The Move to Distributed Healthcare

Devices incorporate sensors and telehealth capabilities to increase access.

By Cheryl Coupé, Contributing Editor

While the need for large medical equipment such as MRIs continues, Jack Gold, president and principal analyst of J. Gold Associates, LLC says, “If you look at what’s taking place in the medical arena over the next few years, we’re moving to a much more distributed approach. And especially we’re moving to a much more sensor-based approach.” Drivers for this change include increased capabilities and improved costs of sensors, increasing processing power (both independent and embedded in the sensor) and the improved availability of wired and wireless networks.

This trend is supported by a new report, “The World Market for Telehealth – A Quantitative Market Assessment – 2011 Edition,” by InMedica, the medical electronics market research group within IMS Research, which forecasts that the world market for telehealth will exceed $1 billion by 2016 and could jump to $6 billion in 2020.

“Many public healthcare systems now have targets to reduce both the number of hospital visits and the length of stay in hospital,” stated Diane Wilkinson, research manager at InMedica. “This has led to a growing trend for healthcare to be managed outside the traditional hospital environment, and as a result, there is a growing trend for patients to be monitored in their home environment using telehealth technologies once their treatment is complete.”

Wilkinson adds, “By far the most established market for telehealth at present is the US, as evidenced by the Veteran’s Health Administration’s extensive home telehealth service, which aims to have 92,000 patients enrolled on telehealth services by 2012. There has also been some large-scale trial activity in Europe, most notably in the UK in 2010 and 2011, where PCTs have initiated some projects involving more than 2,000 patients. What is apparent is the convergence of many different industries in this space, including telehealth companies, device manufacturers, healthcare agencies, service providers and telecommunication companies to name but a few.”

From an embedded perspective, Gold explains, “We’re moving to a world where it’s not just massive machines; it’s also lots of small machines networked together. Embedded capability is revolutionizing the way we think about healthcare.” While we can now gather more information about patients, the peripheral impact is what to do with that information, how to store it and keep it secure and how to compensate providers for its use outside of traditional care environments. These changes are having a dramatic impact in the medical community, and the decisions that are made from governments on down will impact device manufacturers for some time. Embedded developers will need to address issues around reliability and security, power requirements and interoperability. While care providers are being driven by consumer demands for cheaper, more accessible information (and the implications of that), developers reap some of the benefits of consumerization, such as the number of sensors in consumer devices driving costs down, and the trend towards reusable software that should improve both development time and costs.

Ed Hill, Intel’s director of marketing for embedded communications, sees healthcare reform in the U.S. as a significant market force that will change the landscape from a device standpoint. Intel has been involved from both a policy and legislative standpoint and is highly interested in how the reform process will address the costs of delivering healthcare in a new distributed care model that not only provides services in traditional hospitals and clinics but also in the home and remote locations. These changes bring new opportunities for device manufacturers, and Intel wants to be there with them. The company has historically had a foothold at the big machine level, which is where the bulk of market share in medical has been. Intel® processors have traditionally been used for image reconstruction within imaging devices where its advanced vector extensions (AVX) improve performance due to wider vectors, which provide faster image reconstruction time. While device manufacturers eventually reach a point of minimal return in terms of image reconstruction time, Intel processors continue to support higher resolutions required in applications such as 3D diagnostics.

While MIPS and ARM have been primarily found in smaller devices, Intel is looking to make similar moves in healthcare as it has in other markets, working to drive its Intel® Atom™ processor down to smaller handheld and mobile devices. To support this, Intel is continuing to focus on lower power and lower cost devices, with higher battery life for more portability along with high processing performance. This direction meets worldwide needs for medical teleconnection, for instance from a hospital in Beijing, China to a remote community clinic where local doctors can work with a hospital that has expertise to assist on a remote diagnosis using multiple screens, video feed and even real-time image sharing. Hill sees an opportunity for these solutions to be more portable and lower cost to provide remote patient-monitoring systems that include display and camera for remote telehealth discussions, to complement large, dedicated equipment in urban centers.

Security continues to be a hot topic, as well as interoperability between devices, which Hill believes is quickly reaching a point where it will become a standard requirement. Another aspect of healthcare reform that he believes developers need to be concerned about is quality of reporting: what the device is doing and what it is reporting.

Similar to evolutions in other industries (such as smart grid), the technology is moving faster than the infrastructure can handle. Hill believes that a determining factor in the evolution of these connected medical devices will be how insurance companies react – as in, who pays? – and how quickly providers are willing to pay to update their practices. A few things will help drive change: too few doctors for an increasing numbers of patients, the large number of baby boomers with disposable income and consumer demand. Hill also sees an increase in venture capital funds available in healthcare-related technologies – indicating that a large market is perceived to be there.



Cheryl Berglund Coupé is editor of EECatalog.com. Her articles have appeared in EE Times, Electronic Business, Microsoft Embedded Review, and Windows Developer’s Journal. She has developed presentations for the Embedded Systems Conference and ICSPAT. Berglund Coupé has held a variety of production, technical marketing, and writing positions within technology companies and agencies in the Northwest.