Clinicians are looking to use medical devices that communicate and integrate the clinical, physiologic, and biologic information necessary to predict adverse events, prevent medical errors, propose the most rational therapy, and ensure it is delivered properly.

The digital technology revolution in healthcare has changed the way hospitals connect and communicate. Convergence of new measurement technologies, patient demographics, and managed care cost initiatives are 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, which was valued at 466.45 crore, with 46,700 units in 2015-16, is poised to reach 500 crore by 2016. This includes the organized and unorganized segments. Most of the equipment is imported. Skanray and some models by BPL constitute the indigenous range, which are primarily popular in Tier II and III cities.

patient-monitoringpatient-monitoringPhilips is the clear leader in this segment. Mindray and GE have aggressive presence. Nihon Kohden has had excellent sales in 2015, and has joined the leading brands. Mindray and Philips have had good success with their recently launched entry level models.

The patient monitoring market in India primarily finds its place among the urban and metro population of the country. The Indian patient monitoring market is highly fragmented and is catered by many domestic and international players. The patient monitoring market is highly technology based and thus manufacturers have to keep upgrading the product range with latest technology before they become obsolete. The product range is highly segmented based on technology and price range. The Indian market has a pool of underserved patients in the rural and Tier III cities of the country. Manufacturers have strategies in place to target this class of consumers.

Technology Trends

Today we enter into a new era where, thanks to wearable or implantable sensors, patient monitoring will become possible from home. It will create as many opportunities as it raises questions: who should regulate the use of these new products and software applications; what and where is the frontier between medical and consumer products; can patient trust the measurements; what should be monitored and in whom; who is going to receive, interpret, and protect the information; what is the impact on patient care; and who is going to pay for this?

patient-monitoringInteroperability is the key to a range of ongoing and potential improvements in our healthcare system. Electronic health records (EHRs) is just the beginning. The goal is for doctors, nurses, patients, family members, researchers, and insurers to share useful medical data. This holistic approach could create communities of healthcare awareness to provide patient with knowledge, support, and the feeling that they are not alone.

Besides its safety advantages, connectivity opens the door to data integration. Integration of all monitored variables together with the patient's history and laboratory tests coming from electronic medical record (EMR) system opens the doors to the development of smart systems (artificial intelligence) able to suggest a diagnosis or a treatment, and even to deliver therapy. Connectivity and data integration may allow the development of controllers able to process multiple parameters at the same time and guide or unload clinicians in more complex clinical situations.

Data integration is also the cornerstone of predictive analytics. Algorithms have been developed to predict cardiorespiratory deterioration. In this regard, predictive analytics may be useful to trigger the intervention of a rapid response team (RRT) and accelerate ICU admission (for patients in the ward or the emergency department) or to postpone ICU discharge for patients who are about to leave the unit. Although a very exciting and promising research field, one has to acknowledge that these systems will never be able to predict the unpredictable, i.e., external interventions or accidents, which are often the cause for changes in hemodynamic status and patient outcome.

J. Indhumathi,Superintending Engineer-BME, Christian Medical College, Vellore
Second Opinion
Future Trends

A variety of electronic monitoring equipment is generally available to monitor the electrical activities of heart, respiration rate (breathing), blood pressure, body temperature, cardiac output, and the amount of oxygen and carbon dioxide in the blood. But big improvements or changes are ahead. Professional support to patients can be ensured without having to spend time and effort in hospital visits, with the integration of communication technologies into patient care. E-ICU model is increasingly finding adoption in the healthcare industry, using two-way cameras and high-speed Internet.

Remote patient monitoring. In order to reduce expensive hospital stay, the need to monitor patients wherever they live or work is increasing. The electronic health record (EHR) or remote transmission of patient medical data is one such solution. Homecare medical devices are now being integrated with healthcare facilities to help them during critical conditions.

EHR. The goal is to share useful medical data between healthcare professionals, patients, their families, researchers, and insurance companies. The implications of privacy are numerous and worrisome, but will surely save lives and improve quality of life. Allocation of section of broadcast spectrum for medical body area networks (MBBAN) is announced, which will be helpful to stream real-time patient data.

Wireless monitoring. Wires and cables are beginning to be replaced by wireless technologies with wearable sensors. These sensors increase the patient comfort, help in infection control, and patients can be easily assisted and moved. Wearable health monitoring systems are becoming very popular in the detection of emergency event in at-risk patients, especially in enabling the non-invasive diagnosis of vital functions of the human body. Besides typical single sensors, deployment of series of sensors and body-worn sensors enable an effective health-monitoring system.

These and other developments will provide comprehensive and uninterrupted attention to patients. Also, they have potential to lower cost and increase medical outcomes.

J. Indhumathi
Superintending Engineer-BME
Christian Medical College, Vellore


Way Forward

In the future, clinicians will use medical devices that communicate and integrate the clinical, physiologic, and biologic information necessary to predict adverse events, prevent medical errors, propose the most rational therapy, and ensure it is delivered properly. Many questions remain unanswered, and studies will have to demonstrate that in silico progress has clinical value and ideally it is cost effective. But considerable intellectual and financial investments are already made, from small and innovative start-ups to giants, to ensure that some of these new ideas and products soon become a reality.

Indian Market Dynamics is based on market research conducted by Medical Buyer in November 2016.


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