Home telehealth market could reach US$2.1 billion by 2010

Already, digital glucose readers, blood pressure monitors, scales, motion sensors, even pillboxes can transmit patient information to alert remote caregivers of danger signs. Some technology even prompt patients to take care of daily health needs. The report concludes that the U.S. market for such services should reach 64 million patients by 2010.

Monitoring equipment is expensive, and sometimes is just given to patients for a short while to train them in healthy habits (such as weighing themselves daily to catch a sudden weight gain that could indicate a coming heart attack). The Parks Associate report predicts such equipment will become more common, particularly as a nursing shortage restricts home-care visits. Still, home health technology faces triple hurdles: health plans often don't cover it; caregivers don't advocate for it; and most current products are too expensive and hard to use.

An unrelated report by SpyGlass Consulting found that some devices require a high-speed Internet connection, which elderly people are unlikely to have. More successful manufacturers allow home monitoring equipment to transmit information over the phone line automatically.

One of the biggest debates in the home health technology field has been making the technology pay for itself. The usual strategy is to target so-called frequent flyers, patients who end up in the hospital several times a year. For them, reducing the hospital visits can easily cover costs for home monitoring equipment.

Many insurers aren't sophisticated enough to implement such strategies effectively, and want manufacturers to provide evidence of savings.

But many home technology companies are undercapitalised. That creates a Catch-22, writes report author, Harry Wang. "Many small companies have the expertise but not the financial resources to sponsor large-scale studies."

In other words, they can't sell more technology because they haven't done studies, and they can't do studies because they can't sell enough technology.

The report does not mention Intel, which has been aggressively promoting its health IT efforts and has teamed up with Kaiser Permanente. However, even Intel has said that the fragmented health care system does not necessarily provide a market for good products.

There are also policy barriers, particularly if patients live in a different state from clinicians who are monitoring them. Also, doctors are paid more for in-person visits to recommend health care.

But, the Parks Associate report states that, for some people, a mere Internet connection will change the way they have access to healthcare. For example, patients could describe symptoms over the phone and a clinician could decide whether a doctor visit was warranted.

Wang concludes that home health technology is building momentum as early players establish niches, the elderly population grows and the supply of clinicians gets tighter.

He predicts that Medicare will become more liberal in reimbursing for home technology services by 2008. Private payers, who can apply more flexible policies, could move more swiftly.

Ultimately, writes Wang, technology will reinvent health care. "The home will be as important a health care facility as physician offices, clinics and hospitals."