................................................................................230

..

CHAPTER SEVEN: U.S. MARKET SIZE AND FORECAST ...........................233Overview ........................................................................................................................... 233

Total U.S. Market Size and Forecast ............................................................................. 233

Markets by Product Type ............................................................................................... 237Vital Sign Monitoring ................................................................................................... 239Diagnostic Monitoring .................................................................................................. 239Specialized or Disease-Specific Monitoring ................................................................. 239

Markets by Major Disease .............................................................................................. 240Asthma .......................................................................................................................... 245Cancer ........................................................................................................................... 245COPD ............................................................................................................................ 245Diabetes ......................................................................................................................... 245Heart Conditions ........................................................................................................... 246Other .............................................................................................................................. 246

End-User Markets ........................................................................................................... 247Hospitals/Acute Care Centers ....................................................................................... 252Home Health/Telemedicine ........................................................................................... 252

CHAPTER EIGHT: CASE STUDIES ...................................................................253Overview ........................................................................................................................... 253

Examples of Implemented Technologies ....................................................................... 253Honeywell's LifeStream View ........................................................................................ 253St. Alexius Medical Center (SAMC) Telemedicine Project ........................................... 254Ottawa Hospital--Ottawa, Ontario ............................................................................... 255Philips ICU Telemedicine Program .............................................................................. 256Southeast Alabama Medical Center--Dothan, Alabama ............................................... 256Meridian Health—New Jersey ...................................................................................... 257Mount Sinai Hospital and the University Health Network (UHN)—New York, New York ...................................................................................... 257Sentara Healthcare—Norfolk, Virginia ........................................................................ 258Provena Health--Mokena, Illinois ................................................................................. 259The Whole Child Pediatrics P.S.C.—Florence, Kentucky ............................................ 259Remote Monitoring with Honeywell HomMed .............................................................. 260Rural Wireless Healthcare: 3G Mobile Medicine ......................................................... 260

CHAPTER NINE: CORPORATE PROFILES ....................................................262Introduction ..................................................................................................................... 262

Patents .............................................................................................................................. 262

Profiles .............................................................................................................................. 264

..

Abbott Laboratories ........................................................................................................266Company Overview .......................................................................................................266Patents ...........................................................................................................................267Performance Review .....................................................................................................267

Aerotel Medical Systems .................................................................................................269Company Overview .......................................................................................................269Patents ...........................................................................................................................270

Alere ..................................................................................................................................271Company Overview .......................................................................................................271Patents ...........................................................................................................................272Performance Review .....................................................................................................272

AMD Global Telemedicine..............................................................................................274Company Overview .......................................................................................................274Patents ...........................................................................................................................275

American TeleCare ..........................................................................................................276Company Overview .......................................................................................................276Patents ...........................................................................................................................277

AuthentiDate ....................................................................................................................278Company Overview .......................................................................................................278Relevant Patents ............................................................................................................279Performance Review .....................................................................................................279

B. Braun ............................................................................................................................281Company Overview .......................................................................................................281Patents ...........................................................................................................................282Performance Review .....................................................................................................282

Baxter ................................................................................................................................284Company Overview .......................................................................................................284Patents ...........................................................................................................................285Performance Review .....................................................................................................285

Bosch .................................................................................................................................287Company Overview .......................................................................................................287Patents ...........................................................................................................................288Performance Review .....................................................................................................288

Boston Scientific ...............................................................................................................290Company Overview .......................................................................................................290Patents ...........................................................................................................................291Performance Review .....................................................................................................291

C.R.Bard ...........................................................................................................................293Company Overview .......................................................................................................293Patents ...........................................................................................................................294Performance Review .....................................................................................................294

..

Cardiocom ........................................................................................................................ 296Company Overview ...................................................................................................... 296Patents ........................................................................................................................... 297

Carematix ......................................................................................................................... 298Company Overview ...................................................................................................... 298

Compumedics ................................................................................................................... 299Company Overview ...................................................................................................... 299Patents ........................................................................................................................... 300Performance Review ..................................................................................................... 300

Covidein ............................................................................................................................ 302Company Overview ...................................................................................................... 302Patents ........................................................................................................................... 303Performance Review ..................................................................................................... 303

Criticare Systems ............................................................................................................. 305Company Overview ...................................................................................................... 305Patents ........................................................................................................................... 305Performance Review ..................................................................................................... 306

Cybernet Medical ............................................................................................................ 307Company Overview ...................................................................................................... 307Patents ........................................................................................................................... 308

Dräger Medical ................................................................................................................ 309Company Overview ...................................................................................................... 309Patents ........................................................................................................................... 310Performance Review ..................................................................................................... 310

GE Healthcare ................................................................................................................. 312Company Overview ...................................................................................................... 312Patents ........................................................................................................................... 313Performance Review ..................................................................................................... 313

Getinge Group ................................................................................................................. 315Company Overview ...................................................................................................... 315Patents ........................................................................................................................... 316Performance Review ..................................................................................................... 316

GlobalMed Group ........................................................................................................... 318Company Overview ...................................................................................................... 318Performance Review ..................................................................................................... 319

Hoana Medical ................................................................................................................. 320Company Overview ...................................................................................................... 320

Honeywell HomMed ........................................................................................................ 321Company Overview ...................................................................................................... 321Performance Review ..................................................................................................... 322

Infinium Medical ............................................................................................................. 324Company Overview ...................................................................................................... 324

..

InTechnology ....................................................................................................................325Company Overview .......................................................................................................325Performance Review .....................................................................................................326

Intel Corporation .............................................................................................................328Company Overview .......................................................................................................328Patents ...........................................................................................................................329Performance Review .....................................................................................................329

InTouch Health ................................................................................................................331Company Overview .......................................................................................................331Patents ...........................................................................................................................332

Johnson & Johnson .........................................................................................................333Company Overview .......................................................................................................333Patents ...........................................................................................................................334Performance Review .....................................................................................................334Company Overview .......................................................................................................336Performance Review .....................................................................................................337

Masimo .............................................................................................................................339Company Overview .......................................................................................................339Patents ...........................................................................................................................340Performance Review .....................................................................................................340Company Overview .......................................................................................................342Patents ...........................................................................................................................343Performance Review .....................................................................................................343

Mindray ............................................................................................................................345Company Overview .......................................................................................................345Patents ...........................................................................................................................346Performance Review .....................................................................................................346

Nihon Kohden ..................................................................................................................348Company Overview .......................................................................................................348Patents ...........................................................................................................................349Performance Review .....................................................................................................349

Omron Healthcare ...........................................................................................................350Company Overview .......................................................................................................350Patents ...........................................................................................................................351Performance Review .....................................................................................................351

OSI Systems......................................................................................................................353Company Overview .......................................................................................................353Patents ...........................................................................................................................354Performance Review .....................................................................................................354Company Overview .......................................................................................................356Patents ...........................................................................................................................358Performance Review .....................................................................................................358

..

Proteus Digital Health ..................................................................................................... 360Company Overview ...................................................................................................... 360Patents ........................................................................................................................... 361

Roche ................................................................................................................................ 362Company Overview ...................................................................................................... 362Patents ........................................................................................................................... 363Performance Review ..................................................................................................... 363

Second Opinion Telehealth ............................................................................................. 365Company Overview ...................................................................................................... 365

Schiller .............................................................................................................................. 366Company Overview ...................................................................................................... 366

Smiths Medical ................................................................................................................ 367Company Overview ...................................................................................................... 367Patents ........................................................................................................................... 368Performance Review ..................................................................................................... 368

St. Jude Medical .............................................................................................................. 370Company Overview ...................................................................................................... 370Patents ........................................................................................................................... 371Performance Review ..................................................................................................... 371

Welch Allyn ...................................................................................................................... 373Company Overview ...................................................................................................... 373Patents ........................................................................................................................... 374

APPENDIX A: REGULATORY AUTHORITIES AND ORGANIZATIONS ..375

APPENDIX B: LIST OF COMPANIES ................................................................380

C H A P T E R O N E C H A P T E R O N E

Executive Summary

INTRODUCTION

The entire medical technology industry is in flux. The number of elderly individuals is increasing, leading to a higher demand for new and better medical technology products. However, the government is trying to limit and lower public health care costs by instituting a planned health system reform. The main goals of this reform are cost savings and increased efficiency. New patient monitoring systems are emerging in response to increased healthcare needs of an aging population, new wireless technologies, better video and monitoring technologies, decreasing healthcare resources, an emphasis on reducing hospital days, and proven cost-effectiveness.

Advanced Remote Patient Monitoring systems are focused on utilizing the technologies recently introduced to the healthcare field. Advances in remote patient monitoring include new peripherals, real-time audio and video for “face-to-face” interaction between clinicians and patients, wireless communication, systems that “sort” the vast amount of data collected in order to put it into the context of a patient’s condition, portable and ambulatory monitors, web-based access to the patient record, systems that transfer data to an electronic medical record (EMR), and full-service outsourcing that includes a clinician to evaluate data and send a report to the attending physician.

C H A P T E R O N E

Executive Summary

INTRODUCTION

The entire medical technology industry is in flux. The number of elderly individuals is increasing, leading to a higher demand for new and better medical technology products. However, the government is trying to limit and lower public health care costs by instituting a planned health system reform. The main goals of this reform are cost savings and increased efficiency. New patient monitoring systems are emerging in response to increased healthcare needs of an aging population, new wireless technologies, better video and monitoring technologies, decreasing healthcare resources, an emphasis on reducing hospital days, and proven cost-effectiveness.

Advanced Remote Patient Monitoring systems are focused on utilizing the technologies recently introduced to the healthcare field. Advances in remote patient monitoring include new peripherals, real-time audio and video for “face-to-face” interaction between clinicians and patients, wireless communication, systems that “sort” the vast amount of data collected in order to put it into the context of a patient’s condition, portable and ambulatory monitors, web-based access to the patient record, systems that transfer data to an electronic medical record (EMR), and full-service outsourcing that includes a clinician to evaluate data and send a report to the attending physician.

Chapter One: Executive Summary 2


SCOPE AND METHODOLOGY

Market numbers discussed in this report are focused on the global patient monitoring market with special market coverage of the U.S. market. Additionally, there is select coverage for European, Asian and other world markets. All sales are displayed at the manufacturers’ level in U.S. dollars. Although the sales figures are displayed at the manufacturers’ level, in many instances, this figure represents a close comparison to the retail level as many end users are purchasing directly from the manufacturer.

This report includes patient monitoring equipment and devices which have advanced features. The report specifically focuses on technologically advanced (including wireless and remote) patient monitors; monitors with patient data processing applications; and monitors which are capable of data transfer to an EMR system-including equipment and peripherals which coordinate the flow of data to hospital electronic medical record systems.

A brief description of systems and capabilities are listed here:

Advanced Monitors and Devices: wireless and remote technologies that monitor that transmit data either within an institution via wireless or intranet; and all technologies that monitor a patient and forward the data to another party or application. For the most part, devices covered in this report can: 1) provide monitoring information beyond a patient room; and 2) provide data for an EMR system or are expected to add such features within the forecast period.

Patient Data Processing Applications and Equipment: uses algorithms to evaluate monitoring measurements for a patient’s specific condition(s). Usually, these can be customized by the physician, with reports sent to the physician. In the market for Advanced Remote Patient Monitoring systems, the applications and equipment are either integrated into the patient monitoring system or are add-ons to the measuring systems.



EMR Data Transfer Equipment and Applications: described in the report as either components of, or add-ons to, patient monitoring systems. This report does not include EMR software. In general, the applications in this segment transfer data to third-party EMRs.

The base year is 2012, with forecasts provided for each year through 2017. The market was evaluated via a combination of disease prevalence trends, population trends, device innovations, federal and industry standards and regulations. Both primary and secondary sources were consulted in developing market estimates.

Telephone interviews and email correspondence were the primary method of gathering information. For the purpose of this study Kalorama Information conducted interviews with more than 100 key industry officials, consultants, health care providers, and government personnel. These sources were the primary basis in gathering information specifically relating to revenue and market share data presented in this report. Specific interviews with IT company representatives included marketing directors, division managers, and product representatives.

Secondary sources such as company literature, databases, investment reports, and medical, information technology and business journals were used to complement primary information.

Product Details

Patient monitoring parameters range from basic vital signs to electrocardiograms (ECGs). Patient monitoring peripherals and systems include the following:

Blood gases

Blood pressure

Camera

Cardiac event recorder


EMR Data Transfer Equipment and Applications: described in the report as either components of, or add-ons to, patient monitoring systems. This report does not include EMR software. In general, the applications in this segment transfer data to third-party EMRs.

The base year is 2012, with forecasts provided for each year through 2017. The market was evaluated via a combination of disease prevalence trends, population trends, device innovations, federal and industry standards and regulations. Both primary and secondary sources were consulted in developing market estimates.

Telephone interviews and email correspondence were the primary method of gathering information. For the purpose of this study Kalorama Information conducted interviews with more than 100 key industry officials, consultants, health care providers, and government personnel. These sources were the primary basis in gathering information specifically relating to revenue and market share data presented in this report. Specific interviews with IT company representatives included marketing directors, division managers, and product representatives.

Secondary sources such as company literature, databases, investment reports, and medical, information technology and business journals were used to complement primary information.

Product Details

Patient monitoring parameters range from basic vital signs to electrocardiograms (ECGs). Patient monitoring peripherals and systems include the following:

Blood gases

Blood pressure

Camera




Cardiac resynchronization therapy device and defibrillator (CRT-D) monitoring

Dermascope

Ear, nose, and throat (ENT) otoscope

ECG

End-tidal carbon monoxide (EtCO)

Glucose meter

Implanted cardioverter defibrillator (ICD) monitoring

Microscope with camera

Ophthalmoscope

Pacemaker monitoring

Prothrombin time (PT)/International Normalized Ratio (INR)

Pulse oximeter

Retinal camera

Spirometer

Stethoscope

Thermometer

Ultrasound

Weight scale

Picture archiving and communications systems (PACs) allow for images, such as radiology images, to be scanned into an EMR.

Disease state management kits or systems include those for asthma, cancer, cardiovascular disease, COPD, and diabetes.



End-Users

There are four primary markets for these new technologies, which are as follows:

Hospitals

Home healthcare

Nursing homes

Other, including first responders, institutional, physician offices, and military.

Each system has advantages and disadvantages, and each of the end-user markets—hospitals, home healthcare, nursing homes, and other—has different priorities.

Hospitals Hospitals are concerned with the ability to access patient data within the

hospital, during transport and at ancillary facilities. The benefit of having the data sorted for a clinician to access direct patient data quickly and from all departments is far reaching. Use of electronic medical records is more prevalent within hospitals than in the other markets; “remote” patient monitoring often pertains to monitoring within the hospital and locations operated by a hospital group. Hospitals frequently use intranets for data storage rather than web-based systems.

Home Health Home health care can be ordered by hospitals or physicians and can range from

monitoring basic temperature, weight, and vital signs, to specific disease state management of conditions such as chronic obstructive pulmonary disorder (COPD), asthma, cardiovascular conditions, respiratory conditions, perinatal monitoring, sleep apnea, or diabetes. In these cases, patient monitors are user-friendly, often connect to a central hub, and often transmit data via telephone lines. Newer developments use wireless technologies, transmit data using Bluetooth or mobile phones, sort the data



with algorithms specific to the disease state, and use customizable alarms and patient surveys. Few of the systems used in the home healthcare market will transfer data to an electronic medical record (EMR), although this is likely to become a more important component in the future. A concern with remote patient monitoring systems used in homecare is compatibility of devices and software. There are vendors that manufacture peripherals, vendors that manufacture hubs and software that only support select brands of peripherals, and applications for managing data that are not compatible with other technologies.

Nursing Homes Nursing homes, including skilled nursing homes, rehabilitation nursing homes,

and assisted living facilities, have needs somewhere between those of hospitals and home healthcare. Patient monitoring needs can range from basic monitoring of vital signs for rehabilitative patients or relatively mobile patients to monitoring of chronic conditions. Patients range from short-term rehabilitative patients to long-term residents, with all ranges of patient mobility. A useful technology for nursing homes is the health kiosk. A patient can sign in with a password, have various measurements taken, and then upload data into a patient record that can be accessed by the patient, his or her family, and the patient’s healthcare providers. This is a cost-effective means for taking various measurements for a large number of patients. More customizable and continuous solutions can be implemented for patients who require more frequent monitoring.

Other Markets Other markets include first responders, institutions (such as correctional

institutions), and the military. Military users typically need different types of equipment, from first-responder type patient monitoring to portable field hospitals that can provide a full range of monitoring services. Correctional institutions use a combination of home healthcare-type remote technologies and video consultations. First responders need equipment that can provide patient monitoring, relay the information to an emergency room, and be both portable and heavy duty.



ISSUES AND TRENDS

Issues and trends driving the market for patient monitoring, particularly Advanced Remote Patient Monitoring include:

Aging of the population

Increasing life expectancy

Implantable devices

American Investment and Recovery Act of 2009

HIPAA and Electronic Data Security

Medicine- at-Work concept

Healthcare efficiency and inefficiency

Emphasis on reducing hospital days

Decreasing healthcare resources

Intensive care, cardiology nursing shortages

Cost effectiveness

eICU

EMR Adoption

Mental Health Assessments and Telemedicine

New wireless technologies

Issues and trends affecting the development of new patient monitoring technologies include the following:

Audio and video

Algorithms to “sort” data or trigger alarms

Off-site access to data

Full-service outsourcing

Converged wireless networks



Data management and the electronic medical record

Turnkey systems

Disease management kits

HIPAA

FCC rules for medical wireless communication

System compatibility

SIZE AND GROWTH OF THE MARKET

The global Advanced Remote Patient Monitoring market has seen some recent growth with the United States and many European countries at the forefront of implementation. This market includes equipment and devices with wireless and remote technologies, patient data processing applications and features, and applications that transfer patient monitoring results to electronic medical records (EMRs). This does not include EMR applications and equipment. Basic and manual patient monitoring devices are not included. Among products not included are obsolete glucose monitors that are not equipped to be part of a system to forward data to a telemedicine record and standard hospital patient monitoring equipment that does not forward data to a central station. Many of these older devices are no longer purchased from the manufacturer directly and are often purchased as a refurbished item.

The global Advanced Remote Patient Monitoring market is currently worth about $21.8 billion, inclusive of devices, peripherals, software and other applications. The market has benefited from the demand to move to a more wireless and streamlined operation both within major health facilities and in the home treatment markets. The demand to integrate data processing capabilities and EMR transfer options has also fueled the market. There is also an increasing trend to upgrade to ambulatory and hand-held devices.


Data management and the electronic medical record

Turnkey systems

Disease management kits

HIPAA

FCC rules for medical wireless communication

System compatibility

SIZE AND GROWTH OF THE MARKET

The global Advanced Remote Patient Monitoring market has seen some recent growth with the United States and many European countries at the forefront of implementation. This market includes equipment and devices with wireless and remote technologies, patient data processing applications and features, and applications that transfer patient monitoring results to electronic medical records (EMRs). This does not include EMR applications and equipment. Basic and manual patient monitoring devices are not included. Among products not included are obsolete glucose monitors that are not equipped to be part of a system to forward data to a telemedicine record and standard hospital patient monitoring equipment that does not forward data to a central station. Many of these older devices are no longer purchased from the manufacturer directly and are often purchased as a refurbished item.

The global Advanced Remote Patient Monitoring market is currently worth about $21.8 billion, inclusive of devices, peripherals, software and other applications. The market has benefited from the demand to move to a more wireless and streamlined operation both within major health facilities and in the home treatment markets. The demand to integrate data processing capabilities and EMR transfer options has also fueled the market. There is also an increasing trend to upgrade to ambulatory and hand-held devices.



The market for Advanced Remote Patient Monitoring is extremely fragmented. The majority of companies selling peripherals and systems to the home healthcare and nursing home markets are primarily privately-held, smaller companies. However, large, well-known, and well-respected companies in healthcare have developed remote patient monitoring systems for the hospital market, aiding faster acceptance by healthcare professionals and administration.



Table 1-1

The Global Market for Advanced Remote Patient Monitoring Systems

2007-2017

(in millions of dollars)

Year Revenues Percent Change2007 — 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Compound Annual Growth Rate Period CAGR 2007-2012 2012-2017 2007-2017

Source: Kalorama Information



Figure 1-2

Competitor Analysis, Global Advanced Remote Patient Monitoring Equipment and Devices, 2012

Chapter Two: Introduction 34


High infrastructure Cost – The cost of wireless infrastructure and devices is still high. The tipping point that would lead to widespread adoption of the technology has yet to be reached. About 14% of the healthcare organizations identify lack of adequate financial support for IT as the most significant barrier to a successful implementation of IT at their organizations. Additionally, the problem with proving ROI is a concern for implementing and expanding IT options in facilities. About 4% of facilities report this as a barrier to implementing IT solutions.

Figure 2-6

Most Significant Barriers to Implementing IT, 2011 vs. 2012

5

5

4

10

11

18

17

3

4

6

7

9

12

14

21

7

3

4

4

4

s

Percentage of Healthcare Organizations

Source: 23rd Annual HIMSS Leadership Survey, sponsored by Citrix

EMERGING TRENDS

Trends resulting from emerging technologies and evolving social scenarios are bound to have a direct impact on the execution of medical processes and the way


High infrastructure Cost – The cost of wireless infrastructure and devices is still high. The tipping point that would lead to widespread adoption of the technology has yet to be reached. About 14% of the healthcare organizations identify lack of adequate financial support for IT as the most significant barrier to a successful implementation of IT at their organizations. Additionally, the problem with proving ROI is a concern for implementing and expanding IT options in facilities. About 4% of facilities report this as a barrier to implementing IT solutions.

Figure 2-6

Most Significant Barriers to Implementing IT, 2011 vs. 2012

5

5

4

10

11

18

17

3

4

6

7

9

12

14

21

7

3

4

4

4

0 5 10 15 20 25

Lack of Strategic IT Plan

Lack of interoperable Systems

Lack of Top Management Support

Diff iculty Proving ROI

Lack of Clinical Leadership

Lack of Time Commitment from Clinicians

Dif ficulty in End User Acceptance

Vendor Inability to Deliver Produc t

Lack of Adequate Financial Support

Lack of Staff ing Resources

Percentage of Healthcare Organizations

20122011

Source: 23rd Annual HIMSS Leadership Survey, sponsored by Citrix

EMERGING TRENDS

Trends resulting from emerging technologies and evolving social scenarios are bound to have a direct impact on the execution of medical processes and the way



HealthFusion, Inc. also offers a web-based proprietary PureCloud cloud-computing technology. The company has integrated a claims processing technology designed to improve a physician’s ability to efficiently process payment from insurance providers.

In January 2012, The American Podiatric Medical Association (APMA) and HealthFusion announced an agreement to promote adoption of electronic health records (EHRs). The process qualifies for EHR stimulus funding according to HealthFusion. The system is compatible with iPad or Windows-based systems, including mobile devices and desktop devices.

Security of cloud-based structures are a primary concern as reported by professional clients which is also reinforced with government efforts like the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Patients also want to ensure that their health records aren't compromised in any way. An example shows the cost of a HIPAA breech can be extensive. In a 2013 settlement, Hospice of North Idaho (HONI) agreed to pay the U.S. Department of Health and Human Services’ (HHS) $50,000 to settle potential violations related to patient information security. This affected fewer than 500 individuals.

Cloud Connectivity and Compatibility Connectivity is required for cloud-computing. Typically an internet connection

is used to access a web-based portal which gives a person access to the information stored there. Mobile devices like smartphones can access the internet using faster 4G connections, but they can also connect via phone Wi-Fi adapters and wireless modems. For some institutions and locations these will be the fastest connection methods.

Healthcare Establishments

The healthcare industry includes establishments ranging from small private practices of physicians with only one medical assistant to large city hospitals that


HealthFusion, Inc. also offers a web-based proprietary PureCloud cloud-computing technology. The company has integrated a claims processing technology designed to improve a physician’s ability to efficiently process payment from insurance providers.

In January 2012, The American Podiatric Medical Association (APMA) and HealthFusion announced an agreement to promote adoption of electronic health records (EHRs). The process qualifies for EHR stimulus funding according to HealthFusion. The system is compatible with iPad or Windows-based systems, including mobile devices and desktop devices.

Security of cloud-based structures are a primary concern as reported by professional clients which is also reinforced with government efforts like the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Patients also want to ensure that their health records aren't compromised in any way. An example shows the cost of a HIPAA breech can be extensive. In a 2013 settlement, Hospice of North Idaho (HONI) agreed to pay the U.S. Department of Health and Human Services’ (HHS) $50,000 to settle potential violations related to patient information security. This affected fewer than 500 individuals.

Cloud Connectivity and Compatibility Connectivity is required for cloud-computing. Typically an internet connection

is used to access a web-based portal which gives a person access to the information stored there. Mobile devices like smartphones can access the internet using faster 4G connections, but they can also connect via phone Wi-Fi adapters and wireless modems. For some institutions and locations these will be the fastest connection methods.

Healthcare Establishments

The healthcare industry includes establishments ranging from small private practices of physicians with only one medical assistant to large city hospitals that



employ thousands of professionals. Healthcare establishments include the following segments:

Hospitals – Hospitals are responsible for providing medical care, which includes functions such as diagnostics, surgical activities and nursing services. There are some specialized hospitals which perform specific functions and cater to specific ailments. Examples include mental hospitals, cancer hospitals, cardiac hospitals, etc.

Physician Offices – Physician offices comprise approximately 40 percent of the total healthcare establishments in the US. Physicians practice privately as well as in groups performing specific as well as general roles.

Nursing and Residential Homes – The role of nursing care facilities is to provide rehabilitation and other health-related personal care to needy patients. Another type is a residential care facility, which provides 24 hour care to children and elderly patients, etc., alike.

Medical and Diagnostic Laboratories – Laboratories are responsible for providing analytical and diagnostic services the healthcare organizations as well as the patients. Some of the activities carried out by laboratories are blood testing, cytology, imaging, etc.

Home Care – Treatment of chronic diseases remotely from the patient’s home can lead to fewer hospital visits as well as flexibility for the aged people who require treatment.

Outpatient Care Centers – The establishments in this category include kidney dialysis centers, outpatient mental health and substance abuse centers, health maintenance organization medical centers, ambulatory surgical centers, and emergency centers.

Ambulatory Care Services – These include small physicians’ offices, large group practices, and hospital outpatient departments.

Acute Care Services – These include inpatient medical/surgery units and critical care units.



Hospitals

Hospitals are responsible for providing medical care, which includes functions like diagnostics, surgical activities and nursing services. There are some specialized hospitals that perform specific functions and cater to specific ailments such as mental hospitals, cancer hospitals, cardiac hospitals, etc.

While growth in patient monitoring will be slightly faster in the home healthcare segment, the hospital market is more established and likely to see stable market conditions. Additionally, the hospital segment is further along in adapting information technologies and EMRs. The hospital market now needs to incorporate hospital-grade wireless and remote patient monitoring technologies, patient data processing applications, and applications that transfer data to EMRs into their systems.

While growth in the number of units will not be as high for hospitals as for home healthcare, hospitals buy much more expensive units. In addition, there will continue to be significant growth in the hospital market for Advanced Remote Patient Monitoring as hospitals replace older equipment with portable and/or wireless technologies that upload data to centralized workstations.

U.S. Hospital Segment Changes in the hospital segment of the industry have a great influence on the

technology industry. In the United States there is a trend toward consolidation in the hospital industry which results in changes in hospital structures. As shown in the figure below, there is a declining trend in the number of hospitals in the U.S. This can have positive or negative effects on this segment of the market. However, statistics are showing some leveling off in declining facility numbers—by 2015 the figure is estimated to be fairly stable at 5,700 hospitals in the United States.

According to the American Hospital Association, the total number of hospitals has decreased in the last 30 years. From over 7,000 in 1975, the number of hospitals has reduced to 5,754 in 2010 and then to 5,724 in 2011, representing an overall decline of 20 percent. The decline is present in most areas of hospital types, during 2010 there were 4,985 community hospitals which declined slightly in 2011 to 4,973.


4 Source: http://www.aha.org/aha/resource-center/Statistics-and-Studies/fast-facts.html


Government-owned hospitals have declined by about 35 percent from 382 in 1975 to 213 in 2010,4 in 2011, this number declined further to 208.

Table 2-6

U.S. Registered Hospitals by Type, 2011

Hospital Type Registered Facilities

Community Hospitals¹ 4,973Federal Government Hospitals 208Nonfederal Psychiatric Hospitals 421Non-federal Long-term Care Hospitals 112Institutional Hospitals (includes prison hospitals, college infirmaries, etc.)

10

Total U.S. Registered Hospitals 5,724

¹community hospitals include nonfederal, short-term general, state specialty hospitals. Excluded are hospitals not accessible by the general public such as prison hospitals or college infirmaries.

Source: American Hospital Association, U.S. Census Bureau.



Government-owned hospitals have declined by about 35 percent from 382 in 1975 to 213 in 2010,4 in 2011, this number declined further to 208.

Table 2-6

U.S. Registered Hospitals by Type, 2011

Hospital Type Registered Facilities

Community Hospitals¹ 4,973Federal Government Hospitals 208Nonfederal Psychiatric Hospitals 421Non-federal Long-term Care Hospitals 112Institutional Hospitals (includes prison hospitals, college infirmaries, etc.)

10

Total U.S. Registered Hospitals 5,724

¹community hospitals include nonfederal, short-term general, state specialty hospitals. Excluded are hospitals not accessible by the general public such as prison hospitals or college infirmaries.





Figure 2-7

Distribution of U.S. Registered Hospitals by Type, 2011


C H A P T E R T H R E E C H A P T E R T H R E E

Advanced Remote Patient Monitoring Products

OVERVIEW

There are significant numbers of patient monitoring systems and combinations. Systems vary, but can enable monitoring of several parameters and allow use of accessories such as digital cameras. Technologies are either real-time, store-and-forward, or hybrids. Store-and-forward technologies collect the data through monitoring devices; store it (often with a date and time stamp); then forward to the healthcare provider or other collection point via telephone, cellular, Internet, broadband, or other connection.

Patient Monitoring includes all products and services that facilitate healthcare providers to diagnose, consult, monitor, and treat patients. However, remote patient monitoring—which is often achieved through the use of handheld devices—allows physicians to perform these functions even in the absence of a doctor. The concept of remote patient monitoring evolved from the need to provide healthcare access to remote communities, and in turn, to reduce acute patient care volumes. By the implementation of effective chronic disease monitoring with the aid of wireless technologies, physicians can optimize treatment strategies even if the patient is at home, thereby, doing away with the requirement of patient visits to hospitals.

Each system has advantages and disadvantages, and each of the end-user markets has different priorities. Primary end-user markets are as follows:

Hospitals

Physician Offices

C H A P T E R T H R E E

Advanced Remote Patient Monitoring Products

OVERVIEW

There are significant numbers of patient monitoring systems and combinations. Systems vary, but can enable monitoring of several parameters and allow use of accessories such as digital cameras. Technologies are either real-time, store-and-forward, or hybrids. Store-and-forward technologies collect the data through monitoring devices; store it (often with a date and time stamp); then forward to the healthcare provider or other collection point via telephone, cellular, Internet, broadband, or other connection.

Patient Monitoring includes all products and services that facilitate healthcare providers to diagnose, consult, monitor, and treat patients. However, remote patient monitoring—which is often achieved through the use of handheld devices—allows physicians to perform these functions even in the absence of a doctor. The concept of remote patient monitoring evolved from the need to provide healthcare access to remote communities, and in turn, to reduce acute patient care volumes. By the implementation of effective chronic disease monitoring with the aid of wireless technologies, physicians can optimize treatment strategies even if the patient is at home, thereby, doing away with the requirement of patient visits to hospitals.

Each system has advantages and disadvantages, and each of the end-user markets has different priorities. Primary end-user markets are as follows:

Hospitals

Physician Offices

Chapter Three: Advanced Remote Patient Monitoring Products 61


Home healthcare

Nursing homes

Other, including first responders, institutional, and military.

Hospitals are concerned with being able to access patient monitoring data within the hospital, regardless of whether the patient is being transported; needing to have the data sorted and quick access to relevant information; or having access to data from all departments. Use of electronic medical records is more prevalent within hospitals than in the other markets, but “remote” patient monitoring usually pertains to monitoring within the hospital. Hospitals frequently use intranets for data storage, rather than web-based systems.

Home health care can be ordered by hospitals or physicians and can range from monitoring basic temperature, weight, and vital signs, to specific disease state management of conditions such as chronic obstructive pulmonary disorder (COPD), asthma, cardiovascular conditions, respiratory conditions, perinatal monitoring, sleep apnea, or diabetes. In these cases, patient monitors are user-friendly, often connect to a central hub, and often transmit data via telephone lines. Newer developments use wireless technologies, transmit data using Bluetooth or mobile phones, sort the data with algorithms specific to the disease state, and use customizable alarms and patient surveys. Few of the systems used in the home healthcare market will transfer data to an electronic medical record (EMR), although this is likely to become a more important component in the future. A concern with remote patient monitoring systems used in homecare is compatibility of devices and software. There are vendors that manufacture peripherals, vendors that manufacture hubs and software that only support select brands of peripherals, and applications for managing data that are not compatible with other technologies.

Nursing homes, including skilled nursing homes, rehabilitation nursing homes, and assisted living facilities, have needs somewhere between those of hospitals and home healthcare. Patient monitoring needs can range from basic monitoring of vital signs for rehabilitative patients or relatively mobile patients to monitoring of chronic conditions. Patients range from short-term rehabilitative patients to long-term residents, with all ranges of patient mobility. A useful technology for nursing homes is the health kiosk. A patient can sign in with a password, have various measurements taken, and then upload data into a patient record that can be accessed by the patient, his or her family, and the



patient’s healthcare providers. This is a cost-effective means for taking various measurements for a large number of patients. More customizable and continuous solutions can be implemented for patients who require more frequent monitoring.

Other markets include first responders, institutions (such as correctional institutions), and the military. Military users typically need different types of equipment, from first-responder type patient monitoring to portable field hospitals that can provide a full range of monitoring services. Correctional institutions use a combination of home healthcare-type remote technologies and video consultations. First responders need equipment that can provide patient monitoring, relay the information to an emergency room, and be both portable and heavy-duty.

NEW TECHNOLOGIES

Wireless Technologies

Wireless technologies, Bluetooth, and mobile telephones are all being used to transmit patient monitoring data while reducing the clutter of multiple connections. These range from using local area networks (LANs) in hospitals to using cellular telephones from a patient’s home. As patients and clinicians become more familiar with using such devices in everyday life, their ease with using them for patient monitoring increases greatly. These technologies can give both patients and caregivers added mobility and efficiency. Concerns, however, include security and compatibility of technologies.

Smartphones in Healthcare

The use of smartphones in healthcare offers a wide range of features and usable options, including:

Drug reference, interaction guides

Treatment guidelines

Laboratory order entry

E-prescribing




NEW TECHNOLOGIES








E-prescribing




NEW TECHNOLOGIES








E-prescribing




NEW TECHNOLOGIES








E-prescribing



Interfacing with other devices/programs (i.e. medical monitoring, EMR, schedules, billing software)

Education for Intern MDs

Access to medical journals and resources

Benefits of Healthcare Smartphones Faster treatment times

Increased patient scheduling

Improved workflow and efficiency

Reduced number of medical errors

Challenges in the Implementation of Smartphones in Healthcare Settings Privacy issues, HIPAA compliance

Sanitation concerns

System cost

Integration concerns

Remote Monitoring

The meaning of ‘remote monitoring’ varies by setting. In a hospital setting, remote monitoring can be monitoring a patient who has been sent from his or her floor to another department, such as from ICU to radiology. Monitoring can enable a caregiver to constantly (or nearly constantly) monitor the patient from a workstation, regardless of the location of the patient.

In home healthcare, remote monitoring usually means monitoring a patient in his or her home from a home health agency, physician office, or hospital.

Nursing home remote monitoring is a combination of hospital and home healthcare needs. Patients in assisted living may be ambulatory, but need to have constant monitoring. Remote monitoring can allow a patient to periodically send data to a central


Interfacing with other devices/programs (i.e. medical monitoring, EMR, schedules, billing software)

Education for Intern MDs

Access to medical journals and resources

Benefits of Healthcare Smartphones Faster treatment times

Increased patient scheduling

Improved workflow and efficiency

Reduced number of medical errors

Challenges in the Implementation of Smartphones in Healthcare Settings Privacy issues, HIPAA compliance

Sanitation concerns

System cost

Integration concerns

Remote Monitoring

The meaning of ‘remote monitoring’ varies by setting. In a hospital setting, remote monitoring can be monitoring a patient who has been sent from his or her floor to another department, such as from ICU to radiology. Monitoring can enable a caregiver to constantly (or nearly constantly) monitor the patient from a workstation, regardless of the location of the patient.

In home healthcare, remote monitoring usually means monitoring a patient in his or her home from a home health agency, physician office, or hospital.

Nursing home remote monitoring is a combination of hospital and home healthcare needs. Patients in assisted living may be ambulatory, but need to have constant monitoring. Remote monitoring can allow a patient to periodically send data to a central



station that is monitored by a clinician. Nursing home patients who are bedridden or are of limited mobility may need more extensive monitoring. Results can be uploaded to another part of the nursing home or to a fully outsourced monitoring service that evaluates the data and sends a report to the healthcare provider.

For military and first responders, remote monitoring often consists of sending patient data from monitors used in the field to the emergency room, hospital, or other care facility to which the patient will be transferred. While this monitoring is particularly valuable and can save lives, it is also very difficult to reliably integrate into the data management applications used by the responding hospital due to wireless coverage, use of varying hospitals or other healthcare facilities, response in remote locations, and transportation issues in high-speed vehicles or aircraft.

Telemedicine

The American Telemedicine Association defines Telemedicine as follows:

“Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve patients’ health status.”

Telemedicine includes sending images to a specialist, live two-way video consultations between patient and provider, capturing and sending data from monitoring devices, and incorporating data and images into EMRs. Reasons for using Telemedicine include improved access to healthcare for patients in distant locations; cost effectiveness; and patient demand.

Various delivery mechanisms for Telemedicine include the following:

Networked Programs: Linking tertiary care hospitals and clinics with outlying clinics and community health centers in rural or suburban areas. There are an estimated 200 Telemedicine networks in the United States involving close to 3,500 medical and healthcare institutions.

Point-to-Point Connections: Hospitals and clinics use private networks to deliver services directly or outsource specialty services.

Primary or Specialty Care to the Home Connections: Connecting primary care providers, specialists, and home health nurses with patients over telephone-video systems for interactive clinical consultations.


station that is monitored by a clinician. Nursing home patients who are bedridden or are of limited mobility may need more extensive monitoring. Results can be uploaded to another part of the nursing home or to a fully outsourced monitoring service that evaluates the data and sends a report to the healthcare provider.

For military and first responders, remote monitoring often consists of sending patient data from monitors used in the field to the emergency room, hospital, or other care facility to which the patient will be transferred. While this monitoring is particularly valuable and can save lives, it is also very difficult to reliably integrate into the data management applications used by the responding hospital due to wireless coverage, use of varying hospitals or other healthcare facilities, response in remote locations, and transportation issues in high-speed vehicles or aircraft.

Telemedicine

The American Telemedicine Association defines Telemedicine as follows:

“Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve patients’ health status.”

Telemedicine includes sending images to a specialist, live two-way video consultations between patient and provider, capturing and sending data from monitoring devices, and incorporating data and images into EMRs. Reasons for using Telemedicine include improved access to healthcare for patients in distant locations; cost effectiveness; and patient demand.

Various delivery mechanisms for Telemedicine include the following:

Networked Programs: Linking tertiary care hospitals and clinics with outlying clinics and community health centers in rural or suburban areas. There are an estimated 200 Telemedicine networks in the United States involving close to 3,500 medical and healthcare institutions.

Point-to-Point Connections: Hospitals and clinics use private networks to deliver services directly or outsource specialty services.

Primary or Specialty Care to the Home Connections: Connecting primary care providers, specialists, and home health nurses with patients over telephone-video systems for interactive clinical consultations.



Home to Monitoring Center: Links used for pacemaker, cardiac, pulmonary, or fetal monitoring; home care; and other services for patients in the home.

Web-based E-health Patient Service Sites: Provide direct consumer outreach and services over the Internet.

Applications by Disease State

With the recognition that patient monitoring can improve patient treatment and outcomes, reduce hospital admissions and fatalities, result in cost savings, and reduce the burden on healthcare personnel, increased use has led to an overabundance of patient data. New software applications that process data according to disease-specific algorithms and allow customizable measurement limits filter out normal data and reduce the incidence of alarms or warnings. Measurement histories and reports can be customized for a patient’s condition, making them more valuable and saving valuable clinician time in reviewing the reports.

In some cases, these applications also generate subjective patient surveys specific to the patient’s condition. The patient responds to questions relating to his or her current status, with answers and reports forwarded to the clinician.

Chronic disease states account for between 75% and 80% of all U.S. healthcare spending. Some of the most costly chronic diseases to the health system include asthma, cancer, chronic obstructive pulmonary disorder (COPD), congestive heart failure (CHF), coronary artery disease (CAD), osteoarthritis, and diabetes. With all of these diseases, patient monitoring can improve outcomes and reduce costs by decreasing hospitalizations and emergency room visits.

There is overlap among certain conditions, with patients often suffering from more than one condition. Hypertension is one of the most prevalent diseases among all Americans, affecting about 50 million. This is followed by asthma with about 27 million Americans affected. Among Americans aged 65 and over, heart conditions were the most prevalent. Persons in the elderly groups are more likely to be suffering from more than one condition.


Home to Monitoring Center: Links used for pacemaker, cardiac, pulmonary, or fetal monitoring; home care; and other services for patients in the home.

Web-based E-health Patient Service Sites: Provide direct consumer outreach and services over the Internet.

Applications by Disease State

With the recognition that patient monitoring can improve patient treatment and outcomes, reduce hospital admissions and fatalities, result in cost savings, and reduce the burden on healthcare personnel, increased use has led to an overabundance of patient data. New software applications that process data according to disease-specific algorithms and allow customizable measurement limits filter out normal data and reduce the incidence of alarms or warnings. Measurement histories and reports can be customized for a patient’s condition, making them more valuable and saving valuable clinician time in reviewing the reports.

In some cases, these applications also generate subjective patient surveys specific to the patient’s condition. The patient responds to questions relating to his or her current status, with answers and reports forwarded to the clinician.

Chronic disease states account for between 75% and 80% of all U.S. healthcare spending. Some of the most costly chronic diseases to the health system include asthma, cancer, chronic obstructive pulmonary disorder (COPD), congestive heart failure (CHF), coronary artery disease (CAD), osteoarthritis, and diabetes. With all of these diseases, patient monitoring can improve outcomes and reduce costs by decreasing hospitalizations and emergency room visits.

There is overlap among certain conditions, with patients often suffering from more than one condition. Hypertension is one of the most prevalent diseases among all Americans, affecting about 50 million. This is followed by asthma with about 27 million Americans affected. Among Americans aged 65 and over, heart conditions were the most prevalent. Persons in the elderly groups are more likely to be suffering from more than one condition.



Sleep Disorder Monitors Sleep disorders are affecting a growing percentage of the population. In the

United States between 60 and 70 million people battle sleep problems and several hundred people around the world suffer from sleep disorders. A fast-paced lifestyle, diet, and stress are all contributors to the growing prevalence of these disorders. This has become even more evident with the fast-growing sleep treatment market. The pharmaceutical approach to treating sleep disorders has grown to be a $5 billion market.

Several companies offer products to monitor sleeping patterns and provide data on brain, muscle and breathing activity during sleep. The following providers are active in this segment:

CareFusion Corp.

Cleveland Medical Devices

Radiometer Medical ApS

In addition to the medical-grade devices, there are a number of consumer level devices used to monitor sleep patterns. These are low-cost and easy to use devices that often help to determine the level of sleeping problems. Examples include the Lark system (lark technologies) and Zeo (Zeo, Inc.).

PRODUCT OFFERINGS

Patient monitoring parameters range from basic vital signs to electrocardiograms (ECGs) and implantable cardiac monitors. Patient monitoring peripherals and systems include the following:

Blood gases

Blood pressure

Camera


Cardiac resynchronization therapy device and


Sleep Disorder Monitors Sleep disorders are affecting a growing percentage of the population. In the

United States between 60 and 70 million people battle sleep problems and several hundred people around the world suffer from sleep disorders. A fast-paced lifestyle, diet, and stress are all contributors to the growing prevalence of these disorders. This has become even more evident with the fast-growing sleep treatment market. The pharmaceutical approach to treating sleep disorders has grown to be a $5 billion market.

Several companies offer products to monitor sleeping patterns and provide data on brain, muscle and breathing activity during sleep. The following providers are active in this segment:

CareFusion Corp.

Cleveland Medical Devices

Radiometer Medical ApS

In addition to the medical-grade devices, there are a number of consumer level devices used to monitor sleep patterns. These are low-cost and easy to use devices that often help to determine the level of sleeping problems. Examples include the Lark system (lark technologies) and Zeo (Zeo, Inc.).

PRODUCT OFFERINGS

Patient monitoring parameters range from basic vital signs to electrocardiograms (ECGs) and implantable cardiac monitors. Patient monitoring peripherals and systems include the following:

Blood gases

Blood pressure

Camera


Cardiac resynchronization therapy device and



defibrillator (CRT-D) monitoring

Dermascope

Ear, nose, and throat (ENT) otoscope

ECG

End-tidal carbon monoxide (EtCO)

Glucose meter

Implanted cardioverter defibrillator (ICD) monitoring

Microscope with camera

Ophthalmoscope

Pacemaker monitoring

Prothrombin time (PT)/International Normalized Ratio (INR)

Pulse oximeter

Retinal camera

Spirometer

Stethoscope

Thermometer

Ultrasound

Weight scale

Picture archiving and communications systems (PACs) allow for images, such as radiology images, to be scanned into an EMR

Disease state management kits or systems include those for asthma, cardiovascular disease, COPD, and diabetes

The following table provides a listing of manufacturers and their offerings in Advanced Remote Patient Monitoring:


Table 3-6


Table 3-6

Select Patient Monitoring Systems February 2013

Supplier Category Product Name(s) Description

Abbott Glucose CoPilot Health Management System Freestyle

Enables a user to take data from a glucose meter and upload it into reports, charts, or graphs. Glucose monitoring with data tracking and transferring capabilities.

e

Continued on next page


Table 3-6 (continued)




Supplier Category Product Name Description

Bayer Healthcare

Diabetes Contour Personalized glucose monitoring system including the Contour USB device. The USB device connects with a computer and software to help manage diabetes.







Supplier Category Product Name Description

Carematix Multiparameter Carematix Wellness System including devices, services, and a web portal.

Combination of health monitoring devices, hub, and Internet server; care providers can use an Internet connection to access a patient’s data, graph results, monitor trends, set alerts, send reminders and messages, etc.




EXAMPLES OF COMPANY OFFERINGS

Abbott

Abbott has developed the CoPilot Health Management System which enables a user to take data from a glucose meter and upload it into reports, charts, or graphs. This system is compatible with the FreeStyle Optium, FreeStyle Freedom Lite, FreeStyle Lite, FreeStyle Papillon Mini, Optium Xceed, Optium and TrueSense meters. The data can be printed, faxed, or e-mailed. The CoPilot Health Management System is intended for management of both Type 1 and Type 2 diabetes, and also has a synchronization function to allow remote sharing of data. The CoPilot system has a sync function that uses a secure server to store data. Once data is uploaded to the server, another CoPilot user can be invited to view the data.

In May 2011, Abbott received CE Mark for the FreeStyle InsuLinx Blood Glucose Monitoring System in select European countries. The addition to Abbott’s glucose monitors allows users to calculate suggested dose by meal, offers touch screen use, records use and offers reports, reminders and messages for patients and caregivers, is USB capable, automated logbook, and is capable of detailed personalization.

In March 2012, The U.S. FDA approved the application to market Abbott's FreeStyle InsuLink Blood Glucose Monitoring System.

The FreeStyle blood glucose monitoring system includes the OmniPod Personal Diabetes Manager (PDM) offered by Insulet. Abbott and Insulet renewed the agreement for the FreeStyle system to include this data transfer device to continue to be offered as a complete system. The agreement is effective through 2014.

Abbott also offers a professional line of blood glucose devices. The company's Precision Xceed Pro Blood Glucose and B-Ketone Monitoring System is a whole blood testing and monitoring system designed to provide fast, accurate results of glucose levels at the patient's location. The system uses the PrecisionWeb Point of Care Data Management System to offer web-based control over testing results.


EXAMPLES OF COMPANY OFFERINGS

Abbott

Abbott has developed the CoPilot Health Management System which enables a user to take data from a glucose meter and upload it into reports, charts, or graphs. This system is compatible with the FreeStyle Optium, FreeStyle Freedom Lite, FreeStyle Lite, FreeStyle Papillon Mini, Optium Xceed, Optium and TrueSense meters. The data can be printed, faxed, or e-mailed. The CoPilot Health Management System is intended for management of both Type 1 and Type 2 diabetes, and also has a synchronization function to allow remote sharing of data. The CoPilot system has a sync function that uses a secure server to store data. Once data is uploaded to the server, another CoPilot user can be invited to view the data.

In May 2011, Abbott received CE Mark for the FreeStyle InsuLinx Blood Glucose Monitoring System in select European countries. The addition to Abbott’s glucose monitors allows users to calculate suggested dose by meal, offers touch screen use, records use and offers reports, reminders and messages for patients and caregivers, is USB capable, automated logbook, and is capable of detailed personalization.

In March 2012, The U.S. FDA approved the application to market Abbott's FreeStyle InsuLink Blood Glucose Monitoring System.

The FreeStyle blood glucose monitoring system includes the OmniPod Personal Diabetes Manager (PDM) offered by Insulet. Abbott and Insulet renewed the agreement for the FreeStyle system to include this data transfer device to continue to be offered as a complete system. The agreement is effective through 2014.

Abbott also offers a professional line of blood glucose devices. The company's Precision Xceed Pro Blood Glucose and B-Ketone Monitoring System is a whole blood testing and monitoring system designed to provide fast, accurate results of glucose levels at the patient's location. The system uses the PrecisionWeb Point of Care Data Management System to offer web-based control over testing results.



Welch Allyn

Welch Allyn’s FlexNet flexible monitoring system can be configured through wireless or wired networks. The system utilizes Welch Allyn’s Acuity line of central stations and its Atlas, Spot Vital Signs, Micropaq, and Propaq lines of vital signs patient monitors. Welch Allyn’s Connex Data Management System is a software system that enables capture of vital signs and transfer of patient data to electronic medical records (EMRs). The monitors range from ambulatory use to those that can essentially turn any hospital bed into a centrally monitored bed. The system serves emergency room, telemetry, medical/surgical, special procedure, and pediatric patients in hospitals, outpatient and ambulatory care settings, physicians’ offices, and in the field. With continuous monitoring, a patient’s vital signs can be read by a physician even when a patient is in transport from one hospital department to another.

Welch Allyn’s equipment and technologies includes the following:

Propaq CS: 8.4-inch touchscreen color display with 3- or 5-leed ECG, heart/pulse rate, motion-tolerant pulse oximetry, respiration, temperature, Smartcuf noninvasive blood pressure (NIBP), invasive lines, mainstream and/or sidestream end-tidal carbon dioxide (EtCO2), and printer.

Propaq LT: compact, lightweight and easy to read monitor featuring spot check monitoring and continuous monitoring capabilities. Ideal settings for the LT model include hospital and outpatient surgery centers. Offered for both pediatric and adult modes and includes 3- or 5-lead ECG, SpO2, NIBP, pulse rate, respiration.

Propaq Encore: Rugged portable monitor with high-resolution electroluminescent (EL) display. The only portable monitor to receive air-worthiness certification from the U.S. military.

Micropaq: Geared toward emergency departments, this compact, wearable monitor for heart rate, electrocardiogram (ECG), oxygen saturation (SpO2),and pulse bar.

Vital Signs Monitor: Can spot-check or continuously monitor NIBP, pulse rate, temperature, and pulse oximetry.

Spot Vital Signs: Geared toward triage, this multiparameter device is designed specifically for spot-checking vital signs.



Atlas: For conscious sedation, intravenous (IV) anesthesia, and surgical procedures, Atlas provides continuous monitoring of ECG, heart/pulse rate, pulse oximetry, NIBP, temperature, and EtCO2. This monitor is now only available by third-party distributors and as a refurbished product. Welch Allyn does not supply the product as of January 2011.

Acuity Central Station and AcuityLink: Monitoring station for up to 60 patients from a single monitoring station. Optional 24- or 96-hour full disclosure, arrhythmia detection, ST analysis, and color printouts. Also offers clinician notification.

Connex Monitor and Data Management: The Connex portfolio includes devices and software. Connex software is a software system that uses either wireless or wired networks to capture and document patients’ vital signs, then transfer the patient data to EMRs. The Connex product line includes a vital signs monitor and blood pressure monitor.

EarlySense Vitals Surveillance System: This system offers clinicians' immediate access to patient vitals and motion information to improve action by clinicians and reduce patient deterioration. Specifically, provides staff with trended patient vitals including heart rate, respiratory rate and motion, potentially helping to reduce falls, pressure ulcers and code blue events.

C H A P T E R F O U R C H A P T E R F O U R

Competitor Trends and Market Share Analysis

OVERVIEW

The patient monitoring market is extremely fragmented worldwide with suppliers offering products to a variety of end users (professional, home, and consumer segments)--making this one of the largest segments in the health industry.

Although hundreds of companies compete in the patient monitoring market, a handful of companies dominate the segment. Remaining competitive in the widespread patient monitoring market is a struggle with changing health professional demand and attitudes, consumer requirements, new product introductions, insurance issues, and regulatory changes.

ACQUISITIONS AND AGREEMENTS

Strategies for growth often include the acquisition of key product lines. Alternatively, companies may decide to work in collaboration in order to reach new demographics or to develop new products. Acquiring an established product line can provide turnkey entrance to a segment of the patient monitoring market.

C H A P T E R F O U R


OVERVIEW





C H A P T E R F O U R


OVERVIEW





Chapter Four: Competitor Trends and Market Share Analysis 129


Abbott Laboratories

Abbott Laboratories renewed an agreement in August 2012 for the continued integration of Insulet's blood glucose diabetes manager (OmniPod) with the FreeStyle blood glucose-monitoring device by Abbott. This offers the convenience of a two-in-one system--the management of glucose levels and the monitoring and transfer of blood glucose results on-demand.

AlereIn July 2012, Alere acquired MedApps Holding Company, Inc., headquartered in

Scottsdale, Arizona. MedApps is a developer of remote health monitoring solutions. Devices such as the MedApps HealthPAL are small remote patient monitoring systems that update a patient's health records. Medical professionals can use MedApps HealthCOM web-based system for checking data captured by the remote monitors. The company also has a cloud system called CloudCare.

Covidien

In June 2012, Covidien acquired Israel-based Oridion Systems Ltd. Oridion is a leading developer of advanced capnography monitors and modules. This acquisition complements the existing line of monitoring technologies available from Covidien.

An earlier acquisition for Covidien included Somanetics Corporation, a provider of cerebral and somatic oximetry and monitoring systems.

Covidien also acquired Aspect Medical Systems, adding brain-monitoring technology to the company's product offering.

GE Healthcare

In May 2010, GE Healthcare acquired Compagnie française de Gestion de Services de Santé - Sanesco SA, a French company that specializes in healthcare advisory services company. This acquisition has been described as a key partnership that combines clinical strategy capabilities of Sanesco with the performance and process improvements from GE.


Abbott Laboratories




Covidien




GE Healthcare



Abbott Laboratories




Covidien




GE Healthcare



Abbott Laboratories




Covidien




GE Healthcare



m


In December 2009, GE acquired Living Independently Group, Inc., a company that provides the QuietCare Passive Monitoring System for seniors. The technology wirelessly monitors the pattern of seniors which is used to help detect potential health problems earlier. This acquisition is part of the strategic move from GE that involves investing in the Home Health industry, which will be affected by the aging population. GE has also entered an alliance with Intel to invest in the development of new technologies for independent seniors and patients with chronic diseases.

GlobalMed

GlobalMed and Hewlett-Packard entered an agreement concerning the development of mobile medical carts that will be powered by HP computer systems. For example, the GlobalMed “General Practice Cart” utilizes the TotalExam2 Examination Camera, a digital stethoscope, and CapSure image automation software. The company's image automation software may be used to measure, annotate, and stamp (time, date, and location) exam images. Other carts are offered for education and other forms of medical use that would benefit from remote connectivity.

Medtronic

LifeScan, Inc., a Johnson & Johnson company, collaborated with Medtronic for the co-marketing and distribution of blood-glucose meters which were developed by LifeScan. This alliance is for patients inside the U.S.

Outside the U.S., Medtronic has an alliance with Bayer HealthCare to distribute and co-market blood glucose meters. The companies expanded the agreement to include U.S. patients starting in May 2011.

Philips Healthcare

Philips Healthcare continues to strengthen its position in the patient monitoring market with strategic acquisitions. Some of these include:

Dameca A/S, a global provider of anesthesia machines and accessories for the operating room (2011).



GlobalMed


Medtronic



Philips Healthcare





GlobalMed


Medtronic



Philips Healthcare





GlobalMed


Medtronic



Philips Healthcare





Somnolyzer, automated-scoring solutions for improving productivity of sleep centers (2010).

Tecso, a Brazilian leader in providing Radiology Information Systems (2010).

CDP Medical, asset acquisition to expand clinical informatics portfolio in high-growth markets in the area of PACS (2010).

Wheb Sistemas, leading Brazilian provider of clinical information systems (2010).

MedSage Technologies, asset acquisition to strengthen patient interaction and management application offerings (2010.)

Agreements are also a key factor in Philips maintaining its leading position in the monitoring market. The company has furthered its reach by moving to the consumer level and implementing its advanced technologies in new areas. In November 2012, Philips partnered with Weight Watchers International to assist clients in monitoring activity levels by using a Philips ActiveLink monitor to track body motion and provide a measure of acceleration. This data is used with the age, gender, height and weight measurements to calculate how many activity PointsPlus values a person earns while wearing the monitor (a system used by Weight Watchers). This data can be uploaded to a computer database that offers motivational information and activity tips to keep clients moving toward reaching their weight loss and health goals.

Welch Allyn

In November 2011, Welch Allyn signed agreements for the implementation of its EHR Prep-Select services to the New Jersey Health Information Technology Extension Center (NJ-HITEC) and Chicago Health Information Technology Regional Extension Center (CHITREC). The program is for preparing health organizations for EHRs and for selecting an electronic health record (EHR) system.

Welch Allyn paired with ZOLL Medical creating an alliance that combines Welch Allyn’s abilities in portable monitoring with ZOLL’s abilities in resuscitation technologies.


Somnolyzer, automated-scoring solutions for improving productivity of sleep centers (2010).

Tecso, a Brazilian leader in providing Radiology Information Systems (2010).

CDP Medical, asset acquisition to expand clinical informatics portfolio in high-growth markets in the area of PACS (2010).

Wheb Sistemas, leading Brazilian provider of clinical information systems (2010).

MedSage Technologies, asset acquisition to strengthen patient interaction and management application offerings (2010.)

Agreements are also a key factor in Philips maintaining its leading position in the monitoring market. The company has furthered its reach by moving to the consumer level and implementing its advanced technologies in new areas. In November 2012, Philips partnered with Weight Watchers International to assist clients in monitoring activity levels by using a Philips ActiveLink monitor to track body motion and provide a measure of acceleration. This data is used with the age, gender, height and weight measurements to calculate how many activity PointsPlus values a person earns while wearing the monitor (a system used by Weight Watchers). This data can be uploaded to a computer database that offers motivational information and activity tips to keep clients moving toward reaching their weight loss and health goals.

Welch Allyn

In November 2011, Welch Allyn signed agreements for the implementation of its EHR Prep-Select services to the New Jersey Health Information Technology Extension Center (NJ-HITEC) and Chicago Health Information Technology Regional Extension Center (CHITREC). The program is for preparing health organizations for EHRs and for selecting an electronic health record (EHR) system.

Welch Allyn paired with ZOLL Medical creating an alliance that combines Welch Allyn’s abilities in portable monitoring with ZOLL’s abilities in resuscitation technologies.



Another partner, BPL Healthcare (India), signed with Welch Allyn in early 2009 to give health providers in India access to products, services and training programs through BPL. This move highlights a strategic focus for Welch Allyn where it will seek to meet the expected demand of emerging markets. The company also announced that it plans to design next-generation, digitally-connected products for Asia and emerging markets at a new R&D facility in Singapore.

Welch Allyn’s largest distributor is currently Cardinal Health. Cardinal has awarded Welch Allyn with several awards for its innovation, support, sales, and leadership.

COMPETITOR MARKET ANALYSIS

In the Advanced Remote Patient Monitoring segment, the top 15 companies generate more than two-thirds of the total market worth $21.76 billion (2012). These companies include:

Philips Healthcare

Medtronic

Covidien

Roche

St Jude

GE Healthcare

Johnson & Johnson

Omron

Draeger

Boston Scientific

Abbott Laboratories

Nihon Kohden

Masimo

Mindray

OSI Systems


Another partner, BPL Healthcare (India), signed with Welch Allyn in early 2009 to give health providers in India access to products, services and training programs through BPL. This move highlights a strategic focus for Welch Allyn where it will seek to meet the expected demand of emerging markets. The company also announced that it plans to design next-generation, digitally-connected products for Asia and emerging markets at a new R&D facility in Singapore.

Welch Allyn’s largest distributor is currently Cardinal Health. Cardinal has awarded Welch Allyn with several awards for its innovation, support, sales, and leadership.

COMPETITOR MARKET ANALYSIS

In the Advanced Remote Patient Monitoring segment, the top 15 companies generate more than two-thirds of the total market worth $21.76 billion (2012). These companies include:

Philips Healthcare

Medtronic

Covidien

Roche

St Jude

GE Healthcare

Johnson & Johnson

Omron

Draeger

Boston Scientific

Abbott Laboratories

Nihon Kohden

Masimo

Mindray

OSI Systems



Philips Healthcare

Philips Healthcare is the global leader for Advanced Remote Patient Monitoring with nearly 13% of the 2012 market. The company offers several patient monitoring solutions to both the professional and home care markets. The company's product lines include fetal monitoring, cardiac monitoring, respiratory and ventilation monitoring, sleep management, remote cardiac services, and remote patient management.

Philips continues to actively invest in its patient care and clinical informatics business, which contributes significantly to the professional patient monitoring market. Acquisition, such as the 2011 acquisition of Dameca--a global provider of anesthesia machines--has assisted the company in maintaining the leading position in the market. The company also continues to introduce clinical systems that provide advanced monitoring capabilities, such as the IntelliVue systems.

In the home care segment, Philips is focused on expanding both the domestic and international offers of monitoring. Home monitoring in Japan, China, India and parts of Europe are target home monitoring markets for the company. In the U.S. growth continues to maintain momentum with several factors driving sales, including an aging population, self-monitoring lifestyle trends, maintaining independent living, and continued reimbursement of home monitoring equipment.

Medtronic

In 2012, Medtronic was the second largest provider of Advanced Remote Patient Monitoring equipment, devices and technologies with $2.05 billion in sales for the year. This is equal to 9.4% of the global market. Medtronic is a leader in the area of cardiac rhythm management with products such as implantable cardioverter defibrillators, diagnostic and monitoring devices, and patient management tools and services. The company also is active in devices and solutions to help patients manage their diabetes.

Covidien

Covidien is a global leader in the Advanced Remote Patient Monitoring market. The company is active in developing products to meet the needs of the industry while also remaining active in strategic acquisitions and agreements to further its position in the market. Covidien's advanced products have contributed to the company's third leading


Philips Healthcare




Medtronic


Covidien



Philips Healthcare




Medtronic


Covidien




market position with 6.7% for 2012. Sales for Covidien's advanced products are estimated at $1.45 billion for 2012.

Roche

Roche is among the top five providers of Advanced Remote Patient Monitoring technologies. The company focuses on both professional and consumer level monitoring solutions. Diabetes management is a primary segment of the Roche Diagnostic division with the Accu-Chek line of glucose monitors. The company also offers a professional IT solution, Cobas IT, and other consumer level monitors such as the CoaguChek monitor for anticoagulation therapy management. In 2012, Roche generated advanced monitoring revenues of about $1.29 billion, securing 5.9% of the global advanced monitoring market.

St. Jude Medical

St. Jude is one of the leading providers of remote cardiac event monitoring. The company specializes in cardiac rhythm management and has used this experience to move into the remote monitoring segment of the health market. Sales for St. Jude were estimated at $1.23 billion in 2012, consisting of the company's Advanced Remote Patient Monitoring devices and technologies. This places St. Jude among the top five providers globally with 5.7% share of the market.

GE Healthcare

GE Healthcare takes the 6th market position for offering Advanced Remote Patient Monitoring equipment and devices. The company's offers a wide range of products to the market including telemetry systems, critical care monitors, fetal/maternal monitors, vital sign monitoring pulse oximeters and other systems. In 2012, GE Healthcare generated advanced monitoring sales of approximately $1.15 billion, accounting for 5.3% of the global market.



Roche


St. Jude Medical


GE Healthcare




Roche


St. Jude Medical


GE Healthcare




Roche


St. Jude Medical


GE Healthcare




Johnson & Johnson

Johnson & Johnson's LifeScan is a leader in diabetes management products including blood glucose meters, insulin pumps, and accessories. The company is focused on providing the diabetes care segment state-of-the-art, advanced monitoring solutions to help diabetics manage their condition effectively and safely. In 2012, the company was responsible for about 4.7% of the advanced monitoring market due primarily to the diabetes care segment. This amounts to about $1 billion in sales for the 2012 year.

Omron

Omron is a leader in offering consumer grade patient monitoring equipment. The company's specializes in providing at-home, multiparameter monitors and has achieved healthy sales and market share for these products. In 2012, Omron generated roughly $850 million in sales for patient monitors, securing a global market share of about 3.9%.

Draeger

Draeger is a leading provider of Advanced Remote Patient Monitoring equipment and technologies with about $680 million in sales for the segment in 2012. The company offers a full range of monitors with its Infinity line of products. The Infinity products secured the company roughly 3.8% of the global Advanced Remote Patient Monitoring market in 2012.

Boston Scientific

Boston Scientific is estimated to hold 2.9% of the total Advanced Remote Patient Monitoring market. The company's primary focus includes the monitoring and care of cardiac events in patients with related conditions. Boston provides the market with both the devices capable of monitoring and the software system used to record and provide remote monitoring capabilities to physicians. Sales for the company's advanced products are estimated at about $630 million for 2012.


Johnson & Johnson


Omron


Draeger


Boston Scientific



Johnson & Johnson


Omron


Draeger


Boston Scientific



Johnson & Johnson


Omron


Draeger


Boston Scientific




Abbott Laboratories

Abbott continues to focus on the development and supply of its glucose testing and data management devices. The company's diabetes care devices include the newest device offered by the company, the FreeStyle, and several new data management systems to sort, evaluate and store results.

In 2012, Abbott was responsible for roughly 2.3% of the Advanced Remote Patient Monitoring market, largely due to its diabetes care device segment. Sales for Abbott in this area are estimated at about $550 million.

Nihon Kohden

Nihon Kohden is the leading provider of patient monitoring equipment and solutions in Japan. The company secured 2.3% market share for the global market but is estimated to hold a larger share in Japan. The company reported growth for its patient monitors at more than 5% over fiscal year 2011. Sales for Nihon Kohden's Advanced Remote Patient Monitoring equipment and technologies are estimated at $510 million for 2012.

Masimo Corporation

Masimo is currently estimated to hold the 12th position in the global Advanced Remote Patient Monitoring market. The company focuses on noninvasive methods of monitoring, sometimes overlooked and underserved areas of the market. Masimo's monitoring sales are estimated almost $500 million, giving the company a 2.3% share of the global market.

Mindray

Mindray's comprehensive line of patient monitoring solutions secured the company a leading place in the global market, equal to 2.1% in 2012. The company's Advanced Remote Patient Monitoring device and solutions sales are estimated at $450 million for 2012.


Abbott Laboratories



Nihon Kohden


Masimo Corporation


Mindray



Abbott Laboratories



Nihon Kohden


Masimo Corporation


Mindray



Abbott Laboratories



Nihon Kohden


Masimo Corporation


Mindray




OSI Systems

OSI Systems' Spacelabs Healthcare offers a complete line of patient monitoring and connectivity devices and solutions. The company secured a leading position in the global market during 2012 with sales of about $250 million. The company's market share for 2012 is estimated at 1.2%

Other Companies

Several companies fall into the next grouping of leaders, those companies which generate Advanced Remote Patient Monitoring device, equipment, technology sales of between $50 and $200 million. Examples of these companies include:

Alere

Bosch Healthcare

CareFusion

Fukuda Denshi Co.

InTechnology

LifeWatch Technologies

Schiller AG

Welch Allyn

*This does not include a comprehensive list as there are several other providers globally offering Advanced Remote Patient Monitoring equipment and technologies.


OSI Systems

OSI Systems' Spacelabs Healthcare offers a complete line of patient monitoring and connectivity devices and solutions. The company secured a leading position in the global market during 2012 with sales of about $250 million. The company's market share for 2012 is estimated at 1.2%

Other Companies

Several companies fall into the next grouping of leaders, those companies which generate Advanced Remote Patient Monitoring device, equipment, technology sales of between $50 and $200 million. Examples of these companies include:

Alere

Bosch Healthcare

CareFusion

Fukuda Denshi Co.

InTechnology

LifeWatch Technologies

Schiller AG

Welch Allyn

*This does not include a comprehensive list as there are several other providers globally offering Advanced Remote Patient Monitoring equipment and technologies.



Table 4-1

Competitor Analysis, Global Advanced Remote Patient Monitoring Equipment and Devices, 2012

Supplier Revenues Estimates (in billions)

Share ofTotal Market

Philips Healthcare $2.80 12.9%Medtronic 2.05 9.4%Covidien 1.45 6.7%Roche 1.29 5.9%St Jude 1.23 5.7%GE Healthcare 1.15 5.3%Johnson & Johnson 1.02 4.7%Omron 0.85 3.9%Draeger 0.68 3.1%Boston Scientific 0.63 2.7%Abbott Laboratories 0.55 2.5%Nihon Kohden 0.51 2.3%Masimo 0.49 2.3%Mindray 0.45 2.1%OSI Systems 0.25 1.2%Others 6.36 29.2%Total $21.76 100%


C H A P T E R F I V E C H A P T E R F I V E

Issues and Trends

INTRODUCTION

Advanced technologies in patient monitoring are emerging in response to increased healthcare needs of an aging population, new wireless technologies, better video and monitoring technologies, decreasing healthcare resources, an emphasis on reducing hospital days, and proven cost-effectiveness. There are four primary markets for these advanced technologies, which are as follows:

Hospitals

Home healthcare

Nursing homes


There are different sets of trends driving the patient monitoring market and driving developments in advanced technologies, which are discussed in the following two segments:

Issues and trends driving the market

Issues and trends in patient monitoring technologies.

New wireless and Bluetooth technologies, improved infrastructure, and patient familiarity with wireless devices are all combining to advance sales and use of new

C H A P T E R F I V E

Issues and Trends

INTRODUCTION

Advanced technologies in patient monitoring are emerging in response to increased healthcare needs of an aging population, new wireless technologies, better video and monitoring technologies, decreasing healthcare resources, an emphasis on reducing hospital days, and proven cost-effectiveness. There are four primary markets for these advanced technologies, which are as follows:

Hospitals

Home healthcare

Nursing homes


There are different sets of trends driving the patient monitoring market and driving developments in advanced technologies, which are discussed in the following two segments:

Issues and trends driving the market

Issues and trends in patient monitoring technologies.

New wireless and Bluetooth technologies, improved infrastructure, and patient familiarity with wireless devices are all combining to advance sales and use of new

Chapter Five: Issues & Trends 140


technologies in patient monitoring systems. Patients are now more comfortable with using a monitoring device, then having a hub send the data to their healthcare provider via telephone, mobile phone, wireless, PC, or other connection. Supported peripherals such as high-quality video and audio enable an interactive telemedicine encounter.

Within hospitals, wireless technologies can allow for portable monitoring equipment that moves with a patient or a patient’s bed, forwarding data to a central station. This is particularly valuable when a patient is being moved within the hospital or needs to be moved quickly.

Technologies have been advancing quickly. While allowing for new developments, there is a double-edged sword in that equipment is becoming obsolete—or at least outdated—quickly. Healthcare providers are afraid that a better product is on the horizon or that current products will not be compatible.

Although technology is the mainstay of advancements in healthcare, there are times when the pace of technological achievements runs faster than they can be utilized and not all industries embrace changing equally. The medical community is noted for lagging in IT area advancements. However, manufacturers in this field have been working diligently to engineer systems that make it easier for physicians to monitor their patients outside the clinical setting. Medtronic, for example, reports that clinical data show remote monitoring of implantable cardioverter defibrillators and pacemakers, when used in conjunction with the company’s CareLink Network, can detect clinically actionable events more quickly than with traditional in-office follow-up visits. Similar outcomes were realized in other studies in Europe as well. More validation will likely help to advance the adoption of new wireless technologies in the healthcare sector in the future.

Additional segments discuss the opportunities for advanced monitoring equipment in telemedicine and Telemedicine environments and a basic outline of international trends for monitoring equipment and products.

ISSUES AND TRENDS DRIVING THE MARKET

Issues and trends driving the market for patient monitoring, particularly remote patient monitoring include:



technologies in patient monitoring systems. Patients are now more comfortable with using a monitoring device, then having a hub send the data to their healthcare provider via telephone, mobile phone, wireless, PC, or other connection. Supported peripherals such as high-quality video and audio enable an interactive telemedicine encounter.

Within hospitals, wireless technologies can allow for portable monitoring equipment that moves with a patient or a patient’s bed, forwarding data to a central station. This is particularly valuable when a patient is being moved within the hospital or needs to be moved quickly.

Technologies have been advancing quickly. While allowing for new developments, there is a double-edged sword in that equipment is becoming obsolete—or at least outdated—quickly. Healthcare providers are afraid that a better product is on the horizon or that current products will not be compatible.

Although technology is the mainstay of advancements in healthcare, there are times when the pace of technological achievements runs faster than they can be utilized and not all industries embrace changing equally. The medical community is noted for lagging in IT area advancements. However, manufacturers in this field have been working diligently to engineer systems that make it easier for physicians to monitor their patients outside the clinical setting. Medtronic, for example, reports that clinical data show remote monitoring of implantable cardioverter defibrillators and pacemakers, when used in conjunction with the company’s CareLink Network, can detect clinically actionable events more quickly than with traditional in-office follow-up visits. Similar outcomes were realized in other studies in Europe as well. More validation will likely help to advance the adoption of new wireless technologies in the healthcare sector in the future.

Additional segments discuss the opportunities for advanced monitoring equipment in telemedicine and Telemedicine environments and a basic outline of international trends for monitoring equipment and products.

ISSUES AND TRENDS DRIVING THE MARKET

Issues and trends driving the market for patient monitoring, particularly remote patient monitoring include:




Increasing life expectancy

Healthcare expenditures

New wireless technologies

American Reinvestment and Recovery Act of 2009

Medicine-at-Work

Healthcare efficiency

Emphasis on reducing hospital days

Emphasis on error reduction

Decreasing healthcare resources

Nursing shortages

EMR Adoption

Cost effectiveness

eICU

Mental Health Assessments and Telemedicine



AGING OF THE POPULATION

Aging of the population will have several varied effects on the healthcare industry as a whole, with specific implications for patient monitoring. First, aging of the population will bring increased prevalence of chronic diseases—such as asthma, chronic obstructive pulmonary disorder (COPD), congestive heart failure (CHF), coronary heart disease (CHD), diabetes and osteoarthritis—which are more prevalent among the elderly. While this will increase the need for healthcare, overall aging of the population means that the percentage of the population in the workforce, including healthcare professions, is decreasing.

In addition, the elderly population itself is changing. The baby boomer generation is more active later in life and wants to stay at home, rather than in nursing homes or other facilities. Coupled with increased familiarity and comfort with technology, elderly baby boomers will be ideal candidates to use new technologies in patient monitoring, including safety monitoring and medication monitoring.

The use of new technologies in patient monitoring will have several advantages including the following:

It will be easier for patients to self-monitor their conditions and report abnormalities to their care providers immediately.

It will be easier for healthcare providers to more efficiently monitor conditions of more patients, thus allowing fewer healthcare providers to satisfy a greater need.

Hospital admissions will be reduced as adjustments in care can be made before a patient must present in the emergency room.

Medication monitoring will drastically reduce errors. The National Council on Patient Information and Education (Bethesda, MD) estimates that half of all medications are taken incorrectly each year and that mistakes account for 10% of all hospitalizations and 25% of nursing home admissions.



Increasing Life Expectancy and the Demand for Advanced Healthcare Delivery Options

Life expectancy has been increasing around the world due to advances in healthcare, medical research, sanitation, and nutrition. Developed regions have seen relatively steady growth over the past 25 years. Overall women typically live longer. There are several theories why women outlive their counterparts. For example, men fight in more wars, and are believed to take more risks.

The increasing life expectancy is adding more pressure to the health system by demanding care for an increasing number of aging patients for longer. There is also a trend for patients to remain independent of full-service health services for longer. This shows a demand for monitoring technologies that can meet these needs.

GLOBAL HEALTHCARE TRENDS

The worldwide spending on healthcare is approximately $6.5 trillion. This is around 10% of the global GDP. North America is the largest region in terms of total dollars spent on healthcare followed by Europe, then Asia Pacific.

Healthcare costs as a percent of GDP are increasing in almost all countries but there are some exceptions like the Czech Republic. The European Union (E.U.) spends about 10% of the GDP in healthcare. As a whole, the E.U. region has seen some of the smallest increases in healthcare spending between 2000 and 2009 with an average of approximately 3.5-4% growth in total expenditures in real terms.

South America, Asia Pacific and the Middle East are the smallest healthcare markets. This can be attributed to the fact that the health systems in use are unbalanced in terms of demand and supply, and are preventing many from meeting international goals centered on health and poverty. Furthermore, the healthcare systems of many countries in these regions are failing to deliver services of adequate quality, often using resources inefficiently or inappropriately. However, these regions are experiencing more growth as their economies grow.


Increasing Life Expectancy and the Demand for Advanced Healthcare Delivery Options

Life expectancy has been increasing around the world due to advances in healthcare, medical research, sanitation, and nutrition. Developed regions have seen relatively steady growth over the past 25 years. Overall women typically live longer. There are several theories why women outlive their counterparts. For example, men fight in more wars, and are believed to take more risks.

The increasing life expectancy is adding more pressure to the health system by demanding care for an increasing number of aging patients for longer. There is also a trend for patients to remain independent of full-service health services for longer. This shows a demand for monitoring technologies that can meet these needs.

GLOBAL HEALTHCARE TRENDS

The worldwide spending on healthcare is approximately $6.5 trillion. This is around 10% of the global GDP. North America is the largest region in terms of total dollars spent on healthcare followed by Europe, then Asia Pacific.

Healthcare costs as a percent of GDP are increasing in almost all countries but there are some exceptions like the Czech Republic. The European Union (E.U.) spends about 10% of the GDP in healthcare. As a whole, the E.U. region has seen some of the smallest increases in healthcare spending between 2000 and 2009 with an average of approximately 3.5-4% growth in total expenditures in real terms.

South America, Asia Pacific and the Middle East are the smallest healthcare markets. This can be attributed to the fact that the health systems in use are unbalanced in terms of demand and supply, and are preventing many from meeting international goals centered on health and poverty. Furthermore, the healthcare systems of many countries in these regions are failing to deliver services of adequate quality, often using resources inefficiently or inappropriately. However, these regions are experiencing more growth as their economies grow.

Chapter Six: Global Market Size and Forecast 218


Figure 6-7

Distribution of Sales for Global Advanced Specialized/Disease Specific Monitoring Systems, 2012

Glucose Monitors

20%

Cardiac RhythmMonitors

25%Respiratory

Monitors11%

ther Monitors21%

Anesthesia Monitors

23%




END-USER MARKETS

The global $21.8 billion Advanced Remote Patient Monitoring market by end-user is segmented into two general markets: hospital/acute care facilities and the telehome or Telemedicine market (which includes both home/mobile care devices).

Hospitals and acute care include inpatient facilities (ie. Hospitals, trauma centers, etc.), surgery centers, burn units, urgent care clinics and other similar establishments.

The Telemedicine or telehome (home/mobile care) segment includes home healthcare, assisted living homes, first responders, institutions such as prisons, health clubs, malls, corporate locations, specialty clinics, and field military. Health kiosks that take various measurements and then upload the data to the internet are a relatively new segment that is beginning to see significant growth in many developed regions globally. Improvements in kiosks now include robotic kiosks that can move within a location and have audio and video capability.



Table 6-8

The Global Market for Advanced Remote Patient Monitoring Systems, by End User




In Vietnam, AMD Global Telemedicine, Inc. entered a partnership with ELINCO, a Vietnamese company providing telecommunications technologies. ELINCO has already provided military and government hospitals with related services. Under the partnership with AMD, ELINCO will use AMD devices with its Telemedicine portal.

In Japan, the Japanese Telemedicine and Telecare Association was established in 2005. This group reported that the first study trials related to Telemedicine date back to 1971.



Table 6-5

The Global Telemedicine Market 2007-2017

.0%

Compound Annual Growth Rate




Figure 6-9

Growth in Global Telemedicine Market 2007-2017

$0

$5,000

$10,000

$15,000

$20,000

$25,000

2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Millions

of$

0%

5%

10%

15%

20%

25%

Percen

tChange

Sales

%




Global Hospital and Acute Care Patient Monitoring Market

The hospital/acute care monitoring systems account for a slightly larger market segment with nearly 54% of the market in 2012, at $11.76 billion. While the traditional, non-advanced monitoring market is responsible for additional sales for the hospital segment, the $11.76 billion represents advanced monitoring systems--capable of wireless, remote, or other advanced features discussed in this report.

Table 6-6

The Global Hospital and Acute Care Monitoring Market 2007-2017


Year Revenues Percent Change2007 $5,770 — 2008 6,580 14.0% 2009 7,425 12.8% 2010 8,710 17.3% 2011 9,910 13.8% 2012 11,755 18.6% 2013 13,715 16.7% 2014 15,690 14.4% 2015 17,900 14.1% 2016 20,120 12.4% 2017 22,525 12.0%

Compound Annual Growth Rate Period CAGR 2007-2012 15.3% 2012-2017 13.9% 2007-2017 14.6%



Global Hospital and Acute Care Patient Monitoring Market

The hospital/acute care monitoring systems account for a slightly larger market segment with nearly 54% of the market in 2012, at $11.76 billion. While the traditional, non-advanced monitoring market is responsible for additional sales for the hospital segment, the $11.76 billion represents advanced monitoring systems--capable of wireless, remote, or other advanced features discussed in this report.

Table 6-6

The Global Hospital and Acute Care Monitoring Market 2007-2017


Year Revenues Percent Change

Compound Annual Growth Rate Period CAGR 2




Figure 6-11

Global Market for Advanced Remote Patient Monitoring, by Region 012


Chapter Nine: Corporate Profiles 348


NIHON KOHDEN

Company Name: Nihon Kohden Corp.

Address: 1-31-4 Nishiochiai,

Shinjuku-ku, Tokyo 161-8560

Japan

Phone: +81-3-5996-8036

URL: www.nihonkohden.com

Recent Revenue History: 2011- $ 2012-

(US $millions)

Summary: Nihon Kohden is a manufacturer, developer, and distributor of medical electronic equipment.

Key Products: Life Scope monitors, CNS central monitors, telemetry systems, NetKonnect remote access and viewer software, sleep diagnostics

Company Overview

Founded in 1951, Nihon Kohden is a global provider of medical technologies including medical monitors, electroencephalographs, evoked potential and electromyograph systems, electrocardiographs, defibrillators, and hematology analyzers. By 1966 the company had 30 sales branches and several new healthcare related device technologies.

Nihon Kohden has had several advanced product developments in its history, including an electronic writing ECG, a ICU central alarm and monitoring system in 1967, and a wireless EEG in 2004.


NIHON KOHDEN

Company Name: Nihon Kohden Corp.

Address: 1-31-4 Nishiochiai,

Shinjuku-ku, Tokyo 161-8560

Japan

Phone: +81-3-5996-8036

URL: www.nihonkohden.com

Recent Revenue History: 2011- $ 1,500 2012- $1,600

(US $millions)

Summary: Nihon Kohden is a manufacturer, developer, and distributor of medical electronic equipment.

Key Products: Life Scope monitors, CNS central monitors, telemetry systems, NetKonnect remote access and viewer software, sleep diagnostics

Company Overview

Founded in 1951, Nihon Kohden is a global provider of medical technologies including medical monitors, electroencephalographs, evoked potential and electromyograph systems, electrocardiographs, defibrillators, and hematology analyzers. By 1966 the company had 30 sales branches and several new healthcare related device technologies.

Nihon Kohden has had several advanced product developments in its history, including an electronic writing ECG, a ICU central alarm and monitoring system in 1967, and a wireless EEG in 2004.



Patents

Nihon Kohden has 205 U.S. patents filed between 1979 and 2012. The patents are for monitoring physiological signals, power control, pulse oximetry, patient monitoring, defibrillators, and sensors.

Performance Review

Total company sales have grown to $1.6 billion in 2012, approximately 7% growth over 2011 sales of $1.5 billion.

Figure 9-23

Nihon Kohden's Financial Performance, 2010-2012

($millions)

Source: Company Website

1,6001,500

1,200

0

400

800

1,200

1,600

2,000

2010 2011 2012


Patents

Nihon Kohden has 205 U.S. patents filed between 1979 and 2012. The patents are for monitoring physiological signals, power control, pulse oximetry, patient monitoring, defibrillators, and sensors.

Performance Review

Total company sales have grown to $1.6 billion in 2012, approximately 7% growth over 2011 sales of $1.5 billion.

Figure 9-23

Nihon Kohden's Financial Performance, 2010-2012

($millions)

Source: Company Website

1,6001,500

1,200

0

400

800

1,200

1,600

2,000

2010 2011 2012



OMRON HEALTHCARE

Company Name: Omron Corporation

Address: Shiokoji Horikawa, Shimogyo-ku

Kyoto 600-8530

Japan

Phone: +81-75-344-7000

URL: http://www.omron.com

Recent Revenue History: 2011-

(US $millions, projected 2012 revenues)

Summary: Omron is a leader in industrial products, transportation, security, healthcare, automotive equipment and other electronics.

Key Products: blood pressure monitors, portable ECG devices, body composition monitors, vascular monitors, patient monitors

Company Overview

Omron Corporation, based in Japan, is a leader in the healthcare technology sector with various sensing technologies and health services. The company is active in:

Industrial Automation

Electronic and Mechanical Components

Social Systems

Healthcare

Automotive Electronic Components

Other (various electronic devices and environmental solutions)


OMRON HEALTHCARE

Company Name: Omron Corporation

Address: Shiokoji Horikawa, Shimogyo-ku

Kyoto 600-8530

Japan

Phone: +81-75-344-7000

URL: http://www.omron.com

Recent Revenue History: 2011- $7,200 2012- $8,000

(US $millions, projected 2012 revenues)

Summary: Omron is a leader in industrial products, transportation, security, healthcare, automotive equipment and other electronics.

Key Products: blood pressure monitors, portable ECG devices, body composition monitors, vascular monitors, patient monitors

Company Overview

Omron Corporation, based in Japan, is a leader in the healthcare technology sector with various sensing technologies and health services. The company is active in:

Industrial Automation

Electronic and Mechanical Components

Social Systems

Healthcare

Automotive Electronic Components

Other (various electronic devices and environmental solutions)



Omron has a significant share of the blood pressure monitor market. It utilizes its proprietary bio-information sensors for the development of various healthcare technologies. The main focus of the company is in sensing and control systems. There are approximately 36,000 employees with the Omron Group.

Omron's healthcare products include home blood pressure monitors, fitness tools, and electrotherapy devices. It has sold more than 100 million blood pressure monitors.

Patents

Omron is listed as the assignee on 2,219 patents filed between 1974 and 2011. Because the company offers a variety of systems this is reflected in the patented technologies. Patents include systems in blood pressure measurement, body fat measurement, pulse wave measurement, temperature sensing, biochips, and health management.

Performance Review

Omron reported sales of approximately $7,200 million for 2011 and projected sales growth of 11% for 2012 (year end is March). For the first nine months of 2012 Omron reported that strong segment performance in Japan was seen in new products such as healthcare monitors, body composition monitors, and sleep monitors. Some of the growth in Japan for 2012 was due to reduced sales stemming from the Great East Japan Earthquake in 2011.

Healthcare product sales for the first nine months of 2012 were strong in emerging markets such as Russia, China, and Southeast Asia.




Patents


Performance Review






Patents


Performance Review



new from kalorama information advanced remote patient

Documents