Projected Growth in the Telehealth Market

Datamonitor, an independent market research firm based in London, recently issued a report entitled "Telehealth's Increasing Role in Healthcare." They predict that the home telehealth market will grow at a five-year compound annual growth rate of 56 percent, compared to a 10 percent growth in the clinical market. The firm expects the overall global telehealth market will exceed $8 billion by 2012, driven by the needs of an aging population, a shortage of providers, and by extending the technology to a broader array of medical conditions. Growth inhibitors noted were, the lack of reimbursement, and the mismatch between available technologies and the day to day realities and preferences of end users.

Fewer Nursing Home Patients

The USA Today recently reported that 7.4% of Americans aged 75 and older lived in nursing homes in 2006, compared with 8.1% in 2000 and 10.2% in 1990. The article further noted that the percentage of the oldest age group of seniors living in nursing homes has also been dropping. Less than 16% of the 85-plus population was in such facilities in 2006, according to the Census. In 1985, more than 21% in that age group lived in nursing homes. Few would deny that keeping seniors out of an institutional setting, for as long as possible, is good social policy. I'm taken by these observations, especially since they indicate a reduction in nursing home use, before the wide spread adoption of aging services technology.

Wii for Old and Young Alike

A recent article in The State.com caught my eye. It depicted South Carolina nursing home residents in a virtual bowling match using the Wii video game. One respondent noted that the Wii is being used across the country in senior facilities, and continuing care retirement communities, as a way of keeping seniors active. The article notes that the Wii games require the user to stand and mimic the movements of swinging a golf club, serving a tennis ball, rolling a bowling ball, or swinging a baseball bat using a hand-held remote controller. So, there is both a physical and mental component to the game's use. Amazing! And to think that my Grandson wants a Wii for Christmas. Maybe I should think of getting a Wii for one of my senior colleagues as well.

Continua Version One Guidelines

The Continua Health Alliance recently announced the unveiling of it's first guidelines, which will be promulgated early in 2008. The press release indicated that membership in Continua had grown six-fold, from 22 to 133 corporate members. According to the release,

"The comprehensive set of guidelines will help improve the quality of care by empowering consumers and their healthcare providers to more simply share information through common communication channels such as telephones, cell phones, PCs, TV set top boxes, as well as other dedicated health devices."

Continua's vision of readily connected health and medical devices to assist in chronic disease management is compelling.

"These interoperable devices include blood glucose tests, blood pressure monitors, pulse
oximeters and other basic vital sign monitors. Devices such as motion sensors, medication reminders and emergency response services ease the burden on family and professionals who provide care for the aging. These technologies proactively aid the secure, healthy independence of the aging in their own homes. Diet and fitness conscious individuals will also be able to seamlessly share their weight and exercise data with fitness consultants by using devices such as heart rate monitors, connected fitness equipment and activity monitors. Additionally, Continua-certified data transport hardware and software will further enhance broad based interoperability of these devices."

I was particularly taken by the announcement that Continua had decided to retain the services of Abt Associates Inc. to study telehealth reimbursement policy.

"Abt Associates will assist in cataloging, synthesizing and assessing all telehealth studies and
the peer-reviewed cost-effectiveness literature. This work will help Continua determine strategies for initiating increasing telehealth cost effectiveness, initiating quality improvement studies and for securing reimbursement for telehealth products and service."

VeriChips Linkage to Cancer?

Today's Healthcare IT Strategist carried this summary of an Associated Press story, which was presented, in more complete form, in yesterday's New York Times, MSNBC News, and The Lakeland Ledger.

"FDA-approved microchips linked to cancer: study

When the U.S. Food and Drug Administration approved implanting microchips in humans, the manufacturer said it would save lives, letting doctors scan the tiny transponders to access patients' medical records almost instantly. The FDA found "reasonable assurance" the device was safe, and a subagency even called it one of 2005's top "innovative technologies."

But neither the company nor the regulators publicly mentioned this: A series of veterinary and toxicology studies, dating to the mid-1990s, stated that chip implants had "induced" malignant tumors in some laboratory mice and rats. "The transponders were the cause of the tumors," said Keith Johnson, a retired toxicologic pathologist, explaining the findings of a 1996 study he led.

Leading cancer specialists reviewed the research for the Associated Press and, while cautioning that animal test results do not necessarily apply to humans, said the findings troubled them. Some said they would not allow family members to receive implants, and all urged further research before the glass-encased transponders are widely implanted in people."

The Lakeland Ledger conducted a post article survey (n=109 respondents) which responded to the question "Would you allow yourself or a relative to be implanted with a microchip that gives medics access to a patient's medical records?" 64% of the respondents said no, and 36% said yes. People who answered negatively did so for religious reasons, for privacy concerns, or because they had medical reservations about the implant. Positive voices saw value in the implant in an emergency situation, and for use in identifying patients with a chronic disease.

The MSNBC News survey (n=3963 respondents) asked "Will you get microchipped now that it has been revealed that studies are linking tumors in lab animals to the implants?" 7% said yes, 83% said no, and 10% were uncertain.

I'm buying the MSNBC results because of the larger numbers, and because the results seem more aligned with my sense of the US population's "unease" with microchip implants for humans. (Note: Tens of thousands of pets have microchip implants, without adverse medical impact, at least to date.) Privacy, religious concerns, and medical reservations are pretty powerful barriers to customer acceptance. There doesn't appear to be much evidence that these chips will be much more than a niche product, on a going forward basis. Today, VeriChip's (CHIP) stock fell by 11% , and its' lead investor, Applied Digital Solutions (ADSX) stock, fell by 10%.

High Tech Hearing Aids

On August 28th, the Wall Street Journal featured an article entitled "The Sleek, Chic, High-Tech....Hearing Aid." The featured device is Phonek's Audéo. The Phonak Group, headquartered in Stäfa, Switzerland, specializes in the design, development, production and global distribution of technologically advanced wireless and hearing systems. I suggest you check out the Audéo website not only to learn about the device, but to see how this vendor decided to market aging technology to an audience of upscale baby boomers. One of the "Audéo people" is featured to your right. He is described as an "Archeologist, Beach Volleyball Player, and Hopeless Romantic." The tag line for the site is "Your life, amplified." The site includes a sound demo, a self test, FAQ's, and a color guide featuring 15 color combinations with such labels as Green with Envy, Pinot Noir, and Flower Power. The devices cost $2500 to $3000 per ear. To me, the site is well done, but also borders a bit on parody. I should look so good!

Two other innovative hearing devices were mentioned in the Journal article. The first was Great Nordic Pulse and the second was Siemens' CIELO2 Active. Both devices are rechargeable, which is an improvement over the need to change batteries.

The article made several points which are worth noting.

a. By age 65, nearly a third of Americans have hearing loss, and 40-50% will develop such loss by 75.

b. Resistance to the use of hearing aids is high. Only one in 5 people who could benefit from the device wear it.

c. The cost of hearing aids is generally not covered by insurance.

d. The newer, smaller devices have driven overall sales of behind-the-ear devices from 44% last year to 50.2% of hearing-aid sales this year--exceeding sales of in-ear molds for the first time since 1982.

e. Digital hearing aids, in which incoming sound is processed with a computer chip before being fed into your ear, enables almost limitless massaging of the sound. For example, the Audéo automatically switches among four programs, one for music, one for quiet, one for speech alone, and one for speech and noise together.

The 2007 National Positive Aging Conference

I'd like to draw your attention to this Conference, which will be held on December 6-8, 2007 at Eckerd College in St Petersburg, FL. The Conference site will tell you all you need to know about the event. According to the site, benefits for Conference attendees include:

Learn about current and future trends in services and programs for mature adults.
Take home new ideas to integrate into your programs.
Network with program implementers and thought leaders from around the world.
Hear and learn from program participants.
Have hands on opportunities with new and emerging technology and program tools.
Develop contacts and relationships for future program information and development activities.
Explore programming and partnering opportunities beyond your traditional boundaries-step outside the box!
Increase your commitment to a philosophy of “Positive Aging” through association with national and international thought leaders and program developers.

Early registration is recommended.