Connected Care in North America

Connected Care in North America is a comprehensive report from Berg Insight analysing the latest developments on the medical alert system, connected medication management and remote patient monitoring (RPM) markets in this region.

This strategic research report from Berg Insight provides you with 170 pages of unique business intelligence including 5-year industry forecasts and expert commentary on which to base your business decisions.

This report will allow you to: Profit from 20 executive interviews with market leading companies. Identify key players in the connected care ecosystem. Learn about the latest developments in connected care devices and services. Understand the dynamics of the North American healthcare system. Evaluate the business opportunities in the emerging connected medication management segment. Benefit from expert market analysis including detailed market forecasts lasting until 2024.

Executive summary

The ageing population and the increasing prevalence of chronic diseases will be two of the greatest challenges in North America during this century. It is widely believed that connected care solutions can ease the burden on society by enabling more efficient delivery of care and allowing people to live independently for longer. Berg Insight’s definition of connected care includes medical alert systems, connected medication management solutions and remote patient monitoring (RPM) solutions. Medical alert systems, also known as personal emergency response systems (PERS), comprises solutions that trigger an alarm when the user presses a button or when a passive sensor detects an accident. Connected medication management solutions comprise medication dispensers, pillboxes, pill bottles, vials caps, blister packages, injection devices, insulin pumps and inhalers that are connected to a monitoring platform to improve medication adherence. RPM solutions comprise connected medical devices and monitoring services that are used for remote management of patients suffering from arrhythmia, asthma, chronic kidney disease, chronic obstructive pulmonary disease, congestive heart failure, coronary artery disease, diabetes, hypertension or obstructive sleep apnea.

At the end of 2018, there were 18.0 million people that relied on connected care services in North America. RPM is the largest and most mature segment of the connected care market having a total of 16.1 million users at the end of 2018. The market for medical alert systems is considerably smaller with an estimated total of 3.1 million users, whereas the number of connected medication management users reached 900,000 at the end of 2018. There is an overlap between the market segments as medical alert users can also be equipped with a medication management solution or an RPM solution, and vice versa. The market is forecasted to grow at a compound annual growth rate (CAGR) of 18.3 percent during the next six years to reach 49.4 million connected care users by 2024. Berg Insight expects that RPM will remain the largest segment of the connected care market with a forecasted 47.4 million users in 2024. The number of connected medication management users and medical alert system users will at the same time reach 3.2 million and 4.3 million respectively.

Berg Insight estimates that connected care revenues in North America reached US$ 12.5 billion in 2018. This includes revenues from medical alert systems, connected medication management solutions and RPM solutions. The market is expected to grow at a CAGR of 15.7 percent in the following six years to reach US$ 30.0 billion in 2024. RPM solutions accounted for the largest share of the market in 2018 and will remain in lead for the foreseeable future. Revenues from medication management solutions will grow the fastest at a CAGR of 24.2 percent during the forecast period, overtaking the medical alert system market already in 2019.

The market for RPM solutions involves a wide range of actors, from specialised equipment vendors to integrated mHealth solution providers. The leading RPM application has thus far been sleep therapy compliance monitoring. Patients that suffer from sleep-disordered breathing such as obstructive sleep apnea (OSA) are typically prescribed an airflow generator. However, many patients find the devices unpleasant to use and poor compliance is common. Payers increasingly require that patients comply with their treatment plans to be reimbursed for the device which has driven equipment vendors to connect the devices. The sleep therapy device segment is dominated by Philips and ResMed. The market for connected medication management solutions represents an interesting growth opportunity for companies from several markets. The use of connected insulin dosing systems has thus far gained most traction, but different connected solutions for pills and inhaled medication are increasingly adopted. In contrast, the market for medical alert systems is mature and key actors include Anelto, Essence Group, GreatCall, LogicMark, MobileHelp, Mytrex, Nortek and Phillips Lifeline.

The North American market for connected care solutions is affected by several trends and developments that will have an impact on the competitive landscape in the next years. Changing demographics is driving the demand for home care, while technological developments and regulatory changes affect the competitive landscape for solution vendors. One of the major ongoing changes is the sunset of the landline telephone networks and cellular 3G networks, which forces equipment providers to upgrade products. At the same time, the industry is becoming more patient-centric which calls for integrated systems and improved interoperability of connected care solutions. New companies are entering the connected care market and connected medication management solutions are today in the centre of attention for start-ups.

Executive summary
1 Healthcare in North America
1.1 Introduction
1.1.1 The ageing population
1.1.2 Metabolic syndrome and lifestyle-related diseases
1.2 Chronic diseases
1.2.1 Cardiovascular diseases
1.2.2 Chronic respiratory diseases
1.2.3 Diabetes
1.3 Neurological disorders, mental disorders and physical disabilities
1.3.1 Autism spectrum disorders
1.3.2 Dementia
1.3.3 Epilepsy
1.3.4 Other disorders and disabilities
1.4 Healthcare systems
1.4.1 Healthcare
1.4.2 Long-term care
1.5 The regulatory environment
1.5.1 Medical device regulations
1.5.2 Medical data regulations
1.5.3 Standardisation
2 Medical alert solutions
2.1 Market overview
2.1.1 Form factors and use cases
2.1.2 Value chain
2.1.3 Competitive landscape
2.2 Solution providers
2.2.1 Anelto
2.2.3 Climax Technology
2.2.4 Connect America
2.2.5 Empatica
2.2.6 Essence Group
2.2.7 Freeus
2.2.10 Laipac Technology
2.2.11 Life Alert Emergency Response
2.2.12 LogicMark
2.2.14 MobileHelp
2.2.15 Mytrex
2.2.20 Tunstall Canada
3 Medication management solutions
3.1 Market overview
3.1.1 Form factors and use cases
3.1.2 Competitive landscape
3.2 Medication management solution providers
3.2.1 AdhereTech
3.2.2 Adherium
3.2.3 Cohero Health
3.2.4 Compliance Meds Technologies
3.2.5 DayaMed
3.2.6 E-pill
3.2.8 Information Mediary Corporation
3.2.9 Medipense
3.2.10 MedMinder
3.2.11 MedReady
3.2.12 PharmRight Corporation
3.2.13 Pillo Health
3.2.14 Propeller Health
3.2.15 SMRxT
3.2.16 Spencer Health Solutions
3.2.17 Vaica
4 Remote patient monitoring solutions
4.1 Market overview
4.1.1 Form factors and use cases
4.1.2 Value chain
4.1.3 Competitive landscape
4.2 Solution providers
4.2.1 A&D Medical
4.2.2 Abbott
4.2.3 BioTelemetry
4.2.4 Biotronik
4.2.5 Boston Scientific
4.2.6 Capsule Technologies (Qualcomm Life)
4.2.7 Care Innovations
4.2.8 Current Health
4.2.9 eDevice
4.2.10 Fisher & Paykel Healthcare
4.2.11 Get Real Health
4.2.12 Ideal Life
4.2.13 Lark Health
4.2.14 Life365
4.2.15 Livongo Health
4.2.16 Masimo
4.2.19 Omada Health
4.2.20 Omron Healthcare
4.2.21 Philips
4.2.22 Resideo (Honeywell)
4.2.23 ResMed
4.2.24 Roche
4.2.25 Tactio Health
4.2.26 Telus Health
5 Market forecasts and conclusions
5.1 Market trends and analysis
5.1.1 An ageing population increases healthcare expenditures
5.1.2 The sunset of 2G and 3G cellular networks is driving launches of 4G devices 151
5.1.3 Standalone systems to be replaced by platform solutions
5.1.4 Favourable policies that align financial incentives are driving RPM adoption .. 153
5.1.5 The growth of lightweight solutions is broadening the market
5.1.6 The market for connected medication management is gaining traction
5.1.7 From remote patient monitoring to data-driven patient engagement
5.2 Market forecasts
5.2.1 Medical alert systems
5.2.2 Medication management solutions
5.2.3 Remote patient monitoring solutions
5.3 Revenue forecasts
5.3.1 Medical alert systems
5.3.2 Medication management solutions
5.3.3 Remote patient monitoring solutions
List of Abbreviations
List of Companies
List of Figures
Figure 1.1: Population by age group and country (North America 2018–2050)
Figure 1.2: Prevalence of metabolic syndrome by country (North America 2015)
Figure 1.3: Prevalence of major chronic diseases by country (North America 2018)
Figure 1.4: Prevalence of dementia, ASDs and epilepsy by country (North America 2018)
Figure 1.5: Total and per capita healthcare expenditure by country (North America 2016)
Figure 1.6: Healthcare spending by type of service and product (Canada 2016)
Figure 1.7: Health insurance coverage by type of insurance (US 2017)
Figure 1.8: Healthcare spending by type of service and product (US 2016)
Figure 1.9: Long-term public healthcare expenditure by country (North America 2015)
Figure 1.10: Adults with limitations in ADLs and IADLs (US 2017)
Figure 2.1: Adoption of medical alert systems by country (North America 2018)
Figure 2.2: Number of medical alert systems by form factor (North America 2018)
Figure 2.3: The MobileHelp Duo combined in-home and mobile medical alert system
Figure 2.4: The medical alert system value chain
Figure 2.5: Leading vendors of medical alert systems by shipments (North America 2018) .. 30
Figure 2.6: Leading providers of medical alert services by users (North America 2018)
Figure 2.7: Overview of medical alert system providers
Figure 2.8: Embrace2 epilepsy management watch by Empatica
Figure 2.9: GreatCall's mobile medical alert devices
Figure 2.10: GPS SmartSole by GTX Corp
Figure 2.11: QMedic’s medical alert system
Figure 3.1: Prescription medication use by country and age group (North America 2018)
Figure 3.2: Adoption of medication adherence solutions by country (North America 2018)
Figure 3.3: Examples of medication management solutions
Figure 3.4: Leading connected medication management solutions (North America 2018)
Figure 3.5: Medication management solutions by form factor
Figure 3.6: The AdhereTech Smart Pill Bottle
Figure 3.7: The DayaMed MedPod
Figure 3.8: The RxPense connected medication dispenser by Medipense
Figure 3.9: Pillo Health’s medication management solution
Figure 3.10: Propeller Health’s asthma management app and inhaler sensor
Figure 4.1: Adoption of RPM by country (North America 2018)
Figure 4.2: Installed base by disease segment (North America 2018)
Figure 4.3: mHealth gateway form factors
Figure 4.4: Connected medical devices and the provision of care
Figure 4.5: Overview of the remote patient monitoring value chain
Figure 4.6: Connected sleep therapy solutions by vendor (North America 2018)
Figure 4.7: Connected CRM implants by vendor (North America 2018)
Figure 4.8: Remote patient monitoring providers (North America 2018)
Figure 4.9: Overview of RPM solution providers
Figure 4.10: The interface and Merlin@home transmitter
Figure 4.11: FreeStyle Libre Flash glucose meter
Figure 4.12: Biotronik's CardioMessenger devices
Figure 4.13: Latitude NXT wireless communicator
Figure 4.14: The Health Harmony solution
Figure 4.15: Current Health's HomeHub and wearable monitor
Figure 4.16: HealthGO telehealth hub by eDevice
Figure 4.17: The Ellie home dashboard
Figure 4.18: Lark Health's connected device portfolio
Figure 4.19: Livongo’s device family and apps
Figure 4.20: Omron Healthcare’s connected product family
Figure 4.21: The Genesis Touch telehealth monitor
Figure 4.22: ResMed’s AirSense 10 CPAP device and AirFit 20 masks
Figure 5.1: Medicare chronic care spending (US 2007–2017)
Figure 5.2: Cellular connections in the connected care market (North America 2018–2024) 151
Figure 5.3: CMS reimbursement codes for RPM
Figure 5.4: Connected care users by segment (North America 2018–2024)
Figure 5.5: Medical alert system users (North America 2018–2024)
Figure 5.6: Medication management users (North America 2018–2024)
Figure 5.7: RPM users by disease segment (North America 2018–2024)
Figure 5.8: Connected care revenues by segment (North America 2018–2024)
Figure 5.9: Medical alert system revenues (North America 2018–2024)
Figure 5.10: Medication management revenues (North America 2018–2024)
Figure 5.11: RPM revenues by value chain activity (North America 2018–2024)

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