What Will Microsoft's HealthVault Mean to the Telehealth Community?
Thursday, October 18, 2007
| Vince Kuraitis and Tim Gee
Authors:
- Vince Kuraitis JD/MBA, Principal, Better Health Technologies, LLC and author of the
e-CareManagement blog
- Tim Gee, Principal, Medical Connectivity Consulting, and author of the Medical Connectivity blog
What Will Microsoft's HealthVault Mean to the Telehealth Community?
"I've talked about the next wave in remote physiological monitoring. Mobile technologies, devices and web services will soon allow us to remotely monitor patients suffering from chronic diseases or elderly people living alone in their homes. The devices and technologies will be easy to use and ultimately quite affordable as the devices and services become commoditized."
Bill Crounse, MD
Worldwide Health Director
Microsoft Corporation
Health Blog; April 17, 2007
We'll start with our bottom line: HV overall is a positive for telehealth industry growth and scale, even though it will speed the inevitable commoditization of RPM devices.
Microsoft recently announced the creation of their HealthVault (HV) platform:
Microsoft® HealthVault is a new personal health technology platform that lets you gather, store and share health information online. With HealthVault, users control their own health records, so they can privately share their health information with family, friends and healthcare professionals, and have access to trustworthy online health management tools. HealthVault FAQ.
An integral aspect of HV is the Connection Center:
HealthVault Connection Center is a desktop utility that helps you upload the information from your health and fitness devices to your HealthVault account as well as view the information locally on your computer.
While HealthVault is not easy to understand, it lays the foundation for a new ecosystem based on the appropriate, free flow of interoperable and transportable personal health information (PHI).
Telehealth Needs Scale
From Vince:
My roots are in health care and I spent the first 15 years of my career in and around hospitals. Over the last several years I've had opportunities to work with several large consumer technology companies.
I'll share an "aha" moment from my travels. Health care providers start with a unit of one -- the patient. Technology companies think differently.
I remember a conversation with a client -- a well respected GM at a large consumer technology company. We were talking about the state of the multiparameter RPM market (companies like Honeywell HomMed, HealthHero, Philips). Our collective back of the envelope estimate of the size of the current market came to about 150K people being monitored in the U.S.
I asked "So you'd like to understand what it will take to get this market into the millions?"
My moment of clarity came when she responded "No. We're thinking more like tens of millions or hundreds of millions."
Scale is a very different notion for health care providers than for consumer technology companies. Neither view is right nor wrong, they're just different.
HealthVault Lays a Foundation to Build Scale for Telehealth Applications
Today, telehealth applications are based on point to point relationships: home health agency to patient; disease management company to patient; health system to patient.
Telehealth devices and their connectivity are similar. There is a proprietary chain of key components for a remote patient monitoring (RPM) solution: 1) the RPM device; 2) a gateway -- which could be mobile like the Biotronik Cardio Messenger or static like a personal computer -- to aggregate data from multiple devices and move data to a server-based application; and 3) the server application that stores and manages the data in accordance with the application, e.g., glycemic control, medication compliance, etc.
The data flow across these components is proprietary, and data from the server application cannot flow easily across various health care providers and care managers. (For more thoughts on HV and device connectivity see this post.)
Telehealth (and the rest of health care) needs to move toward a network model of data exchange. HV promises to be a platform to facilitate the transfer of RPM device data to multiple care providers and care managers.
RPM data can and should enter the consumer electronics mainstream. In addition, RPM data should be viewed as just one more type of medical data, similar to lab data, pharmacy data, physician notes, etc., that is equally plug and play.
But...There are Tradeoffs
Depending on whether you are a user or a seller of RPM, you probably reacted differently when reading Bill Crounse's casual reference to devices and services becoming "commoditized". Regardless of your reaction, he's right. HV will hasten the already occurring commoditization of RPM devices.
When the RPM market started, many of the devices were priced in the $6-8 K range. Today prices have dropped to $1-2 K, and will go lower.
We have all heard stories where RPM devices eventually would become consumer purchases made at Best Buy and Circuit City, and that prices would be in the range of other consumer technology purchases. That day will arrive in 2008 when Continua Alliance compliant offerings begin hitting the street.
The RPM market is moving from
- High unit prices rooted in the industry's early focus on medical device markets and business models
- Proprietary devices, proprietary IT, non-interoperable data
- Low unit volume, moderate margins per unit
- Competition based on the vendor lock-in through high changing costs
To:
- Low unit prices as the technology evolves toward consumer markets and consumer business models
- Intereroperable devices, common IT platforms, and interoperable data
- High unit volume, low margins per unit
- Competition based on value and service
Where exactly commoditization and HV come together is not clear. The efforts of Continua will bring to market multi vendor interoperability, true plug and play connectivity. Microsoft can deliver plug and play interoperability with your personal computer, but little else.
We welcome your thoughts.