Esther Rodriguez Villegas, founder of medtech startup Acurable and director of the Wearable Technologies Lab at Imperial College London, discusses how the remote monitoring market needs a new approach.
Acurable
At a time when economies remain sluggish and business growth is hard to come by, m-Health (mobile health) is experiencing remarkable growth. A new study suggests that 77 million patients were remotely monitored in 2023 through IoT technology. The Berg Insight report tracked every patient in what they call m-Health care programmes, where connected devices are used as part of the care package. The headline figure is impressive enough by itself, but the research house is additionally forecasting that patient numbers will nearly double in the next four years, hitting 140 million by 2028. New technologies are enabling clinicians to provide care to patients who they have only been able to reach previously through expensive and cumbersome clinic-based treatments. This will be disruptive to the existing market of healthcare device providers for a simple reason: it will put the patient in the driving seat.
To understand what I mean by putting the patient in the driving seat, we have to take a look at the context of what lies behind the boom in m-Health care. A generation or two ago, healthcare was mostly reactive. Patients would only seek medical treatment in extreme circumstances, and many of our medical institutions, such as hospitals, were set up to deal principally with meeting demand for acute care. The large hospital model has many advantages. Its scale makes it possible to offer a wider range of medical specialisations in one place. The centralised top-down delivery model, however, struggles when it comes to chronic, long-term illnesses. Progress in medical treatment, living standards and public health have made acute illness less common. That means population-wide chronic long-term illnesses are now more prominent, and the need to treat them effectively more urgent. Nearly half the UK population report long-standing health issues. Diagnosing, treating and managing these conditions requires monitoring over long periods of time and centralised hospital and primary care systems do not have the resources to manage and treat problems of this kind on an in-patient basis.
To complicate matters further, many of these conditions, whilst being chronic, only manifest periodically and unexpectedly. Due to this, to be accurately diagnosed, patients of this kind have to hope to suffer from an episode at the same time as they have their once or twice-yearly appointment in the surgery or hospital. For example, look at paroxysmal atrial fibrillation. There are millions of patients with it in the UK (ex-Prime Minister Tony Blair is a well-known sufferer). But, for quite a few of them, their clinicians will have never seen any physical proof that they are suffering from it (since, unlike for the UK former Prime Minister, other patients lack the round-the-clock medical support that goes with the job of being the leader of a country).
The good news is that advances in technology are starting to make it possible to diagnose and monitor patients remotely at home using a new generation of medical devices. The rapid increase in adoption predicted by the Berg Insight report is no surprise. Long-term conditions will require a different pathway from the classic top-down care model. The patient will be much more of a partner in all aspects of the treatment. Many, if not most, of the pathway steps will be outside the clinic using remote monitoring which means the patient will need to be actively engaged with and support the treatment steps. Devices will be as attractive to the patient as they are to professionals in the clinic. In this new chapter the patient is going to be powerful: if the device is hard to use, invasive, restrictive or simply uncomfortable, patients will simply not use it. Devices that are successful will combine the precision of conventional clinical based equipment and/or healthcare professionals themselves with the convenience and ease of use of a smartphone. Over time they have the potential to become “thermometers” of conditions: a device that everyone has at home to diagnose, monitor or manage a variety of health problems.
Established medical device manufacturers might think this is a market that is theirs for the taking, but unless they radically change to a patient-led approach, they could face major disruption from new entrants into the market. Those who are thinking like consumer product and services companies are best positioned to reap the benefits of that explosive growth the Berg Insight report predicts.
