Continua Health Alliance

Key Insight Business Briefing

Chuck Parker
Executive Director
The Continua Health Alliance

6/11/2009
 RPM Market : enablers and drivers

Health Cost Burden
National Action
Increasing costs of the 
old model of health care  Economic pressures force 
become a national crisis nations to demand new 
health solutions

Connected
Personal Health
New Knowledge
A new path to personal 
Modifiable lifestyles are key  wellness, citizen 
drivers for population  productivity, and 
health and disease sustainable health costs

Enabling Technology

Telehealth devices, 
personalized biometrics, 
Perspective Shift device interoperability

From treatment of disease 
to proactive nurturing 
of personal wellness

6/11/2009 2
 RPM Market: The Need

• The challenge:
– In England 15.4 million people, including 60 percent of those over age 60,
suffer from a long-term condition. LTCs account for 72 percent of all
inpatient bed days, 65 percent of all outpatient appointments and 52
percent of all GP appointments. LTCs consume 69 percent of England’s
primary and acute care budget (NHS England)
– Up to 60% of all medication prescribed is taken incorrectly, or not at all
(National Council on Patient Information & Education).

National Health Expenditures,

Aggregate and Share of Gross
Domestic Product (GDP),
1960-2017

Source: Employee Benefit Research

Institute estimates from Centers for
Medicare and Medicaid Services and U.S.
Department of Commerce.
Last Updated: January 6, 2008

6/11/2009 3
 RPM Market: the Need for Transformation

• The area of telehealth/home health monitoring is predicted to grow

very rapidly, from a $3B market in 2009 in North America and Europe to
an estimated $7.7B in 2012 (Data Monitor, 2007)
• Number of telehealth subscribers worldwide will increase to 55.5
million by 2016, representing a forecast CAGR of almost 72%, (InMedica,
2008)

• There is increasing evidence to support the value of remote monitoring

for patients with chronic diseases, including:
– 35-56% reduction in mortality;
– 47% reduction in risk of hospitalization;
– 6 days reduction in length of hospital admission and
– 65% reduction in office visits;
– 40-64% reduction in physician time for checks and
– 63% reduction in transport costs
(Cleland et al 2005; Lee R, Goldberg et al, 2003; Scalvini S et al., 2001; Elsner et al, 2006; Van
Ginneken et al 2006)
6/11/2009 4
 Continua Use Cases

• To organize its work, Continua segmented the market in

three large use cases:

Aging Independently
• An adult child helping their elderly parents
age gracefully in their own home.
• Basic life monitoring as appropriate (ADL)

Health & Wellness Disease Management

• Weight loss
• Fitness
• Email / chat / video
• Appt scheduling
• Personal Health Records
• Vital sign monitoring
(RPM)
• Medication reminders and
compliance
• Trend analysis and alerts
• Connect with family care
givers

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 Continua Use Cases
• Disease management market:
– evolve the current models of care; chronic and post-acute
– connect patients, families and healthcare providers to the right
information at the right time
– more informed decision-making
– empowering people to take a more active role in their own care
– e.g.: Northern Ireland, West Lothian (UK); AOK Cardio Integral (DE)
– mostly led by public healthcare administrations; statutory health insurers

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 Continua Use Cases
• Health and wellness market:
– health conscious and worried well
– fitness and lifestyle trackers, PHRs
– employer programs and occupational health (HRA)
– national public health programs, screening
– e.g.: Diabetes Prevention DEHKO (FI); metabolic syndrome – mandatory
HRA (JP); 10K Steps a Day; Nike Plus; Google Health; MS HealthVault;
Dossia
– mostly privately driven; a few national programs

6/11/2009 7
 Continua Use Cases
• Ageing independently market:
– residential care, independent living facilities, individual homes
– support ADL, fall detectors, bed occupancy, medical reminders, …
– personal emergency response services
– e.g.: Tunstall, Philips Lifeline, GE Quiet Care
– driven by a mix of social care providers, group housing, individual
subscribers

6/11/2009 8
 RPM market now: Current Participants

• Continua membership shows across the board interest

both from supply and demand sides:
– Medical devices
– Fitness
– IT
– Pharma
– Health care providers
– Health insurers
– Telecommunications
– Sensors
– Internet
– Applications (PHR, EHR, desktop)

6/11/2009 9
 RPM market in the future

• The individual / home as the hub

• Convergence consumer / healthcare
• Consumer health / PHRs fitness - sometimes with
public incentives
• Support public health and corporate wellness
programs
• Rewards for keeping people healthy
• Greater integration among wellness, health and social
care
• Best-of-breed plug and play
• Increased connectivity, evolutionary, scalable, service
driven offerings
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 RPM market in the future:
the continuum of life and care
Infant Amateur Diet/Fitness Worried Chronic Acute Elderly Living
Athlete Focused Well Patient Recovery Independently

CONTINUUM of LIFE

The Continua Health Alliance “connected health and care” vision blurs the frontiers
across solutions for healthcare, wellness and ageing independently. The individual
truly becomes the hub for wellness and health management.

CONTINUUM of CARE GIVERS

Fitness
Wellness Home
Coach The Family Nursing Doctor/NP/Nurse
New Parents Professional

6/11/2009 11
 Address 60-80% modifiable Adverse Health

• Many diseases can be broken 91% Diabetes 83% Heart Disease

down into non-modifiable

and modifiable contributors
69% Cancer
• Non-modifiable contributors
– Age, gender and genes

• Modifiable contributors
– Lifestyle choices
• Today, poor lifestyle choices
increasingly are the largest
contributors to common
adverse health outcomes
6/11/2009
Actual Goal
Non-modifiable Contributors to Disease
Modifiable Contributors to Disease
Hu et al. Diet, lifestyle and the risk of type 2 Diabetes in women. NEJM 2001
Sep 13;345(11):790-7.
Stampfer MJ, Hu FB, Manson JE, Rimm EB, Willett WC. Primary prevention of
coronary heart disease in women through diet and lifestyle. N Engl J Med.
2000; 343: 16–22 12
 Goal: Realize Peak Health Potential
• Goal
– Experience peak health potential throughout life for a high quality of life at minimal
costs
• Reality
– Average individual is experiencing much less of full health potential than expected
at a high financial & quality of life cost
• Cause
– Adverse health events such as stress, poor nutrition, inactivity… are causing the
population to fall away from their peak health potential

Time Peak Health Potential Line

Min
Max

Unpredictable Health
Event/Accident Expectations
Health

Costs
Poor nutrition, Actual Health
inactivity, Experience
Stress…

Non-modifiable & Unpredictable Health

Max
Min

Modifiable & Predictable Health

Adapted from Oregon Medical Labs
Death
6/11/2009 13
 RPM Market: the Market Segments

Multiple providers / service oriented

Wellness Biometrics
Management/Support Device / Testing
Systems
Systems / Sensors Glucose
Meter
Weight
Scale
Bio-metric/
Weight
Behavioral Cholesterol Spirometer

Blood-Presser Responses HDL/LDL HRA/Health

Administrative
Cuff Triglycerides
Blood- Assistant
Fitness, Pressure
nutrition, stress Blood
management… Sugar

Person Fitness
Lung Air

Pulse
Centered Volume
Equipment

Healthcare
provider Oximeter

Wellness
Resting Body Fat Center
Disease Heart Rate %
Gait
management
Pedometer analysis Body Fat
service
Information Analyzer
Systems
Medication
Activity
Tracking
Hub

PHR/PHA
Classes
Elderly Family
monitoring care
services givers
6/11/2009 14
 Thank You

Thank you!

www.continuaalliance.org

Chuck.parker@continuaalliance.org

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