The Future for MedTech and IoMT

Medical technology (MedTech) companies manufacture more than 500,000 different types of medical devices, including wearable external medical devices (skin patches, insulin pumps, and blood glucose monitors), implanted medical devices (pacemakers and implantable cardioverter defibrillator devices), and stationary medical devices (home monitoring devices, connected imaging devices, and scanning machines). Most patient interactions with the healthcare system involve the use of medical equipment and devices.

Like most other industries, the healthcare sector is increasingly realizing the transformative nature of IoT technologies. Connectivity enhancement can be applied to most categories of medical devices. The rise in the number of connected medical devices, together with advances in the systems and software that support the capture and transmission of medical-grade data, connectivity technologies and services, has created the Internet of Medical Things (IoMT).

IoMT brings together the digital and physical worlds to improve the speed and accuracy of diagnosis and treatments, and monitor and modify patient behavior and health status in real time. It also improves healthcare organizations’ operational productivity and effectiveness by streamlining clinical processes, information, and work flows.

Connectivity between sensors and devices aids real-time patient care, even from remote locations, while improving communication within and between medical facilities. The large volume of data generated creates opportunities for new models of care and supports the delivery of 4P medicine – medicine that is predictive, preventive, personalized, and participatory.

IoMT brings together people (patients, caregivers, and clinicians), data (patient or performance data), processes (care delivery and patient support), and enablers (connected medical devices and mobile applications) to deliver improved patient outcomes efficiently.
While IoMT has the potential to help alleviate some of the cost, access, and care coordination challenges facing healthcare, the generation of data points through millions of connected medical devices will have little impact unless data can be turned into actionable insight.

More specifically, connected medical devices are a key enabler across the six predictions in the report, The future awakens: Life sciences and healthcare predictions 2022. The extent to which the predictions are realized is heavily dependent on the continued innovation and adoption of connected medical devices at scale. MarketsandMarkets valued the IoMT market at USD 41.2 billion in 2017 and expects it to rise to USD 158.1 billion in 2022. The connected medical devices segment (helping to diagnose, monitor, and treat patients) of the IoMT is expected to rise from USD 14.9 billion in 2017 to USD 52.2 billion by 2022.

The rise of the IoMT comes at a time when healthcare is becoming increasingly expensive, with global healthcare spending expected to grow 4.2 percent per year, from USD 7.1 trillion in 2015 to USD 8.7 trillion by 2020, largely due to a growing and ageing population, with more people living longer but with multiple comorbidities. As a result, without radical transformation, healthcare in many countries risks becoming increasingly unaffordable. The MedTech industry has an important role to play in helping to reduce costs, improve the quality and efficiency of care, and support the shift to value-based care (VBC). However, the industry also faces a number of systemic challenges and opportunities that need to be addressed for the full value of the IoMT to be realized. These include:

• Developing an in-depth understanding of end users – as more providers adopt VBC models, the speed of adoption and integration of connected medical devices will increase. Data and insights on patients and processes are key to VBC. Challenges include the extent to which an organization’s IT infrastructure is able to handle or process the connections and data, and whether clinicians and patients can be convinced of the safety and effectiveness of the devices. MedTech companies need to develop a deep understanding of the end-user and create business models and scenarios that demonstrate how their new and existing devices not only improve patient outcomes but also create value for key healthcare stakeholders.
• Developing new funding, business, and operating models – as healthcare organizations focus more on improving quality and reducing the costs of providing care, they require MedTech companies to demonstrate greater evidence on the added value of both new and enhanced products. Deloitte commissioned a survey that found that MedTech companies are having mixed results in demonstrating the value of their connected medical devices, although some are engaged in providing services rather than just products. Different types of innovations will require different business models, and progress will depend on both the innovators themselves working in new ways to take on risks and rewards, and the evolution of existing payment systems by both public and private payers.
• Understanding interoperability requirements – interoperability is arguably the biggest challenge for MedTech, including complying with various national and international standards and protocols around the exchange and use of data. There are also technical challenges, such as creating an integrated governance framework and obtaining consent for access to healthcare data. For interoperability to work effectively, the direction of travel should be toward open platforms, based on open data standards. This will enable payers, providers, and technology vendors to come together to make data more available to each another.
• Maintaining cybersecurity – cybersecurity issues are pervasive across MedTech, as the increasing numbers and capability of connected medical devices present additional risks for data security. The scale and cost of breaches are often significant and far reaching. Although four-fifths of the survey respondents considered they were reasonably well prepared to deal with the cybersecurity of their devices, another research suggests many stakeholders do not have a strong understanding of such risks, how to prevent them and what to do once a risk has been identified. Regulators acknowledge that cybersecurity threats cannot be completely eliminated, and stakeholders need to work together and adopt a more proactive approach to managing risks. MedTech companies need to adopt a security by design approach and establish real-time monitoring, cyber threat modeling and analysis, threat mitigation, and remediation.
• Successfully navigating regulatory change – managing the raft of regulatory change occurring, particularly in relation to the new European and US regulations is imperative for both developing connected medical devices and the success of the IoMT. Managing the impact of regulatory change requires MedTech companies to take a proactive and well-planned approach. If an innovation model is to be sustained, companies need to build engagement with regulators into their innovation model, and involve clinicians and patients in product design.
• Attracting digital talent and building digital capability – there is increasing concern among key stakeholders that a growing skills gap will delay the deployment of IoMT solutions and constrain market growth. If MedTech companies are to remain competitive they need to develop a new, digital-first skill set, including employing data scientists and multidisciplinary talent from creative and scientific backgrounds. Accessing this talent will require more resourceful recruitment and retention strategies, including collaborations and partnerships with a diverse range of existing and emerging players, especially academia, data-first tech companies, and innovative new start-ups.
• Maintaining trust in a digital age – global technology companies and other new entrants into the healthcare ecosystem are becoming more involved in the connected medical device industry, and traditional medical device companies are becoming more involved in data management and analytics. Consequently, as MedTech companies develop strategies and services based on the generation and transmission of patient data, they need to ensure they demonstrate clearly to patients, the public, and the healthcare professionals that the data are being protected and used responsibly. MedTech companies need to develop key principles of data management and consent that give patients control over their own data, including the right not to share it.
• Improving the adoption of medical technology at scale – a key challenge for MedTech is ensuring that healthcare organizations, clinicians, and patients understand the added value of connected medical devices and use them at scale to drive better economics and patient outcomes. Difficulties include the lack of governance standards and sufficient, robust evidence that demonstrate that connected medical devices are more cost effective, and how they can help drive the VBC agenda. This includes ensuring that the devices are intuitive and easy to use and, where necessary, providing training and support to staff to embed the skills needed to optimize the use of the technology.
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Creating an effective IoMT at scale requires collaboration and partnership working between patients, providers, payers, pharma, academia, and other MedTech manufacturers. Deloitte research has identified multiple case studies that demonstrate MedTech’s important role in the IoMT and the conditions that lead to the adoption of connected products and services. The key enablers driving the IoMT and the transformation of healthcare include:

• • Collaboration between healthcare providers and MedTech is key to the effective deployment of the IoMT – integrating connected medical devices into established care pathways is challenging and requires significant cooperation across the IoMT ecosystem. Collaboration strategies, such as partnerships and joint ventures, help ensure the effective transmission, aggregation, analysis, and management of data from connected devices. These collaborations allow all stakeholders to improve their understanding of patient needs and deliver more proactive cost-effective care. Survey respondents ranked collaborations with healthcare providers as the most important for the development of their respective businesses models, followed by collaborations with healthcare payers and other MedTech companies.
  • Connected medical devices benefit patients, providers and payers – partnerships with healthcare providers allow MedTech companies to understand the clinical context in which devices are used. Medical devices are almost always designed for a specific application. Adding connectivity to a device allows data to be generated on a patient’s condition and the effectiveness of the healthcare provider’s operations. Being able to quantify, contextualize, and communicate these interactions allows the MedTech industry to provide solutions that deliver value to all healthcare stakeholders.
  • Joining the dots between connected medical devices and healthcare IT systems – a number of large MedTech companies have developed connected ecosystems that act as a common platform to share, aggregate, and view data to drive both clinical and operational value. Linking disparate sets of data that sit within healthcare organizations is central to achieving connectivity at scale.
  • Applying advanced analytics to the data generated from connected medical devices to provide critical insights and empower better decision-making – mining, managing, and analyzing a vast array of data from medical grade wearables, connected imaging devices, and monitoring devices is a key part of deriving value from the IoMT. The insights generated by linking connected medical devices and health data sets can play a key role in aiding health systems to reduce costs and improve quality, identify populations at risk, connect with consumers, and better understand performance.
  • MedTech services that demonstrate improvements in patient outcomes and reduce healthcare costs – MedTech companies are utilizing the increasing sophistication of connected medical devices, improved interoperability across healthcare organizations and advances in analytics to develop service-orientated solutions that provide the tenants of VBC. These services include managed catheterization laboratories and transformations from a product manufacturer to a healthcare provider helping improve patient outcomes and reducing the costs of healthcare.

How will the IoMT evolve to impact care?
The healthcare and life sciences industries are in transition from reactive and largely episodic models of care that are proving increasingly costly and inefficient to operate, to care models that are proactive, digitally-enabled, and deliver better value for patients. MedTech companies and the IoMT can capitalize on the possibilities presented by these changes to help to connect patients, providers, and payers and enable them all to become more patient-centric, productive, and cost-effective. These disruptive technologies are changing ways of working across the whole IoMT ecosystem. Big data, AI, mobile applications, 3D printing, advanced sensors and other technologies will continue to create new opportunities for MedTech companies. Voice technology is being adopted faster than any previous technology from chatbots to doctor visits, to home healthcare. At the same time, large technology companies are using their vast reach and expertise to create an interoperable electronic health record that can integrate data from a variety of sources and enable real-time access. Although robotics and automation will inevitably replace some jobs, they will also add new ones that blend employee skill sets and the development of transferable skills.

A growing number of MedTech companies are capitalizing on the above trends to develop service-orientated solutions that support VBC. Often these services align closely with the therapeutic expertise and specialized products of the organization, enabling MedTech to maintain high-quality patient outcomes while reducing costs compared to similar services run by traditional healthcare providers.

Other companies are utilizing IoMT capabilities to aggregate data and offer consultative services and predictive analytics, including opening up health data to organizations that have typically found it difficult to gain access to data outside of their own organization. These and other developments provide clear opportunities for MedTech to transition from a provider of innovative products to an insightful partner in healthcare.