Remote monitoring equipment has come in the forefront of wearable devices and sensors, and advances in data integration and interoperability have revolutionized patient monitors.
New patient monitoring systems are emerging in response to the increased healthcare needs of an ageing population, new wireless technologies, better video and monitoring technologies, decreasing healthcare resources, reducing hospital stays, and proven cost-effectiveness. There is extensive interest in using wireless technologies in patient monitoring in various environments including hospitals and nursing homes. This system is more useful for elderly people as they are more prone to chronic diseases and need continuous health monitoring. They provide real-time the condition of patients to doctors immediately. The system offers faster, reliable, effective, and cost saving therapy so it has become more popular. Wireless technology requires three key aspects of accessibility to information, convenient usage, and cost effectiveness. Convergence of new measurement technologies, patient demographics, and managed care cost initiatives is driving patient monitoring away from caregiver facilities and into patients' homes. Remote monitoring equipment has come in the forefront of wearable devices and sensors, and advances in data integration and interoperability have revolutionized patient monitors.
Indian Market Dynamics
The Indian patient monitoring equipment market estimated at Rs.420.56 crore, with 37,530 units in 2014 is poised to reach Rs.432 crore at 38,500 unit by 2015. Most of the equipment is imported, with Chinese products cannibalizing the market. Skanray, offering an indigenous range is perhaps the exception. Emco, and Nasan also offer some indigenous products.
The patient monitoring market is highly technology based and manufacturers have to keep upgrading the product range with latest technology before they become obsolete. The products range is highly segmented based on technology and price range. The Indian market has a pool of underserved patients in the rural and tier 3 cities of the country. Manufacturers have formed strategies to target that section of society. High population base and improved purchasing power of patients are the major drivers.. In India, despite significant progress within the monitoring device industry, the widespread integration of wearable sensors technology into medical practice remains limited.
The global market for patient monitoring equipment is projected to reach USD 4.7 billion by 2023 from USD 3 billion in 2014. The increased adoption of portable multi-parameter patient monitoring equipment is a major trend in the upcoming market. Clinicians and home users are increasingly adopting portable, compact, and low-cost multi-parameter monitoring equipment. The increasing ageing population is a key driver that is expected to propel growth. Improved standards of healthcare and sophisticated treatment options have led to an increase in life expectancy rates leading to rise in ageing population. Further, high cost and low accuracy of equipment is a key challenge in the market.
The high-acuity monitors segment accounted for the largest share of over 40 percent of the market in 2014, on the back of increasing admissions to intensive care units with respiratory and cardiovascular diseases. The forecast is of expansion ofÂ low-acuity monitors at the fastest rate with a growing need for ambulatory and transport monitoring services.
Remote patient monitoring. The technology remains a vital aspect of strengthening patient health outcomes and quality of care across the medical field. The technology has a wide variety of functions including determining respiration rate, cardiac output, oxygen and carbon dioxide levels in the blood, and body temperature. A variety of healthcare organizations have already begun utilizing remote patient monitoring systems including cloud-based technologies to better track chronic medical conditions among their patient base. These remote patient monitoring (RPM) tools, if properly integrated into a medical facility and interoperable or connected among a variety of necessary medical devices, could lead to the reduction of medical errors and drop in the rates of hospitalizations throughout the healthcare industry. One of the key technologies that are making an impact on RPM is videoconferencing capabilities or telehealth services. RPM needs a wide variety of differing technologies including electronic messaging and remote telemedicine-based consultations. Essentially, these tools will offer greater access to care for patients living in remote, rural areas as well as those living in communities that are facing doctor shortage.
Cloud computing. The integration of Internet of Things (IoT), sensor technology, and cloud computing is aimed at overcoming resource constraints as it enables different networks to cover large geographical areas so that they can be connected and used by several users at the same time when required. In addition, the recent emergence of cloud computing and sensor awareness of infrastructure architecture methods, service-oriented architecture, software delivery, and development models are also contributing factors to a smart environment. In order to provide real-time healthcare informatics, hospitals need some type of monitoring system to track objects and medical equipment in which security, efficiency, and safety are ensured, with reduced occupational risks. The key feature of the smart monitoring system is to provide identification of users and objects, so that an adequate service customization can be obtained. The increase in competition between companies that provide and produce smart sensor technologies, which cover large areas to meet rapid changes and users' needs, has contributed to competitive advantage in location-based services.
Advent of nanotechnology. Nanotechnology incorporated in sensors has changed the outlook of patient monitoring. A silver nanowire sensor overcomes the deficiencies of traditional technology with the potential to significantly improve long-term monitoring of a patient's health. Electrocardiograms (EKG) and electroencephalograms (EEG) comprise some of the traditional technologies used in long term patient monitoring. Despite their sophistication in keeping healthcare workers updated about a patient's vitals, the drawback with this existing technology is the method in which information is obtained using electrolytic gel. These sensors are known as wet sensors because of their requirement for the gel, which needs to be replaced regularly for the devices to function effectively. If the gel dries out, not only does it cause discomfort to the patient, but it can also skew the sensor readings. Also, these sensors do not allow patients to move around much, keeping them confined to the bed. The most prominent advantage of this silver nanowire sensor is that it is a dry sensor, with no requirement of an electrolytic gel. With the difficulties associated with regular reapplication of gels out of the picture, the silver nanowire sensor can be used for hassle-free long-term patient monitoring. The sensor also has signal quality that is as good as an EEG or EKG, a factor that keeps its readings accurate. And while the EEG and EKG are associated with a bunch of wires and general bulkiness, the silver nanowire sensor is a small device that can be placed on the wrist and fastened securely by a band allowing the patient using it to be mobile. Its small size, dryness, and signal quality make it a more accurate and effective electrophysiological sensor as compared to other existing technologyies.
Advances in perioperative monitoring. Minimal mandatory monitoring in the perioperative period has become an integral part of anesthesia practice. The technologies in perioperative monitoring have advanced, and the availability and clinical applications have multiplied exponentially. Newer monitoring techniques include depth of anesthesia monitoring, goal-directed fluid therapy, trans-oesophageal echocardiography, advanced neurological monitoring, improved alarm system, and the technological advancement in objective pain assessment. Newer perioperative monitoring techniques include depth of anesthesia (DOA) monitoring, goal-directed fluid therapy (GDFT), transesophageal echocardiography (TOE), neurological monitoring, the advancement in the alarm system, and technological advancement in perioperative pain assessment.
While there have been major improvements in intensive care monitoring, including the development of clinical information systems, the medical industry, for the most part, has not incorporated many of the advances in computer science, biomedical engineering, signal processing, and mathematics that many other industries have readily embraced. Acquiring, synchronizing, integrating, and analyzing patient data remains difficult with insufficient computational power and lack of specialized software, incompatibility between monitoring equipment, and limited data storage. All of these technical problems are now surmountable. Today, being on the verge of the data-intensive science era, hypotheses will be generated automatically among the enormous amount of data available by using computational science with inductive reasoning. In this new era, information technology enabling the development of an integrated critical care informatics architecture that supports clinical decision-making at the bedside will be essential. While modern clinical information systems do provide end-to-end platforms for the ICU, there are several limitations too. First, they remain limited in terms of functionality and the acquisition of high-resolution physiologic data; second, there is currently neither processing nor analysis of data. While a few monitors can display raw trends, even basic analyses (mean, median, standard deviations) are difficult to perform at all let alone in real-time and higher-level analyses are impossible. New physiological models are now emerging suggesting that nonlinear changes in dynamics over time may have more predictive value. Understanding this complex physiology can lead to more timely intervention and better outcomes.
Remote patient monitoring technology can be a key method for reducing costs and boosting patient health outcomes. This type of continuous stream of data could truly revolutionize patient care, as it would allow medical providers to analyze information on a larger population health management platform. Additionally, the government's efforts in both reducing the costs of care while improving the quality of services throughout the medical industry, will further aid patient monitoring. Many factors are critical to the rising demand for remote patient monitoring devices, chiefly including the rising availability of user-friendly, portable devices, and the rising prevalence of chronic conditions such as diabetes, respiratory diseases, and a number of cardiovascular diseases across the globe. A major ongoing trend in healthcare today is the accumulation and analysis of big data. This offers a major area of research and new treatment opportunities for patients. New technologies like remote monitoring systems offer a clear path for collecting more information and boosting the analysis of big data. Clearly, healthcare trends today are leading to a greater need for remote patient monitoring technology and health IT systems. New and improved monitoring techniques have undoubtedly led to dramatic changes in anesthesia practice. Various factors that need to be considered with the use of improved monitoring techniques are the validation data, patient outcome, safety profile, cost effectiveness, awareness of the possible adverse events, and knowledge of technical principle and ability of the convenient routine handling. The integration of cloud computing, wireless sensor technology, and IOT in a healthcare environment along with the use of wireless sensor technology is emerging as a significant element of next-generation patient monitoring services in real-time.