M2M telemedicine will have a vital role to play in relieving the massive pressure placed on health services by a combination of a growing elderly population and higher numbers of chronic illness sufferers.

Demand for healthcare is expected to rise exponentially over the next decade. According to PriceWaterhouseCoopers' Healthcast 2020 study, the 24 OECD countries spent a total of $2.7 trillion on healthcare in 2002 - by 2020 that will have risen to $10 trillion. In the past, the answer to increased demand was simply to provide more hospital beds, but these figures show that this approach is no longer sustainable.

The need to control costs, along with the development and expansion of faster wireless broadband networks, smart phones and data compression solutions is expected to drive growth in telemedicine, which can be defined as the use of telecommunications technology for medical diagnosis and patient care when the provider and client are separated by distance. A report from market research firm Pike and Fischer estimates that the market for telemedicine devices and services will be worth more than $3.5 billion by 2014.

Diabetes monitoring

One of the processes particularly well suited to M2M telemedicine is diabetes monitoring. Diabetes is a condition in which the body either does not produce enough, or does not properly respond to insulin, a hormone produced in the pancreas. This causes glucose to accumulate in the blood, which can lead to various health complications. It is estimated that one in ten Europeans will develop some form of diabetes in their lifetime.

The M2DM (multi-access services for telematic management of diabetes mellitus) project developed by a group of European hospitals combined Web and computer telephony integration technologies. A tiny sample of the patient's blood was obtained via a simple handheld device that measured the sugar content of the sample and displayed it on the inbuilt LCD screen. By connecting the device to a special modem, blood sugar measurements were uploaded to the hospitals' central server. 

Blood pressure monitoring

One of the potential concerns around increased adoption of telemedicine is the quality of the information generated remotely. However, an application developed at Philadelphia's Temple University to monitor blood pressure (a major risk factor for developing a serious cardiovascular problem such as a stroke) found that the data recorded on home-based monitors was extremely reliable.

Each patient received a home sphygmomanometer with which they took and recorded their blood pressure reading at least once a week. During office visits, the meters were downloaded and blood pressure readings were taken and compared to those submitted by the patients. Comparison of the results indicated a very high accuracy rate for the home readings.

Cardiac rhythm management

Other treatment areas where telemedicine is considered to have significant cost saving potential include cardiac rhythm management (CRM) and management of chronic illnesses such as obesity. It is estimated that half of all hospital beds in Europe are occupied by patients suffering from chronic illnesses and that such conditions account for more than two thirds of healthcare expenditure.

A remote monitoring solution for patients implanted with cardiac rhythm management devices developed by Orange and medical device manufacturer Sorin reduces the need for hospitalisation by sending data from the device to a monitoring system in the patient's home, which then transmits it to the physician. Using this detailed information, arrhythmia or cardiac disease progression can be detected and appropriate therapy prescribed.

Patients with CRM devices require regular check-ups with their physicians to ensure their devices are functioning properly and that they are receiving the correct treatment. The introduction of this remote monitoring system has the capacity to significantly reduce the time taken to manage the growing number of patients implanted with such devices.

Obesity

In Spain, the University Clinic of Navarra in Pamplona has introduced a remote management system that uses a mobile device for transmission of medical indicators associated with illnesses such as obesity, enabling continuous monitoring by endocrine disease specialists at the university hospital. Through medical sensors, the mobile device receives the blood glucose levels, blood pressure and body weight of the patient.These measurements are transmitted to the hospital, where the specialists are automatically informed of changes in habit or medical indicators.

Assisted living

M2M telemedicine also has a role to play in enabling older people to live in their own home rather than in hospitals or care facilities, which has been shown to have a positive impact on quality of life. Researchers from GE Healthcare and Intel are working on a system that tracks a range of behaviour - from how much time the person spends asleep to how many times they visit the lavatory - and combines it with medical data to create an algorithm capable of identifying even subtle health changes.

The researchers are working on more advanced sensors that could identify early signs of instability or how long it takes the subject to get out of bed in the morning. Falls are a major cause of disability and the leading cause of mortality resulting from injury in people aged over 75.

Berg Insight expects data monitoring and distance disease management to become key elements of future healthcare systems, although the market for wireless monitoring solutions for home medical care is still in its infancy. The company states that 250 million people in the EU and the US suffer from one or more diseases that may require home monitoring.

ABI Research estimates that the market for wearable wireless sensors is set to grow to more than 400 million devices by 2014, driven by demand from the sports and fitness market as well as professional and home healthcare. A recent study by the company predicts the market for wireless devices that monitor patients' condition and report that data to healthcare providers will be worth $950 million within five years.

Drug trials

The variety of sensors available is growing rapidly, measuring a growing array of vital signs and symptoms and devices are getting smaller. There is even a prototype of a pill containing a digestible radio that will confirm the medication has been taken.

 This article was co-written with Paul Golden.