tele-health carts, servers, and monitoring: market … 2012 brochure.pdf · telehealth telemedicine...

WinterGreen Research, INC.

REPORT # SH25081313 366 PAGES 111 TABLES AND FIGURES 2012

$3,700 SINGLE COPY -- $7,400 WEB SITE POSTING

Tele-Health Carts, Servers, and Monitoring: Market Shares, Strategies,

and Forecasts, Worldwide, 2012 to 2018

Tele-Health: Clinical Services Leverage Medical Information Delivered In Home On Tablet Devices, Remote Care Diagnosis and Treatment

Torrie The Cat in the Tulips Picture by Susan Eustis

WinterGreen Research, Inc.

Lexington, Massachusetts www.wintergreenresearch.com




CHECK OUT THESE KEY TOPICS

Chronic heart failure CHF

Chronic heart disease Telehealth

Telemedicine Telemonitoring

CMS Telemonitoring Heart disease treatment

efficacy Care Management

CMHCB Health Buddy System Medicare Monitoring

Remote patient monitoring Heart failure mortality

Health economics Heart Failure

Heart Diseases Cardiovascular Diseases

Behavior CHF patient Behavior Modification

Telemedicine Hypertension monitoring

Chronic heart disease telemonitoring

Health care delivery efficacy Chronic Diseases Monitoring Health Services and Systems

Telehealth DRE

Health Monitoring Health Communication

Aging Monitoring Technology

Health engagement Medical innovation

Mobile health Remote health monitoring

Clinical communication Medical communication

Telemedicine Telehealth Tele-health

Remote medical support Telepharmacy

Seniors and health Diabetes Monitoring

Telemedicine Remote patient monitoring

Chronic heart failure mortality

health economics

Heart Failure Heart Diseases

Cardiovascular Diseases Quality of Care

American Medical Group Association

Department of Veterans Affairs telemonitoring

Chronic disease management Health Buddy System

Healthcare telemonitoring Medicare telemonitoring

Bosch telehealth, Treatment Monitoring

Tele-Health: Tablet Based Monitoring and Information Exchange Provides Growth

Tele-Health: Carts, Servers, and Monitoring Market Shares, Strategies, and Forecasts, Worldwide, 2012-2018

LEXINGTON, Massachusetts (December 11, 2012) – WinterGreen Research announces that it has a new study on Tele-Health Carts, Servers, and Monitoring Market Shares and Forecasts, Worldwide, 2012-2018. The 2012 study has 366 pages, 111 tables and figures. Tele-health improves treatment of chronic disease, reduces cost of care delivery, lets baby boomers age gracefully in their homes. Tele monitoring is evolving more sophisticated ways of monitoring vital signs in the home, thus protecting people in a familiar, comfortable environment. The improvements in care delivery relate to leveraging large information sources that permit understanding what care works for what conditions.




Tele-health systems server markets are anticipated to grow because they represent a way to steer patients with a particular clinician to those most expert in treating that particular condition. Tele-health is not yet to the point where it is able to be used effectively to implement changes that represent significant improvements in overall healthcare delivery, they are largely confined to being used in the treatment of chronic conditions. The aim of tele-health systems that will grow markets significantly is if the tele-health is used to prevent the onset of chronic conditions of CHF and diabetes through interventional medicine, wellness programs, and simply intelligent nutrition and exercise programs implementation. Is this the task of the hospitals? Or, are well ness programs meant to be implemented elsewhere? In any case, tele-health represents the delivery mechanism for the programs. Statins have a warning label that indicates that patients who take these drugs risk mental deterioration and diabetes. Is this what we want for our people? Or are there wellness programs that provide alternatives. These are issues confronting hospitals, physicians, clinicians, big pharma, and patients everywhere. We are all patients; the task is to figure out good tele-health systems that work to implement wellness programs before the onset of chronic conditions. Under this scenario, the local physician and specialist becomes the expert in ordering the correct diagnostic tests, not just any test they can think of, but a proper test that is recommended by the expert systems and by the expert clinician. In this manner the out of control testing costs in the US can be controlled. There will need to be some law changes, there will need to be some adoption of protections for the expert doctors, but when decisions are backed by standards of care instantiated as tele health servers we begin to have a rational, very effective health care delivery system. Use of tele-health systems in the treatment of chronic conditions is important. 90% of the cost of care delivery is tied up in the treatment of chronic conditions. A large percentage of the tele-monitoring servers was sold in the U.S., where the VA system did home monitoring of 92,000 patients in 2012. Tele-health equipment shipments are anticipated to grow rapidly worldwide as efficiencies of scale are realized for monitoring and treating people with chronic conditions in a more standardized manner that addresses the particular combinations and clusters of conditions any one patient presents. Tele-health systems rely on monitors with integrated connectivity. Systems use monitoring hubs with integrated cellular capability and carts that permit remote diagnosis for places where there is a shortage of good doctors and where people want second opinions from a trusted expert. A physician that sees hundreds of patients a week with a certain condition is more apt to render an accurate diagnosis and to provide effective treatment than a physician that only sees that condition once a year. The only way to connect patients with a particular condition with a clinician expert in treating that condition is through telemedicine. Everyone knows that a surgeon who operates within a particular specialty every day is more expert than one who operates only once a year. The same is true across the board for all specialties.




Systems like the Bosch health management programs with evidence-based guidelines are great in this context. These evidence based systems can be used to keep physicians and clinicians focused on the most significant part of the condition being treated. IBM Watson is similarly great in the context of connecting expert clinicians with patients presenting a certain combination of symptoms. This type of care delivery represents significant change, but it is change for the better, it is lower cost care delivery with higher quality of care. Watson or competing computing systems have the potential to be incredibly useful in this context. Because Watson and other cognitive computing systems can recognize clusters of symptoms in a particular patient, these types of systems are potentially useful in guiding patients to the care delivery clinician that is most likely to be able to recognize the best treatment and to provide the recommendation ot other clinicians as to what will be the highest level of effective care for the least cost. The aim of tele-monitoring is to improve patient compliance with standards of care known to support improved outcomes for patients with chronic conditions. Tele-monitoring is one way to improve patient compliance, but there are other ways to achieve that as well. Tele-monitoring increases patient compliance. The aim is to improve the delivery of healthcare to clients by monitoring vital signs to detect changes in patient condition that may indicate the onset of a more serious event, much as nurses in the hospital monitor patient vital signs. According to Susan Eustis, the principal author of the study, “The advantage of telemonitoring is that it increases patient compliance. It brings expert medicine into the home and attempts to present it in manner patients can hear. The aim is to improve the delivery of healthcare to clients by performing medical exams remotely and monitoring vital signs to detect changes in patient condition that may indicate the onset of a more serious event, much as nurses in the hospital monitor patient vital signs for the purpose of permitting sophisticated care delivery.” Tele-health equipment units decrease the cost of care delivery while improving the quality of care and the quality of lifestyle available to patients. They have been widely adopted and extremely successful in use by the veterans administration in the US and by CMS Medicare and Medicaid. Use is anticipated to be extended to a wide variety of care delivery organizations based on this base of installed systems. Healthcare delivery is an increasing concern worldwide. Markets for the carts and associated servers segment of the market at $98 million in the first three quarters of 2012 are anticipated to reach$1.4 billion by 2018. WinterGreen Research is an independent research organization funded by the sale of market research studies all over the world and by the implementation of ROI models that are used to calculate the total cost of ownership of equipment, services, and software. The company has 35 distributors worldwide, including Global Information Info Shop, Market Research.com, Research and Markets, Bloomberg, Electronics.CA and Thompson Financial.




treatment efficacy, Care Management, CMHCB, Health Buddy System, Medicare Monitoring, Remote patient monitoring, Heart failure mortality, Health economics, Heart Failure, Heart Diseases, Cardiovascular Diseases, Behavior CHF patient, Behavior Modification, Telemedicine, Hypertension monitoring, chronic heart disease telemonitoring, Health care delivery efficacy, Chronic Diseases Monitoring, Health Services and Systems, Telehealth, DRE, Health Monitoring, Health Communication, Aging, Monitoring Technology, Health engagement, Medical innovation, Mobile health, Remote health monitoring, Clinical communication, Medical communication, Telemedicine, Telehealth, Tele-health, Remote medical support, Telepharmacy, Seniors and health, Diabetes Monitoring, Telemedicine, Remote patient monitoring, Chronic heart failure mortality, health economics, Heart Failure, Heart Diseases, Cardiovascular Diseases, Quality of Care, American Medical Group Association, Department of Veterans Affairs telemonitoring, Chronic disease management, Health Buddy System Healthcare telemonitoring, Medicare telemonitoring, Bosch telehealth, Treatment Monitoring, http://wintergreenresearch.com/reports/tele-monitoring.html

Companies Profiled

Market Leaders

GlobalMed

Bosch Group

Bayer HealthCare / Viterion TeleHealthcare

Philips

Market Participants

Aetna Accenture Aetna American Well Systems Assa Abloy 5-4 AT&T Boehringer Ingelheim Bosch Bayer - Viterion Biotronik BT Cardionet Centerstone Research Institute Centerstone Research Institute ciCoach.com Cisco Cleveland Clinic CMS

Deutsche Telecom Eliza Corp EMC Healthrageous Honeywell HomMed Humedica GlobalMed IBM Intel Kaiser Mayo Clinic Medical Strategic Planning Medullan NTT Partners Healthcare Philips Polycom PwC

Qolpac Qualcomm Sorin Group Sotera Skype Sony Sutter Center for Integrated Care Telecare Telesofia Medical Textron Systems VA Department of Veterans Affairs Verizon Vidyo Walmart Worksmart




Tele-Health: Carts, Servers, and Monitoring Market Shares, Strategies, and Forecasts, Worldwide, 2012 to 2018

Report Methodology

This is the 508th report in a series of primary market research reports that provide forecasts in communications, telecommunications, the Internet, computer, software, telephone equipment, health equipment, and energy. Automated process and significant growth potential are priorities in topic selection. The project leaders take direct responsibility for writing and preparing each report. They have significant experience preparing industry studies. Forecasts are based on primary research and proprietary data bases.

The primary research is conducted by talking to customers, distributors and companies. The survey data is not enough to make accurate assessment of market size, so WinterGreen Research looks at the value of shipments and the average price to achieve market assessments. Our track record in achieving accuracy is unsurpassed in the industry. We are known for being able to develop accurate market shares and projections. This is our specialty.

The analyst process is concentrated on getting good market numbers. This process involves looking at the markets from several different perspectives, including vendor shipments. The interview process is an essential aspect as well. We do have a lot of granular analysis of the different shipments by vendor in the study and addenda prepared after the study was published if that is appropriate.

Forecasts reflect analysis of the market trends in the segment and related segments. Unit and dollar shipments are analyzed through consideration of dollar volume of each market participant in the segment. Installed base analysis and unit analysis is based on interviews and an information search. Market share analysis includes conversations with key customers of products, industry segment leaders, marketing directors, distributors, leading market participants, opinion leaders, and companies seeking to develop measurable market share.

Over 200 in depth interviews are conducted for each report with a broad range of key participants and industry leaders in the market segment. We establish accurate market forecasts based on economic and




market conditions as a base. Use input/output ratios, flow charts, and other economic methods to quantify data. Use in-house analysts who meet stringent quality standards.

Interviewing key industry participants, experts and end-users is a central part of the study. Our research includes access to large proprietary databases. Literature search includes analysis of trade publications, government reports, and corporate literature.

Findings and conclusions of this report are based on information gathered from industry sources, including manufacturers, distributors, partners, opinion leaders, and users. Interview data was combined with information gathered through an extensive review of internet and printed sources such as trade publications, trade associations, company literature, and online databases. The projections contained in this report are checked from top down and bottom up analysis to be sure there is congruence from that perspective.

The base year for analysis and projection is 2010. With 2010 and several years prior to that as a baseline, market projections were developed for 2011 through 2017. These projections are based on a combination of a consensus among the opinion leader contacts interviewed combined with understanding of the key market drivers and their impact from a historical and analytical perspective. The analytical methodologies used to generate the market estimates are based on penetration analyses, similar market analyses, and delta calculations to supplement independent and dependent variable analysis. All analyses are displaying selected descriptions of products and services.

This research includes referencde to an ROI model that is part of a series that provides IT systems financial planners access to information that supports analysis of all the numbers that impact management of a product launch or large and complex data center. The methodology used in the models relates to having a sophisticated analytical technique for understanding the impact of workload on processor consumption and cost.

WinterGreen Research has looked at the metrics and independent research to develop assumptions that reflect the actual anticipated usage and cost of systems. Comparative analyses reflect the input of these values into models.

The variables and assumptions provided in the market research study and the ROI models are based on extensive experience in providing research to large enterprise organizations and data centers. The ROI models have lists of servers from different manufacturers, Systems z models from IBM, and labor costs by category around the world. This information has been developed from WinterGreen research proprietary data bases constructed as a result of preparing market research studies that address the software, energy, healthcare, telecommunicatons, and hardware businesses.




YOU MUST HAVE THIS STUDY

Tele-Health: Servers, Carts, and Monitoring Market Shares, Strategies, and Forecasts, Worldwide, 2012-2018

Table of Contents Tele-Health Executive Summary

The study is designed to give a comprehensive overview of the tele-health equipment market segment. Research represents a selection from the mountains of data available of the most relevant and cogent market materials, with selections made by the most senior analysts. Commentary on every aspect of the market from independent analysts creates an independent perspective in the evaluation of the market. In this manner the study presents a comprehensive overview of what is going on in this market, assisting managers with designing market strategies likely to succeed.

TELE-HEALTH EXECUTIVE SUMMARY ES-1 Tele-Health Market Driving Forces ES-1

Measures of Tele Monitoring Effectiveness ES-7 Real-Time Monitoring Of Physiological Data ES-8 Home Patient Monitoring Supports Patient Education ES-8

Tele-Health Market Shares ES-9 GlobalMed ES-11 GlobalMed Telemedicine Services ES-12 Tele-Monitor Market Shares ES-13

Tele-health Systems Forecasts ES-14 Watson ES-16

Tele-Health Market Description and Market Dynamics

1. TELE-HEALTH MARKET DESCRIPTION AND MARKET DYNAMICS 1-1 1.1 TeleHealth Payor Solutions 1-1

1.1.1 Telemedicine Products | Medical Technology 1-2 1.2 Mobile Brings Healthcare Transformation 1-3 1.3 Consumer Tele-health 1-7

1.3.1 Internet Health Products 1-7 1.3.2 VA Tele-health Lauded As Model Healthcare Program 1-8

1.4 US National Prevention Council 1-9 1.4.1 UK National Health Service (NHS) 1-10 1.4.2 U.S. Veterans Health Administration (VHA) 1-10 1.4.3 Chronic Disease Issues 1-11 1.4.4 Maximize The Impact Of Technology on Tele-health 1-14 1.4.5 Telehealth Reimbursement Set to Grow 1-14

1.5 IBM Watson 1-14 1.6 Issues in International Health Policy 1-17

Tele-Health Market Shares and Market Forecasts




This section selectively describes market shares, forecasts, segments, and regional revenue. Numbers are the result of primary research in all cases. Selected companies are described from an independent analyst perspective with a thumbnail sketch or analysis of their market numbers or commentary on their strengths and weaknesses. Some of the analysis is focused on looking at the topic segment by segment, including company descriptive analyses by segment and subsegment.

2. TELE-HEALTH MARKET SHARES AND FORECASTS 2-1 2.1 Tele-Health Market Driving Forces 2-1

2.1.1 Measures of Tele Monitoring Effectiveness 2-8 2.1.2 Real-Time Monitoring Of Physiological Data 2-9 2.1.3 Home Patient Monitoring Supports Patient Education 2-9

2.2 Tele-Health Market Shares 2-10 2.2.1 GlobalMed 2-12 2.2.2 GlobalMed Telemedicine Services 2-13 2.2.3 Tele-Monitor Market Shares 2-14 2.2.4 Bosch 2-15

2.3 Tele-health Systems Forecasts 2-17 2.3.1 Tele-health Device Market Thriving 2-22 2.3.2 Tele-health Issues 2-22

2.4 Wireless Tele-monitoring Devices 2-23 2.4.1 Smart Phone Home Tele Monitoring 2-25 2.4.2 eICUs 2-25 2.4.3 Rapid Readmissions 2-26 2.4.4 Tele-health Originating Site Facility Fee Payment Amount Update 2-27 2.4.5 Technical Correction to Include Emergency Department Tele-health Consultations in Regulation 2-29

2.5 Watson 2-29 2.5.1 Tele-health IBM Watson, Honeywell, Vitarian, and Bosch Diagnostic Support Expert Systems 2-31 2.5.2 Tele-health Market Forces 2-32 2.5.3 UK National Health Service (NHS) 2-39 2.5.4 U.S. Veterans Health Administration (VHA) 2-39 2.5.5 Measures of Tele Monitoring Effectiveness 2-39 2.5.6 Home Patient Monitoring Supports Patient Education 2-40 2.5.7 Wireless Telemonitoring Devices 2-41 2.5.8 Real-Time Monitoring Of Physiological Data 2-43 2.5.9 Bosch Healthcare Tele-health Custom Messaging Feature 2-44 2.5.10 Bosch Healthcare Tele-health Wireless Modem Option 2-44 2.5.11 Bosch ViTelCare T400 Home Health Monitor 2-44 2.5.12 Bosch Installed Base 2-45 2.5.13 Bosch Tele-health Solutions 2-45 2.5.14 Bosch Tele-health 2-45 2.5.15 Bosch Tele-health Systems Certification in Disease Management From NCQA 2-46 2.5.16 Bayer / Viterion 2-47 2.5.17 Bayer / Viterion Tele-health care 2-48 2.5.18 Philips 2-48 2.5.19 Intel / GE Care Innovations 2-48 2.5.20 Honeywell HomeMed 2-51 2.5.21 Honeywell HomMed Genesis Touch™Tele-health 2-52 2.5.22 Samsung 2-52 2.5.23 Samsung Medical Business 2-53 2.5.24 MedApps HealthPAL MA105to Extend the Home Selects VRI 2-53 2.5.25 Nonin 2-54




2.5.26 VRI 2-54 2.5.27 VRI Healthcare Services 2-54 2.5.28 Gemalto / Cinterion 2-55 2.5.29 Gemalto CINTERION Wireless Module Functions 2-56

2.6 Chronic Disease Conditions 2-58 2.6.1 Congestive Heart Failure 2-58 2.6.2 Diabetes Chronic Illness Numbers 2-61 2.6.3 Incidence of Chronic Disease 2-63 2.6.4 Chronic Diseases Account For Two-Thirds Of Worldwide Healthcare Spending, Ninety Percent in the US 2-65 2.6.5 Clinical Staff / Patient Ratios: Physician Shortages 2-65 2.6.6 Viterion Home Health Outcomes in a CHF Population: 2-66

2.7 Telemonitoring Prices and Reimbursement 2-69 2.7.1 Cost of Honeywell Homemed Home Health Monitoring & MedPartner 2-70 2.7.2 TouchPointCare 2-70

2.8 Interactive Voice Response (IVR) 2-70 2.8.1 Healthcare Providers Use Technology To Improve Effectiveness Of Care Providers 2-75 2.8.2 HHSC 2-75

2.9 Tele-Monitoring Alarm Devices 2-76 2.10 Tele-Server Regional Markets 2-78

2.10.1 Remote Patient Monitoring Market In The US 2-80 2.10.2 Remote Patient Monitoring Market In Europe 2-80 2.10.3 Bosch Remote Patient Monitoring Regional Market Participation 2-80 2.10.4 Smart Phone Installed Base By Country And Region 2-81

Tele-Health Product Description

This section describes selected companies and selected products. Products for this market segment are described with attention to the most significant aspect of features and functions in this category of product. The juxtaposition of a range of different product descriptions from a single market category provides a really good way to access market directions and achieve market competitive analysis. This section is arranged products. Company products are described in the appropriate sections, meaning a company is mentioned several times in the chapter in different places.

3. TELE-HEALTH PRODUCT DESCRIPTION 3-1 3.1 Telemonitors 3-1 3.2 Bosch 3-1

3.2.1 Bosch on Medicare’s CMHCB Demonstration Project 3-4 3.2.2 Bosch Health Buddy System Installed Base 3-4

3.3 Bayer – Viterion 3-8 3.3.1 Bayer Viterion 500 3-8

3.4 Philips 3-10 3.5 Honeywell 3-11

3.5.1 Honeywell HomMed LifeStream 3-11 3.6 Sony 3-12 3.7 Tele-Health Carts 3-13 3.8 GlobalMed 3-13

3.8.1 GlobalMed Telemedicine Products | Telehealth Equipment | Medical Technology 3-14 3.8.2 GlobalMed Telemedicine Carts | Telehealth Carts 3-14 3.8.3 GlobalMed i8500™ Mobile Telemedicine Station 3-16 3.8.4 GlobalMed TES (Transportable Exam Station) 3-16 3.8.5 GlobalMed FirstExam™ Mobile Telemedicine Station 3-18




3.8.6 GlobalMed Teleaudiology Cart | Mobile Medical Carts 3-20 3.8.7 GlobalMed Medical Technology Products | Mobile Medical Carts 3-20 3.8.8 GlobalMed Mobile Telemedicine Carts 3-20 3.8.9 GlobalMed TotalExam™ HD Examination Camera 3-23 3.8.10 GlobalMed Diagnostic Imaging | Medical Imaging 3-23 3.8.11 GlobalMed Diagnostic Imaging | Medical Imaging Equipment 3-25

3.9 Video Conferencing Health Apps - CMS 3-26 3.9.1 Internet Health Products 3-28

3.10 Vidyo 3-29 3.11 Cisco 3-30 3.12 Google 3-31 3.13 Microsoft/Skype 3-31 3.14 Polycom 3-31 3.15 Intel 3-32 3.16 Sony 3-33 3.17 eICUs 3-34 3.18 TeleHealth Software 3-34 3.19 IBM Smarter Analytics 3-34

3.19.1 IBM Watson for TeleHelathcare 3-42 3.20 GlobalMed Health Information Exchange 3-43

3.20.1 GlobalMed Software 3-44 3.20.2 GlobalMed CONi™ Services 3-46

3.21 CapSure® 2.0 3-46 3.22 Medical Strategic Planning 3-47 3.23 WebMD 3-49

3.23.1 WebMD CameraDirect 3-50 3.23.2 Hand-held Telemedicine Kit (HTK) 3-50

3.24 Microsoft 3-51 3.25 Mobile TeleHealth Product Description 3-52 3.26 CareSpeak Communications, FitNow, and Fitbit 3-52 3.27 Government Telehealth Initiatives 3-52 3.28 US Government 3-52

3.28.1 CMS 3-54 3.29 UK Government 3-55 3.30 Canadian Government Telehealth Ontario 3-56 3.31 Japanese Government 3-57 3.32 Taiwanese Government 3-57 3.33 Telehealth Networks 3-58 3.34 Georgia Telehealth Initiative 3-59 3.35 Arkansaw Telehealth Initiative 3-60 3.36 Avera Telehealth Network 3-61 3.37 Eastern Maine Telehealth Network 3-62 3.38 Eastern Montana Telemedicine 3-63

3.38.1 Montana Telemedicine Network 3-64 3.39 Idaho and Oregon Telehealth 3-65 3.40 Louisiana Telehealth Network 3-66 3.41 Mississippi Telehealth Network 3-67 3.42 Nebraska Telehealth Network 3-68 3.43 California Telehealth Network of Regents of University 3-69

3.43.1 Telehealth Network Grantee Site Maps 3-70 3.44 Telecommunications Service Provider Tele-Health Initiatives 3-71 3.45 Verizon Healthcare Monitoring 3-71 3.46 BT 3-72 3.47 Deutsche Telecom 3-73




3.48 NTT 3-74 3.49 AT&T 3-75 3.50 EMC 3-76 3.51 Qolpac 3-77 3.52 Qualcomm 3-78 3.53 Tele-health Consulting Companies 3-78 3.54 Accenture 3-79 3.55 Sutter Center for Integrated Care 3-80 3.56 Healthrageous 3-80 3.57 Humedica 3-82 3.58 Telesofia Medical 3-83 3.59 Textron Systems 3-83 3.60 ciCoach.com 3-84 3.61 American Well Systems 3-85 3.62 Boehringer Ingelheim 3-87 3.63 PwC 3-88

3.63.1 PwC Health & Welfare Benefits Programs 3-89 3.64 Eliza Corp 3-90 3.65 Eliza Corp 3-92 3.66 Basis Band Personal Health Tracker 3-92 3.67 Body Composition Tracker 3-94

3.67.1 Linear Software 3-94

Tele-Health Technology

4. TELE-HEALTH TECHNOLOGY 4-1 4.1 Patient-Centered /-Participatory Congestive Heart Failure Telemonitoring 4-1

4.1.1 Heart Failure Congress 2011 4-5 4.1.2 TIM-HF Study CHF 4-6 4.1.3 TheTEHAF study 4-8 4.1.4 Johns Hopkins Home-Based Telemonitoring 4-10

4.2 Diabetes Remote Monitoring 4-12 4.2.1 Diabetes Remote Monitoring Drivers 4-12 4.2.2 Partners HealthCare Diabetes Remote Monitoring Program Overview 4-13 4.2.3 Partners HealthCare Diabetes Monitoring Member 4-14

4.3 Partners Healthcare Blood Pressure Home Monitoring Health Initiative 4-18

4.3.1 Partners Healthcare Blood Pressure Connect 4-18 4.4 Medtronic 4-20 4.5 Health Monitoring 4-24

4.5.1 Patient-Centered Home Tele Health Monitoring 4-25 4.6 Chronic Heart Failure Clinical Studies 4-28 4.7 Texas Pilot Program 4-32

4.7.1 Obstructive Sleep Apnea (OSA) A Major Chronic Condition 4-33 4.7.2 Hypertension Intervention Nurse Telemedicine (HINTS) Study 4-33

4.8 Ingestible Event Marker 4-34 4.9 Real-Time Remote Medical Diagnosis System (RTRMDS) 4-35

4.9.1 Tele-pharmacy 4-35 4.9.2 Electronic Medical Records Detail Drug Information Effectiveness 4-36 4.9.3 Consumers Increasingly Involved In Treatment Decision-Making 4-36




4.10 Health Care Monitoring Solutions Technology 4-37 4.10.1 Health Information Exchange Services 4-38

4.11 Home-Based Care 4-40 4.12 ‘Mobile Health Clinics’ 4-42

4.12.1 Self-Service Kiosks 4-42 4.12.2 Mobile Health Care 4-42 4.12.3 Mobile Office a Set Of Commonly Used Mobile Communication Tools 4-44 4.12.4 Telemedicine Allows Medical Professionals To Consult And Diagnose Patients Remotely 4-46

4.13 DICOM Index Tracker NDS Surgical Imaging, LLC 4-48 4.14 Population Of The Developed World Is Growing Older, Medical Costs Are Rising, Not Enough Doctors To Heal The Elderly Sick 4-49

4.14.1 Remote Monitoring Device 4-49 4.15 US Government Tele-Health Subcommittees 4-50

4.15.1 Telehealth Product Medical Device Regulation In The United States 4-51

4.16 American Telemedicine Association’s Home Telehealth Clinical Guidelines 4-52

Tele-Health Company Profiles

This section selectively describes company strategies, partners, acquisitions, and revenue by segment and regional revenue when available. Companies are described by looking at what is most interesting about that company. The descriptions collectively give a sense of market directions within the industry segment. The alphabetical listing of company thumbnail sketches provides an accessible way to find out what is going on in any particular company. 5. TELEHEALTH COMPANY DESCRIPTION 5-1 5.1 Aetna 5-1 5.2 Accenture 5-1 5.3 Aetna 5-2

5.3.1 Aetna Health Benefits And Insurance Plans 5-3 5.4 American Well Systems 5-3 5.5 Assa Abloy 5-4

5.5.1 Assa Abloy Regional Division - EMEA 5-4 5.5.2 Assa Abloy Regional Division - Americas 5-6 5.5.3 Assa Abloy Regional Division – Asia Pacific 5-7 5.5.4 Assa Abloy Acquisitions 2012 5-8

5.6 AT&T 5-9 5.7 Boehringer Ingelheim 5-10 5.8 Bosch 5-11

5.8.1 Bosch Group 5-11 5.9 Bayer - Viterion 5-13 5.10 Biotronik 5-15 5.11 BT 5-15 5.12 Cardionet 5-16 5.13 Centerstone Research Institute 5-17 5.14 Centerstone Research Institute 5-18 5.15 ciCoach.com 5-19 5.16 Cisco 5-19 5.17 Cleveland Clinic 5-21

5.17.1 Cleveland Clinic MyChart 5-21 5.18 CMS 5-22




5.19 Deutsche Telecom 5-22 5.20 Eliza Corp 5-23 5.21 EMC 5-23 5.22 Healthrageous 5-24 5.23 Honeywell HomMed 5-25 5.24 Humedica 5-26 5.25 GlobalMed 5-26

5.25.1 GlobalMed Telemedicine Services 5-26 5.26 IBM 5-27

5.26.1 IBM Revenue Q2 2012 5-29 5.26.2 IBM Business Model 5-29 5.26.3 IBM Revenue Second-Quarter 2012 5-32 5.26.4 IBM Geographic Regions Q2 2012 5-33 5.26.5 IBM Growth Markets Q2 2012 5-33 5.26.6 IBM Services Q2 2012 5-34 5.26.7 IBM Software Q2 2012 5-34 5.26.8 IBM Hardware Q2 2012 5-35 5.26.9 IBM Financing Q2 2012 5-35 5.26.10 IBM Lombardi 5-35

5.27 Intel 5-36 5.28 Kaiser 5-37

5.28.1 Kaiser 5-38 5.29 Mayo Clinic 5-39

5.29.1 Mayo Clinic Telehealth 5-40 5.30 Medical Strategic Planning 5-40

5.30.1 Medical Strategic Planning (MSP) Alliance Organizations 5-41 5.31 Medullan 5-42

5.31.1 Medullan Services 5-43 5.32 NTT 5-44

5.32.1 Operating Revenues 5-44 5.33 Partners Healthcare 5-45

5.33.1 Partners Healthcare Integrated Health Care System 5-46 5.34 Philips 5-46 5.35 Polycom 5-47 5.36 PwC 5-48 5.37 Qolpac 5-48 5.38 Qualcomm 5-49 5.39 Sorin Group 5-52 5.40 Sotera 5-52 5.41 Skype 5-53 5.42 Sony 5-53 5.43 Sutter Center for Integrated Care 5-54 5.44 Telecare 5-55 5.45 Telesofia Medical 5-56 5.46 Textron Systems 5-56 5.47 VA Department of Veterans Affairs 5-57 5.48 Verizon 5-58 5.49 Vidyo 5-59 5.50 Walmart 5-59

5.50.1 Walmart Affordable Healthcare 5-60 5.51 Worksmart 5-61

List of Tables and Figures Tele-Health Executive Summary




Table ES-1 ES-4 Tele-Health Market Driving Forces Table ES-2 ES-5 M-Health Market Driving Forces Table ES-3 ES-6 Telemonitoring Market Driving Forces Figure ES-4 ES-10 Tele-Health Market Shares, Dollars, Worldwide, First Three Quarters 2012 Table ES-5 ES-11 Tele-Health Market Shares, Dollars, Worldwide, First Three Quarters 2012 Figure ES-6 ES-13 Tele-Monitor Market Shares, Dollars, First Three Quarters 2012 Figure ES-7 ES-15 Tele-Server Market Forecasts, Dollars, Worldwide, 2012-2018 Figure ES-8 ES-17 Tele-health Market Factors Figure ES-9 ES-18 Aging of the Population, 600 Million Elderly Individuals World Wide Figure ES-10 ES-19 Tele-health Challenge: One Billion Adults Over Weight, 86 Million Individuals with Chronic Conditions Figure ES-11 ES-20 Tele-health Goal: Improve Lifestyle Choices

Tele-Health Market Description and Market Dynamics

Table 1-1 1-2 Telemedicine Product Benefits Table 1-2 1-3 Telemedicine Product Features Integrated systems. Figure 1-3 1-4 Mobile Transformation of Business Model Figure 1-4 1-6 Mobile Transformation of Healthcare Business Model Figure 1-5 1-8 Healthcare Mobile Business Challenges Figure 1-6 1-9 US National Prevention Council Documents Increase in Number of Americans Healthy At Every Stage of Life Figure 1-7 1-11 Chronic Disease Issues Figure 1-8 1-18 Healthcare Spending Per Capita by Country Figure 1-9 1-19 International Comparison of Spending on Health 1980-2008 Figure 1-10 1-20 Supply, Use and Price of Diagnostic Imaging in OECD Countries.

Tele-Health Market Shares and Market Forecasts




Table 2-1 2-4 Tele-Health Market Driving Forces Table 2-2 2-5 M-Health Market Driving Forces Table 2-3 2-7 Telemonitoring Market Driving Forces Figure 2-4 2-11 Tele-Health Market Shares, Dollars, Worldwide, First Three Quarters 2012 Table 2-5 2-12 Tele-Health Market Shares, Dollars, Worldwide, First Three Quarters 2012 Figure 2-6 2-14 Tele-Monitor Market Shares, Dollars, First Three Quarters 2012 Table 2-7 2-15 Tele-Monitor Market Shares, Dollars, Worldwide, First Three Quarters 2012 Figure 2-8 2-18 Tele-Server Market Forecasts, Dollars, Worldwide, 2012-2018 Table 2-9 2-19 Tele-Health Market Forecasts Units and Dollars, Worldwide, 2012-2018 Table 2-10 2-20 Tele-Servers Installed Market Forecasts Units, Worldwide, 2012-2018 Table 2-11 2-21 Tele-Health Servers Shipped, Market Forecasts Units, Worldwide, 2012-2018 Table 2-12 2-24 Smart Phone Market Shares, Units and Dollars, Worldwide, 2011 Table 2-13 2-25 Total Smart Phone Installed Base Units, Worldwide, 2012-2018 Table 2-14 2-26 Remote And Wireless Patient Monitoring Device Using Wireless Networks Table 2-15 2-27 The Medicare Tele-health Originating Site Facility Fee and MEI Increase by the Applicable Time Period Table 2-16 2-33 Factors Likely To Create Shift To Telehealth Table 2-17 2-34 Telehealth Adoption Rate Issues And Concerns Figure 2-18 2-35 Tele-health Market Factors Figure 2-19 2-36 Aging of the Population, 600 Million Elderly Individuals World Wide Figure 2-20 2-37 Tele-health Challenge: One Billion Adults Over Weight, 86 Million Individuals with Chronic Conditions Figure 2-21 2-38 Tele-health Goal: Improve Lifestyle Choices Table 2-22 2-42 Tele-Monitoring Critical Issues Addressed




Table 2-23 2-42 Tele-Monitoring Clinical Results Table 2-24 2-43 Tele Health Monitoring Problem Solution Aspects Table 2-25 2-56 Gemalto CINTERION Wireless Module Functions Figure 2-26 2-60 Congestive Heart Failure (CHF) Patients Worldwide, Forecasts, Number, 2012-2018 Figure 2-27 2-62 Diabetes Patients Worldwide, Forecasts, Number, 2012-2018 Table 2-28 2-64 Number of Patients with Disease Conditions Requiring Wheelchairs, By Diagnosis, Number, Worldwide, 2012-2018 Figure 2-29 2-73 Follow Up Link Increases Exponentially In Europe Table 2-30 2-74 Tele-Monitoring Program Benefits Table 2-31 2-77 Tele-Monitoring Alarm Devices Figure 2-32 2-78 Tele-Server Regional Market Segments, Dollars, First Three Quarters 2012 Table 2-33 2-79 Tele-Server Regional Market Segments, First Three Quarters 2012 Table 2-34 2-82 Smart Phone Installed Base By Country and Region

Tele-Health Product Description

Figure 3-1 3-1 Bosch Health Buddy System Table 3-2 3-6 Bosch Health Buddy Tele-Health Evidence Based Management Programs* Figure 3-3 3-8 Bayer Viterion 500 Table 3-4 3-9 Bayer Viterion 500 Features Figure 3-5 3-10 Philips Telehealth Figure 3-6 3-11 Honeywell Genesis Touch Figure 3-7 3-12 Sony Healthcare Products Figure 3-8 3-15 GlobalMed Telemedicine Carts Figure 3-9 3-16 GlobalMed Telemedicine Carts Mobile Medical Stations Figure 3-10 3-17 GlobalMed Telemedicine Cart | Mobile Medical Station Figure 3-11 3-19




GlobalMed i8500 Teleaudiology Station Figure 3-12 3-21 GlobalMed Telehealth Cameras Figure 3-13 3-23 GlobalMed TotalExam™ HD Examination Camera Figure 3-14 3-24 TotalExam™ Examination Camera Figure 3-15 3-25 GlobalMed iREZ® i5770 PTZ Camera Figure 3-16 3-29 Vidyo Telehealth Figuree 3-17 3-30 Cisco Hospital Video Survellience Figure 3-18 3-31 Polycom Telehealth Figure 3-19 3-32 Intel mHealth Figure 3-20 3-54 CMS Services Table 3-21 3-55 CMS Medicare Coverage Figure 3-22 3-69 Telehealth Network of Regents of University of California Figure 3-23 3-71 Verizon Healthcare Monitoring Figure 3-24 3-72 BT eHospital Figure 3-25 3-73 Deutsche Telecom e-Health Figure 3-26 3-74 NTT TeleHealth Figure 3-27 3-75 AT&T Telehealth Solutions Figure 3-28 3-77 Qolpac Telehealth Figure 3-29 3-80 Healthrageous Telehealth Figure 3-3/ 3-82 Humedica TeleHealth Figure 3-31 3-85 American Well Systems Consultation Table 3-32 3-86 American Well Systems Consultation Features Figure 3-33 3-88 PwC TeleHealth Figure 3-34 3-93 Basis Band Personal Health Tracker

Tele-Health Technology

Table 4-1 4-2 New England Journal of Medicine (NEJM) Sarwat I.




Chaudhry, M.D Telemonitoring Research and Letters That Critique The Study Table 4-2 4-15 Evident Health Services Target Patient Metrics, Best Practice Targets Blood Pressure, Blood Lipids Table 4-2 (Continued) 4-16 Evident Health Services Target Patient Metrics, Best Practice Targets Blood Pressure, Blood Lipids Table 4-3 4-17 Evident Health Services Target Patient Metrics, Best Practice Obesity and Insulin Targets Table 4-4 4-19 Partners Healthcare Tele-Monitoring Benefits Figure 4-5 4-20 Medtronic CareLink Disease Management Figure 4-6 4-21 Medtronic Device Monitoring and Disease Management Figure 4-7 4-22 Device Follow-up and Disease Management Figure 4-8 4-23 Medtronic Cardiac Implantable Device Monitoring Heart Failure Guidelines Figure 4-9 4-27 Viterion Device for Tele-Health Monitoring Table 4-10 4-38 Health Information Exchange services Example Solutions Table 4-11 4-39 Health Information Exchange Services Benefits Table 4-12 4-41 Home-Based Care Telemedicine Benefits Table 4-13 4-43 Mobile Health Care Solution Table 4-14 4-45 Mobile Office Solutions Table 4-15 4-47 Telehealth Readiness Assessment System Functions

Tele-Health Company Profiles

Table 5-1 5-5 Assa Abloy Regional Division – EMEA Situation Figure 5-2 5-18 Centerstone Research Institute Telehealth Figure 5-3 5-38 Kaiser Thrive Campaign Table 5-4 5-39 Kaiser Services Table 5-5 5-40 Mayo Clinic Services Figure 5-6 5-43 Medullan Services Figure 5-7 5-57




VA Services

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WinterGreen Research, research strategy relates to identifying market trends through reading and interviewing opinion leaders. By using analysis of published materials, interview material, private research, detailed research, social network materials, blogs, and electronic analytics, the market size, shares, and trends are identified. Analysis of the published materials and interviews permits WinterGreen Research senior analysts to learn a lot more about markets. Discovering, tracking, and thinking about market trends is a high priority at WinterGreen Research. As with all research, the value proposition for competitive analysis comes from intellectual input.

WinterGreen Research, founded in 1985, provides strategic market assessments in telecommunications, communications equipment, health care, Software, Internet, Energy Generation, Energy Storage, Renewable energy, and advanced computer technology.

Industry reports focus on opportunities that expand existing markets or develop major new markets. The reports access new product and service positioning strategies, new and evolving technologies, and technological impact on products, services, and markets. Innovation that drives markets is explored. Market shares are provided. Leading market participants are profiled, and their marketing strategies, acquisitions, and strategic alliances are discussed. The principals of WinterGreen Research have been involved in analysis and forecasting of international business opportunities in telecommunications and advanced computer technology markets for over 30 years.

The studies provide primary analytical insight about the market participants. By publishing material relevant to the positioning of each company, readers can look at the basis for analysis. By providing descriptions of each major participant in the market, the reader is not dependent on analyst assumptions, the information backing the assumptions is provided, permitting readers to examine the basis for the conclusions.

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Ellen T. Curtiss, Technical Director, co-founder of WinterGreen Research, conducts strategic and market assessments in technology-based industries. Previously she was a member of the staff of Arthur D. Little, Inc., for 23 years, most recently as Vice President of Arthur D. Little Decision Resources, specializing in strategic planning and market development services. She is a graduate of Boston University and the Program for Management Development at Harvard Graduate School of Business Administration. She is the author of recent studies on worldwide telecommunications markets, the top ten internet equipment companies, the top ten contract manufacturing companies, and the Top Ten Telecommunications market analysis and forecasts.

Susan Eustis, President, co-founder of WinterGreen Research, is a senior analyst. She has done research in communications, healthcare equipment, and computer markets and applications. She holds several patents in microcomputing and parallel processing. She has the original patents in electronic voting machines. She has new patent applications in format varying, mulitprocessing, and electronic voting. She is the author of recent studies of the Regional Bell Operating Companies' marketing strategies, Internet equipment, biometrics, a study of Internet Equipment, Worldwide Telecommunications Equipment, Top Ten Telecommunications, Digital Loop Carrier, Web Hosting, Web Services, and Application Integration markets. Ms. Eustis is a graduate of Barnard College.




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