Medical Device Daily

Don't call it Big Brother. Just, maybe, Better Homecare.

In an effort to help the overall healthcare system contain costs by encouraging seniors to live independently at home – even while battling chronic illness – Royal Philips Electronics (Andover, Massachusetts) this week gave commercial launch to its Motiva product, an in-home TV monitoring system.

The hope is that the TV-based system will enter the home to encourage seniors, including the growing numbers of “Boomers,” as they age, to modify or develop healthier lifestyle behaviors by better managing chronic diseases, including congestive heart failure, diabetes, asthma and depression, as well as conditions such as obesity and smoking.

And one of the most important aspects of this platform is that it is delivered through the television – a medium with which most people are (unless attempting to program their VCR or DVD systems) perfectly comfortable.

Motiva is designed to support daily vital signs monitoring for chronic patients using wireless devices installed in the home. The user sends the monitored data, along with any question or comments, through a secure transmission to a healthcare provider for review. Sent back are educational instructions and personalized feedback, often accompanied with motivational and coaching messages in the form of health tips, educational video clips, even quizzes to test comprehension.

The current product includes Bluetooth-enabled weight measurement, while blood pressure will be added in the third quarter of this year.

Philips emphasizes that using the device is just as simple as pushing buttons on a remote control. The Motiva remote is connected with a secure broadband connection and set-top box installed at enrollment to make the connection work.

John Ryan, senior product manager for Motiva, in an e-mail to Medical Device Daily, wrote that the Motiva platform enables clients to “create mass-customized, multi-year care plans” for senior patients with chronic diseases or conditions. For example, he wrote, the care provider could design one diabetes care plan, and “then easily tailor it for each of their diabetic patients.”

“To the patient, it feels like it was created just for them, which can help lead to greater engagement, behavior change . . . and subsequently lower medical costs,” Ryan wrote. “For the care provider, it can help enable them to manage more patients with fewer human resources, while ensuring more consistent care delivery via daily multimedia health interactions for each patient.”

In the system's pre-reimbursement period, those most interested providing the in-home system include those “people who are at financial risk for the patients' claims, such as health plans,” Ryan told MDD.

Other examples of interested parties could include disease management programs and integrated delivery networks and pharmacy benefit managers, he said.

“Motiva gives patients a friendly and familiar way to connect everyday with their healthcare organizations – the home television,” said Jay Mazelsky, vice president and general manager for Philips Medical Systems (also Andover).

While the healthcare provider assumes the cost of providing the Motiva system, Ryan told MDD that pilot programs in remote health monitoring are now being conducted by Medicare. Initial results of those programs are expected in the next 12 to 24 months.

Ultimately, the expectation is that such services will secure reimbursement status due to the overall cost-lowering expected as the result of enabling patients to remain in their homes longer and reduce the number of hospitalizations.

A spokesperson for Philips Medical wrote that the cost to use the system is expected to be about $50 to $150 per month per patient, or “competitive with the telemonitoring industry.”

The spokesperson wrote that home telemonitoring has been “proven in many studies,” including one that demonstrated 72% decrease in heart failure hospitalizations and another that showed “reduction in mortality over usual care.”

As the Motiva platform continues to be developed, any number of monitoring devices that can be transmitted with Bluetooth technology could be added to the system, Ryan said.

Patients are intended to spend a few minutes each day at their convenience interacting with Motiva.

For every patient, Motiva questions patients about changes in their knowledge, motivation and confidence levels, which offers “insights nurses can use to adapt care plans and gauge impact on long-term behavior,” Philips said.

Philips first reported in 2004 that it was conducting a pilot study of the Motiva program in the U.S., along with Comcast (Philadelphia) and cardiovascular care provider Cardiovascular Associates of the Delaware Valley (Haddon Heights, New Jersey) (Medical Device Daily, Nov. 5, 2005).

At that time, Mazelsky said the “key” to Motiva's success “is that when [patients] wake up in the morning, this becomes part of their routine, and they want to make it part of their routine. You can't force compliance. You have to provide an experience and activities that engage patients and allow some level of self-management.”

In January, Philips unveiled plans to acquire Lifeline Systems (Framingham, Massachusetts), a large North American provider of personal emergency response systems, in a deal valued at $750 million to continue to expand its already large presence in the healthcare monitoring space (MDD, Jan. 20, 2006).