Remote Patient Monitoring: 9 Promising Start-ups in 2013
From telemedicine robots to toilet sensors, remote patient monitoring technology continues to win venture capital. These nine startups have landed funding in the past year.
In 12 remote patient monitoring deals this year, venture capitalists put a total of $102 million into RPM companies, reports Rock Health, a seed fund for digital health. Why the focus on remote monitoring technology? Investors are betting that new federal requirements and changes in how doctors get paid will force hospitals to buy more gadgets to help watch over and care for patients outside the hospital setting.
The Affordable Care Act is expected to push more medical billing from the traditional fee-for-service model to the new fee-for-performance model; in other words, hospitals will get paid to keep people healthy. Keeping people healthy will force healthcare providers to do things such as prevent readmissions back to a hospital for an infection or relapse after a treatment, or keep people from needing a hospital stay at all. And that will happen only if providers have some insight into what patients are doing at home.
“Patient monitoring is becoming a necessary measure for hospitals and doctors to measure their business,” said Jack Young, head of Qualcomm Life Fund, a wireless health investment company. “The focus is shifting whether they like it or not.”
The theory is that better chronic care management will keep costs down. If patients can manage conditions such as diabetes and heart disease better outside of the hospital, costly major medical episodes are less likely to occur.
Remote patient monitoring companies are popping up left and right in the industry because it’s relatively cheap to enter the market. Wireless transmission of data and sensors to collect data aren’t new developments — venture capitalists are getting interested now because new payment models are creating demand from providers.
“The technology has existed for years,” said Promod Haque, a senior managing partner at Norwest Venture Partners, which invests in health IT companies. “This isn’t new innovation. It’s about new applications.”
In 2010, the Affordable Care Act required the Department of Health and Human Services to establish a readmission-reduction program. Remote patient monitoring done right could significantly reduce the likelihood of readmission by heading off small problems before they become critical.
“It’s in the best interest of hospitals to prevent readmission, so we’re seeing a flurry of funding, especially as the ACA is really starting to take hold,” said Paul Sonnier, head of digital strategy at Popper and Co., a healthcare consulting firm.
Remote patient monitoring faces some big obstacles. Older patients might be unfamiliar with the technology, and people of all ages still have to be persuaded to use it. There is little standardization among the devices because of the number of companies in the market, so IT faces an integration headache getting them to work with existing electronic records.
Another obstacle is that regulators view some monitoring apps the same as medical devices, and so they need Food and Drug Administration approval for use in clinical settings. Providers also need to figure out how to use all the data collected. For instance, how to automate the analysis to alert a nurse or doctor at the right time to follow up, but not so often that clinicians are overrun with warnings?
But venture investors are used to such risks with emerging tech and are sure there’s money to be made as a few remote monitoring companies grow large enough to “emerge as victors and go public,” said Hague.
Looking at the types of remote patient monitoring companies that venture capitalists are funding offers a window on where the technology is headed. Here are nine remote patient monitoring startups that have received new venture capital funding within the past year.
BAM Labs provides an FDA-approved sensor mat that is placed under mattresses to monitor a patient’s presence, sleep pattern, heart rate and breathing rate. The clever part is that the patient isn’t connected to any wires — the “smart bed” does all the work. The mat can be used in a hospital or home setting. Data collected is transmitted online to an app viewable on any Internet-connected device. Doctors and caregivers can monitor multiple patients at once from the app.
Independa has created an integrated system for monitoring a person in the home that can include gathering clinical measurements such as blood pressure and glucose, to sensors that monitor motion, toilet flushing and door opening. The system is intended to enable independent living for seniors, while letting caregivers passively monitor and be alerted if something seems wrong, like no movement in the house for some period. The system can monitor a patient’s activity via those sensors and reports data back via an online app. Independa also provides tablet and television interfaces for email and for medication and appointment reminders.
The doctor is in — at least in robot form. InTouch has developed an FDA-approved platform to let doctors conduct real-time clinical consultations remotely via a roving “robot.” The device consists of a videoconferencing screen mounted on an upright robot that the doctor can guide from another location using an iPad.
InTouch has developed one version of the telemedicine robot with iRobot, maker of the Roomba automated vacuum. It has other RPM products in development, including a handheld screen, allowing for consultations at home or a hospital or clinic room. The telepresence link relies on Wi-Fi.
Vivify provides cloud-based applications that patients can use from home to access their care plan and keep track of their vital signs. The data is transmitted to physicians, who can access it on mobile devices, computers and Internet-connected television. The software includes medical coaching, customized care plans, videoconferencing with physicians and educational videos. The platform is interoperable with EMRs, PHRs and HIEs. The challenge Vivify and providers will have with many of these patient-data tools is getting people to use them consistently.
Sotera’s ViSi mobile system gives physicians and caregivers remote access to a patient’s vital signs from anywhere within the hospital. The system monitors heart and pule rates, ECGs, blood oxygen saturation level, blood pressure, respiration rate and skin temperature — both in and out of bed and in transport. The color touchscreen device is strapped to the patient’s wrist, with sensors attached to the patient’s chest and arm. Data is transmitted to physicians via Wi-Fi to desktops, tablets and mobile devices.
Watermark’s FDA-approved device determines the severity of obstructive sleep apnea. The wireless device is worn on the forehead while sleeping and measures the patient’s blood oxygen saturation, pulse, airflow, snoring levels, and head movement and position. The device can store up to three nights of data, letting people collect data at home rather than coming into a hospital sleep lab for an overnight exam.
iRhythm’s Zio patch cardiac rhythm monitor provides continuous monitoring for up to 14 days. It’s intended for asymptomatic patients or those with secondary symptoms. The patch is worn on the chest and is recyclable.
Another iRhythm product, the Zio event card, is a prescription-only device that provides continuous ECG monitoring. The disposable device is about the size of a credit card and weighs less than two ounces. It can be worn around the neck or on a belt clip for up to 30 days. The card scans for ECG data all day and night, but only stores symptomatic data. If the patient is experiencing symptoms, he presses a button that causes the card to store the previous 45 seconds of ECG data plus the first 15 seconds after the button is pressed. The patient then calls the iRhythm National Clinical Center for further instructions on how to transmit the data.
Sense4Baby is a wireless, portable, remote fetal and maternal heart rate monitoring system. It provides doctors with a fetal monitoring center and a cloud-based Web portal to review results. Sense 4 Baby is intended for high-risk pregnancies. It is pending FDA approval and is not for sale in the U.S.
Healthsense develops technology aimed at keeping seniors living independently and safely in their homes. One of its remote monitoring products, eNeighbor, uses sensors on the patient and throughout the home to detect falls, wandering and missed medication. It also includes an emergency call pendant. Emergency call services have been around for a long time, but eNeighbor tries to bring sensor data into the mix.