Medtronic alliance looks to expand use of home-monitoring devices

The poke of needles, the whiff of antiseptic, the mental grog from being awakened repeatedly in the night — the lingering sensations from a night in the hospital are enough to convince many people to finally start taking steps to avoid returning.

The companies that make and sell home-monitoring devices for medically complex patients know this, and they are keen to take advantage of the golden window of opportunity that follows a hospital stay. It's a good time to put a plug-and-play device in the hands of patients who could benefit from learning to monitor their own health from a dining-room table.

"Sometimes the most engaged patient is the one just coming out of the hospital, because they do not want that experience again," said Sheri Dodd, vice president and general manager of Medtronic Care Management Services in Chanhassen. "So that's where we try to capture them, because the patient would prefer to be in their home."

Medtronic is known more for its pacemakers than its health care services. But the Minnesota-run multinational corporation actually has one of the longest track records in the field of remote-patient monitoring, with 15 years of experience — including the years before 2013, when Medtronic bought its way into the field by acquiring Twin Cities-based patient-monitoring device maker Cardiocom for $200 million.

Cardiocom was focused on heart conditions, but Medtronic has worked to greatly expand the applicability of its home-monitoring devices.

Medtronic has developed automated protocols to handle more than 20 different conditions and disease states, with a focus on complex patients who often have multiple conditions to manage. In addition to heart problems, the system manages diabetes, hypertension and psychological disorders.

This month Medtronic expanded its offering of in-home monitoring further by striking a deal with Boston-area company American Well.

American Well is a provider of telemedicine services. It connects health care professionals to patients via two-way video chat for doctors visits, through agreements with most major health plans and nearly 1,000 hospitals nationwide. The companies declined to provide financial details of the arrangement.

"This will help clinicians more effectively manage patients, while providing patients with flexible access to expert care when they most need it," American Well CEO Ido Schoenberg said in a news release. "These new capabilities will serve clients of both Medtronic Care Management Services and American Well, enhancing the capabilities available to health plans, major health systems, and other customers pursuing more efficient care of complex patients."

From the patient's perspective, Medtronic Care Management Services is a health-and-education service offered through phone or video, often using a small tabletop device with a screen or a tablet computer to ask automated health questions based on a person's diseases. The system includes educational snippets, and is designed to avoid showing the same screens over and over. More than 98,000 patients are enrolled in the system today.

A patient with heart failure might be prompted with questions about sudden weight gain or difficulty breathing, which can signal onset of an acute episode. A patient with a new knee implant might be asked whether pain has increased or if they are having trouble urinating. In some cases, the patient will be asked to snap a picture of the painful area or take a reading with a special blood-pressure device or other external component that plugs into the unit.

With American Well, some patients will also get the chance to have live video visits with doctors on the same device. The doctor on the call will have secure access to the patient's past medical history, and the visit and any conclusions will be documented in the record afterward, said Patrick Lyon, senior director for strategy and marketing at Medtronic Care Management Services.

From the hospital or insurance company perspective, Medtronic Care Management Services is a way to prevent costly hospital admissions by giving patients more education and a hands-on way to proactively monitor and manage their own health at home.

The hospitals and insurance companies who pay the fee for the service get to analyze the daily monitoring results, including seeing a list of patients prioritized by their day's problems. If a heart-failure patient is showing signs of decompensation, their drugs can be adjusted before a hospital visit is needed. If a knee implant is developing infection, or if the side-effects of pain drugs are piling up, those can be adjusted before a trip to the ER.

"We want to be able to manage that patient in their home for as long as we can, by getting insight into what is going on with that patient and being able to intervene with clinical action before it gets to the point where they need acute services," Dodd said.