Taking Health Into Your Own Hands

It is evident from the popularity of wellness programs, crowded fitness centers, nutrition stores and health care Web sites that people are taking their health into their own hands. Many factors are thought to contribute to the trend of active health care consumers including: more accessible information, baby boomers who are living longer and asking questions, consumer awareness of the cost of health care, the lack of reimbursement for many products and research studies that emphasize the value of healthy living. In short, consumers are getting the message that it makes sense to prevent the onset of a condition or, if diagnosed with an illness or condition, to manage it proactively.

The health care consumer has changed and is more aware of the importance of prevention, early warning signs and monitoring health. Close monitoring of health can significantly reduce the possibility of death or disability by detecting any conditions or potential problems early.

With information and research studies about preventing heart disease and diabetes--two leading causes of death in the United States--so readily available, consumers are now more likely to be active participants in their health maintenance, altering their lifestyles with healthier choices and products that support this healthier lifestyle. More autonomous consumers are good news for the manufacturers of home diagnostic equipment because they have a receptive audience.

"The market for home diagnostics is growing based on the fact that more consumers are being educated about their own health care," said Richard Stark, general manager of Medisana USA Inc., Charlotte, N.C.

Close monitoring of health and vital signs is essential for those interested in making lifestyles changes based on a diagnosis of high blood pressure, (also called hypertension), congestive heart failure (CHF) or diabetes. Home diagnostic equipment can improve overall health outcomes, whether it is for consumers managing a condition or for those hoping to prevent one.

"People are talking more to their doctors and combining this with a home diagnostic plan, which means a greater amount of purchases," Stark said.

Companies that manufacture home diagnostic products are finding that customer demand is up and the market, particularly for blood pressure monitors (BPMs), is increasing.

"The blood pressure monitor market seems to be very strong," Stark said. "With retailers, home medical sales, the Internet and catalog sales increasing, the blood pressure monitor is no longer something just seen at a doctor's office."

Dave Fahrner, trade marketing manager of Omron Healthcare Inc., Vernon Hills, Ill., said people are absolutely more concerned with their health and taking preventive measures today than they were in the past."People continue to find ways to be and stay healthy," Fahrner said.

Home Monitoring

Home digital BPM devices fall under three categories: arm-cuff, wrist-cuff and finger-cuff.

Medisana USA Inc. manufactures a line of wrist and arm BPM units and a home cardio heart monitoring unit.

The Medisana Cardiocheck is the first heart and pulse monitoring device on the market, according to the company. This hand held unit is an early warning system that displays main EKG parameters and alerts the user if there are any irregularities. Patients put a liquid on their thumbs, press their thumbs against the contact areas, and the machine will give a reading of their cardiac impulse. Correct measurement is assured by filtering out noise before the results are made.

"This is an excellent system for those who have had strokes or are worried about their heart rhythms, though it should not take the place of the diagnostic visits to your regular doctor," Stark said.

New to Medisana's line of wrist and arm monitors is the Medisana Perfect HGM which has 14 memories and is fully automatic. The unit incorporates fuzzy logic to accurately measure BPM and pulse rate.

Fuzzy logic incorporates technology based on automatic inflation. Highly sensitive sensors located inside the cuff determine whether the device needs slightly more inflation or

The market for home diagnostics is growing based on the fact that more consumers are being educated about their own health care.
deflation in order to obtain an accurate reading. Fuzzy logic inflates the cuff by simply pressing a button, rather than the traditional method of manual inflation -- where a patient pumps a rubber ball.

The Medisana Perfect HGW is highly accurate dual pulse measurement wrist BPM with 50 memories including a date and time stamp with the reading, Stark said. The unit has a fully automatic function that fills the cuff with air to the correct level and then it takes the blood pressure reading.

"I think consumers are becoming more aware of their well being in terms of what these diagnostic numbers mean," Stark said.

Omron Healthcare markets the HEM-630 Ultra Compact Wrist BPM, which is the most compact and lightweight of all BPMs according to the company. It features a 21-reading memory, one-button operation and unique IntelliSense technology that inflates to the proper level on the first try for maximum comfort. Readings can be stored in memory with a date and time stamp, enabling users and physicians to spot patterns.

A clip in the cuff, electronics and digital display are all featured in one easy-to handle-unit. The snug fit of the cuff ensures an accurate reading and the entire monitor weighs three ounces without batteries.

The HEM-630 is designed for arthritics, travelers or anyone who prefers the convenience of having all of its features in one unit.

"The wrist design has been proven in independent studies to be comparable in accuracy to arm models, and it fits wrists of virtually any size," Fahrner said.

Customers are seeking these products because they are compact, easy to use, easy to read and because of reliability, he added.

Industry Benefits

Not only is this market driven by manufactures' innovations of compact and easy to use products, but also more medical professionals are recommending that patients monitor their blood pressure on a regular basis, according to research by Frost and Sullivan Healthcare, San Jose, Calif. The demand for home diagnostic equipment also is fueled by the need for patients to monitor their health in private--in the comfort of their own home and at their leisure.

The advances in technology and the improved accuracy of these products have made customers believers and buyers. It also boils down to dollars and cents. If customers can prevent the onset of CHF or if they can manage it through close monitoring, they also know that they are preventing costly treatments that occur when bad health conditions go undetected.

Another benefit of home monitoring is that it can bring more accurate readings when patients are more relaxed and not tense or stressed by the environment of the physician's office. Daily monitoring also can increase compliance by reminding patients to take blood pressure medication and watch their exercise and eating habits.

BPMs also can save time and money by avoiding visits to the doctor's office. They are convenient because users no longer have to be in a quiet environment in order to listen to the artery beat through a stethoscope and readings can be done anywhere.

While home medical equipment (HME) providers often have to compete with mass retailers in the BPM market, they have created their own niche because they typically have the higher-end products.

"The HME providers carry more sophisticated models which don't compete in the mass market. The Medisana brand is not available to the mass market -- the HME provider would be safe carrying our brand," Stark said.

Low end units are typically less accurate, less reliable and do not have all the features of Medisana wrist and upper arm type BPMs, Stark explained.

Fahrner agreed that HME providers have a niche in the market that mass retailers do not have. "HME providers have more sophisticated models with memories that the user can take back to their doctor and say, 'here are my last 14 readings.' The products they carry are more feature laden," he said.

Although not covered by Medicare, which can hinder sales, HME providers can market to the aging baby boomers who are willing to spend disposable income on these devices that offer benefits and convenience.

The aging population is boosting the market and people are increasingly aware of the benefits of early diagnostics and regular health monitoring.

"Consumers are becoming more informed and more proactive in their health care especially since the population is getting older," Stark said.

Industry Challenges

Although there are many benefits of monitoring blood pressure at home, there are many challenges that HME providers face in this market. Some potential consumers have low confidence in the reliability of home blood pressure monitoring, reluctance for self-monitoring and reluctance for record keeping. Another

People are talking more to their doctors and combining this with a home diagnostic plan, which means a greater amount of purchases.
concern is lack of education that exists on the interpretation of readings. However, there are many things the HME provider can do to address these challenges.

The technology of BPMs has improved and companies stand behind the accuracy of their products. The technology used in the products now incorporates memory and recording features, so patients don't have to be concerned with documenting their results. In order to address consumer confidence with interpretation of the readings, the HME provider can educate users about the products.

Many patients have more faith in their physicians than in conducting blood pressure readings on their own. Yet physicians who are increasingly recommending BPMs to their patients are convincing their patients to have faith in these products.

One of the problems patients have in self-monitoring is failing to take readings at regular intervals, under the same conditions, and recording measurements for comparison. However, many people do not comply with those requirements.

Though some models have memory and printer capabilities, some patients are still reluctant about recording their results with BPMs that have limited memory. Others are concerned with losing the paperwork that documents their results and these patients would rather rely on their physician's documentation of their blood pressure. However, HME providers can educate consumers on the importance of using BPMs to augment the care of their health and not to substitute for regular physical check-ups. In addition, blood pressure results taken at home can be useful information to provide to physicians.

Education on usage and available models with memory features can address these problems.

Another challenge exists in reaching patients who have high blood pressure or hypertension and are not aware they do. Research by Frost and Sullivan Healthcare refers to hypertension as a "silent killer" because it does not have symptoms. Monitoring is crucial for these patients, but first the HME provider has to reach this population segment.

Lack of Medicare reimbursement is another challenge, but BPMs are convenient in size and bring many benefits. When the features of BPMs are combined with consumers who are actively seeking preventative care products, the sell is not always a tough one.

Customer education is extremely important for this market because there are many potential customers who either do not realize that these products exist or that there are products that can meet their needs or alleviate their concerns.

The home blood pressure monitoring device market is estimated to reach $185.8 million by 2004, according to Frost and Sullivan Healthcare. Also by 2004, the number of BPMs sold is expected to reach $4.1 million.

With consumers seeking out information on their own, awareness of BPMs is expected to grow. "Consumer adoption is still in the early stages, but it has a definite growth period ahead," Stark said.

This article originally appeared in the April 2001 issue of HME Business.

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