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These 4 Companies Could Alter the Future of Telehealth

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42% of U.S. hospitals are now using telehealth platforms to treat patients remotely, according to a new report published in February's Health Affairs  journal.

The report -- conducted by the Center for Connected Health, University of Michigan, and Brigham and Women's Hospital -- revealed that telehealth adoption was higher in rural areas compared to urban ones. On a state-by-state basis, Alaska topped the list with a 75% adoption rate, while Rhode Island was at the bottom with 0%.

This interesting trend represents a key point of convergence between technology and health care, in which companies like Google (NASDAQ: GOOGL  ) , Microsoft (NASDAQ: MSFT  ) , iRobot (NASDAQ: IRBT  ) , and Medtronic (NYSE: MDT  )  are taking center stage.

Google Helpouts lets doctors help patients remotely
In a previous article, I discussed three ways search giant Google could revolutionize health care -- through biotech, medical devices, and electronic health records (EHRs). One additional way is through remote telehealth connections.

Some people might remember Google Answers, an online knowledge marketplace launched in 2002 but closed (except in Hong Kong) in 2006. The service allowed users to pay money to ask a Google-vetted researcher to answer questions. Accepted answers could cost between $2 to $200, with Google taking a 25% cut of the researcher's payment and an additional $0.50 per question. The client could leave a tip up to $100.

Last November, Google launched the successor to Google Answers, known as Google Helpouts. Instead of using a flat rate per question payment model, Google Helpouts lets experts charge clients per session, per minute, or both. Clients need a Google+ account, payments are made via Google Wallet, and Google takes a 20% cut of the fee.

Google Helpouts. Source: Author's screenshot.

Helpouts' video question and answer platform can be used for a wide variety of purposes, but improving telehealth is one of Google's top priorities. Google waives its 20% for all health care related questions, and it ensures that all of its video interchanges are HIPAA (Health Insurance Portability and Accountability Act) compliant.

Helpouts has attracted individual physicians and companies such as One Medical, all of whom consider it to be a useful tool in scheduling remote appointments for busy or distant patients. Cloud-connected remote monitoring devices -- such as blood pressure monitors, pacemakers, and glucose monitors -- could eventually be added for real-time physical examinations as well.

Paging Dr. Kinect
Although Microsoft's Kinect is usually recognized as a motion-control peripheral for Xbox 360 and Xbox One video games, Microsoft's joint venture with Accentureknown as Avanade, has transformed the device into an important telehealth tool as well.

Avanade accomplishes this by combining the motion-tracking abilities of the Kinect (which uses cameras to synchronize to the user's body parts), Skype video chat, and Microsoft's HealthVault cloud-based EHR program.


Physicians using the Kinect as a telehealth device can go a step further than Google Helpouts by instructing patients to perform physical movements to gauge flexibility and a range of movement, all of which can be measured by the Kinect's cameras. The Kinect can also use a pre-programmed set of instructions to conduct a preliminary exam without a doctor present, shortening the length of the remote care session. The results are then recorded over the cloud into HealthVault. The whole system can cost less than $1,000, depending on the setup of the PC. Neither Google nor Microsoft generate meaningful revenue from these telehealth projects, but they could catch on quickly, thanks to their massive footprints in the consumer tech market.

The 5-foot tall robot doctor will see you now
iRobot, the company best known for its Roomba vacuum robots, has created the RP-VITA (Remote Presence Virtual and Independent Telemedicine Assistant), a 5-foot tall robot which is equipped with a video screen, webcam, and an onboard stethoscope.

The RP-VITA can navigate hospitals and locate patients independently using a programmed map. The physician then interacts with the patient via an Apple iPad.

Source: iRobot.

The RP-VITA can be used in a wide variety of situations as long as a constant Internet connection is available. For example, the robot could be sent to remote locations lacking adequate medical facilities, or used in quarantined environments too risky for human doctors to enter. So far, robots have only been installed in seven hospitals in the U.S. and Mexico, but at a relatively low cost of $4,000 - $6,000 per month, use could spread over the next decade. Although the RP-VITA isn't a meaningful contributor to iRobot's top line yet, it could eventually represent a way to diversify away from its domestic robots (Roomba, Scooba, Mirra, Looj), which accounted for 89% of its revenue last quarter.

Medtronic's remote monitoring devices could save lives
Medtronic, the largest medical device maker in the world, is also a key name to watch in telehealth. Several of Medtronic's insulin pumps, glucose monitors, and heart devices can transfer patient data over the Internet to a secure server on its CareLink website. In its cardiac devices, Medtronic's OptiVol Fluid Status Monitoring system can detect fluid buildup in the thoracic cavity and send a report to the patient's doctor in a timely manner.

For diabetics, Medtronic's insulin pumps and CGM (continuous glucose monitoring) devices upload periodic insulin trend reports to the CareLink server. Medtronic has stated that its eventual goal is to provide a patient's entire care team with continuous real-time glucose therapy information to avoid life-threatening high or low glucose conditions.

An illustration of how CareLink works. Source: Medtronic.

To accelerate its efforts in telehealth, Medtronic acquired Cardiocom, a maker of remote monitoring devices for heart disease patients, for $200 million in August 2013.

Enhancing its cardiac and diabetes devices with better connectivity could boost sales at both business segments. Last quarter, sales of Medtronic's cardiac and diabetes devices only edged up 2.9% and 4% year over year, respectively. The two segments account for nearly two-thirds of the company's revenue.

The Foolish takeaway
When we combine these pieces of telehealth technology offered by Google, Microsoft, iRobot, Medtronic, and other companies, the future becomes clear -- more patients in rural areas will have immediate access to quality health care, and visits to the doctor's office could only be a mouse click (or touch of a finger) away.

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Read/Post Comments (2) | Recommend This Article (6)

Comments from our Foolish Readers

Help us keep this a respectfully Foolish area! This is a place for our readers to discuss, debate, and learn more about the Foolish investing topic you read about above. Help us keep it clean and safe. If you believe a comment is abusive or otherwise violates our Fool's Rules, please report it via the Report this Comment Report this Comment icon found on every comment.

  • Report this Comment On February 07, 2014, at 11:13 AM, rdowney wrote:

    First of all, I'm glad the Motley Fool has discovered telemedicine. Now, an issue with your "fool"-ish terminology. No videoconferencing codec, software or hardware, is HIPAA-compliant. What you can say is that some may, and some may not, be used in a HIPAA-compliant way. You see, HIPAA does not cover devices or software or vendors. It only applies to "covered entities:" healthcare providers and hospitals and "business associates." A business associate is someone or something that handles patient health information. For example, a cloud service that stores patient medical records or a billing service.

    That being said, if Google's Helpouts can be safely used for medical purposes, it must be able to do two things: notify a user that a breach attempt has occurred, one in which a hacker has tried to gain access to the conversation, and maintain a log of the session and the users at all ends of the conversation.

    That's the knock on Skype. It was never meant for medical purposes, so it doesn't do either. Most doctors, with the exception of the recently disciplined physician in Oklahoma. Dr. Thomas Trow, and those who have looked into telemedicine, have been unaware of this. They don't look beyond the fact that it is free. The Oklahoma Medical Board took issue with Dr. Trow's use of Skype for the very reasons I've just mentioned.

    Regarding the InTouch Robot. It gets a lot of publicity because a physician who isn't at the hospital can do virtual rounds by driving it through hospital corridors to his patients' rooms. There is concern among hospital risk management folks because of the possibility, not the likelihood, that the robot could run into someone or something. Some hospitals require a staff member to accompany the robot as it wends its way through the hospital. Another problem - if you are a multi-floor hospital, you have to have one on each floor because it doesn't do elevator thresholds well and can't select a floor. The robot can video conference with patients, but if the remote physician wants the patient's vital signs, he (or she) must still rely on a nurse in the room to get them. The other aspect is the cost. Besides the price of each robot, the hospital must have the necessary bandwidth as well as the wireless router coverage for it to work well at any location on the floor.

    Nothing against Medtronic which has developed a number of life-saving and beneficial devices, but the Medical Device Tax is going to be a problem unless it is repealed. Medtronic is probably big enough to survive, but many devices are invented by small businesses and physicians. The tax cannot be passed on to customers, so already thin margins will be reduced and often the second thing to go after advertising when times are tough is the R&D budget.

    What I guess I'm saying is the fool should do a little more research, but his heart is in the right place.

    For the sake of disclosure, I work for GlobalMed, the worldwide industry leader in Connected Health solutions (telemedicine).

  • Report this Comment On January 27, 2015, at 3:07 PM, ThriveCounseling wrote:

    I think it's too early to say whether any of these four companies are going to make the impact some people think. Regarding Google Helpouts, the product has been in beta for a long time, and it's still a very closed platform. In fact, they're not even inviting more healthcare providers at this time. I think that Helpouts could easily go the way of Google health, or Skype Prime (Skype's pay per minute service that was discontinued some years ago). We've seen Google "sunset" other--bigger--projects. And some verticals that they're competing in such as social networking (G+) and reviews, and getting beat badly by competitors. As for the companies that are providing the robotic technology, it's hard to say if the technology is going to quickly become a commodity. Perhaps the real influencers in this space are going to be the hospitals and healthcare companies that will begin providing the services. I'd keep a close eye on what's happening at major research hospitals like the Mayo Clinic, Cleveland Clinic, and smaller companies like Thriveworks ( ), and other startups including online behavioral health clinics. For behavioral health, the technology has been available for over a decade--the hold up has been that insurance companies don't want to pay for online services (perhaps because it might increase utilization rates?).

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Leo has covered the crossroads of Wall Street and Silicon Valley since 2012. Follow him on Twitter for more updates!

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