Remote Patient Monitoring - How Are RM Systems Affecting Home and Hospital Ecosystems? Bill Betten Director of Business Solutions Devicix

Key Take-Aways Explore what s new and emerging in remote patient monitoring What new sensors and new measurement capabilities are coming? What are the challenges of remote devices for hospitals and the home environment? 2

Devicix Overview Contract Product Development & Commercialization Full staff of Project Managers, Electrical, Mechanical, Design, Human Factors, Software and Quality ISO 13485 & 14971 Certified, IEC 60601, 62304 & 62366. FDA Registered Contract Manufacturer HQ Location: Eden Prairie, MN Acquired by Nortech Systems in 2015 (mhealth, Telemedicine & Connectivity) Our exclusive focus is in medical devices! 3

Evolution of Technology 1946, upgraded in 1964 1962, upgraded in 1985 1966, upgraded indefinitely Today 4

Trends Driving Remote Monitoring Aging population: 55 million Americans over age 65 by 2020 Chronic disease increase (75% of health care costs): - Seven chronic diseases cancer, diabetes, hypertension, stroke, heart disease, pulmonary conditions, and mental illness have a total impact on the economy of $1.3 trillion annually (2007) rising to $4.2 trillion in treatment costs and lost economic output by 2023. 1 The Affordable Care Act (ACA) and its Hospital Readmissions Reduction Program. Shortage of qualified health care professionals 1. R. DeVol and A. Bedroussian, An Unhealthy America: The Economic Burden of Chronic Disease. Milken Institute. (2007) Accessed at http://www.milkeninstitute.org/pdf/es_researchfindings.pdf 5

The Shift in Healthcare 100% Quality Of Life Healthy, Independent Living Chronic Disease Management HOME CARE Community Clinic Doctor s Office Assisted Living Skilled Nursing Facility RESIDENTIAL CARE Specialty Clinic ACUTE CARE ICU 0% Community Hospital $1 $10 $100 $1,000 $10,000 Source: Intel Corp., Center for Aging Services Technologies (CAST) 6

Technology Growth and the Internet of Things (IoT) Gartner, Inc. forecasts that 6.4 billion connected things will be in use worldwide in 2016, up 30 percent from 2015, and will reach 20.8 billion by 2020. They further estimate that the Internet of Things (IoT) will support total services spending of $235 billion in 2016, up 22 percent from 2015. (November 2015) Source ABI Research 7

Types of Medical Monitoring Devices in Use Today 8

Considerations for Monitoring Devices Sensor Type What data do you want to collect? Body Location External or implanted, where on the body? Architecture Local; Distributed, Cloud Connectivity Wired or wireless; WiFi, Cellular or BT? Power AC; Battery; Energy Harvest User Experience Look and Feel; Displays; Interaction Security Data locations; Connection points Regulatory FDA; FCC 9

Medication Adherence Source: National Association of Chain Drug Stores, Pharmacies: Improving Health, Reducing Costs, July 2010. Based on IMS Health data. Nonadherence results in an economic burden of $100 to $300 billion per year. Annually, nonadherence costs $2,000 per patient in physician visits. The rate of nonadherence is expected to increase as the burden of chronic disease increases. 10

Impact of Mobile Health Key findings (Research Now, March 2015) 46% of healthcare professionals say that they will introduce mobile apps to their practice in the next five years. 86% of healthcare professionals believe that health apps will increase their knowledge of patients conditions. 96% of users think that health apps help to improve their quality of life. 72% of healthcare professionals believe that health apps will encourage patients to take more responsibility for their health. 11

FDA Regulation of Mobile Apps Note: First app approved in 1997. Total of 103 by 2013. 12

Examples of Medical Device Smartphone Convergence Airstrip Patient Monitoring Withings Blood Pressure Monitor Sanofi Aventis ibgstar Blood Glucose Monitor istethoscope Expert AliveCor ECG Sleeve 13

Preventice BodyGuardian Heart and Medtronic Linq 14

Tandem Diabetes Care : t:slim Pump 15

The Reality Home Sleep Study Equipment Required for Home Sleep Study: Pulse Oximeter (wired or wireless) Respiration detector Breath sensor Recording device Tape and wire to yourself for overnight use. 16

17 Source: Dr. Joseph Smith; Westhealth

The Future of Remote Monitoring 18

The Promise of Mobile Health Benefits for Patients: Improved health outcomes and quality of life Real-time support and interventions Extension of care at home after discharge Reduced hospital stays Benefits for Care Providers: Extension of clinical environments into a patient s home Increased frequency of patient health data Ability to continue monitoring patient health Support of an increased level of accuracy for clinical monitoring readings Reduced costs from re-admissions and reduced hospital stays Benefits for Insurance Payors: Better visibility on patient compliance practices More accountability from patients 19

The Future Epidermal Electronics Epidermal Electronics, Science, Aug. 12, 2011. With John Rogers, PhD, University of Illinois 21

The Future Yes, But When? Given Imaging PillCam Proteus Digital Health Courtesy of UCSD Image from Ubergizmo 22

Summary Medical products evolving toward consumer devices, driven by elderly and chronic illness monitoring as well as technology. Most common wearable products today do not provide medically relevant information (accelerometers on steroids). Hybrid devices initial impact likely to be in remote monitoring of chronically ill or elderly. Keep in mind the product s intended use what do you want to measure, where, and how often? Consider all the users (patient, clinician, doctor, regulator) when designing the product. The value of devices is no longer only in the actual product itself. Don t deliver data; deliver information that leads to action. 23 Devicix Copyright 2016

Questions??? Bill Betten Director of Business Solutions Email: wbetten@devicix.com