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Research finds that high use of connected care solutions in North America.


 A new report from the IoT analyst firm Berg Insight has found that around 18.0 million people in North America were using connected care solutions at the end of 2018.
The figure refers to users of medical alert systems, connected medication management solutions and remote patient monitoring (RPM) solutions in Canada and the US. RPM is the largest and most mature segment having a total of 16.1 million users at the end of 2018. The market for medical alert systems is considerably smaller with an estimated total of 3.1 million users, whereas the number of connected medication management users reached 900,000 at the end of 2018. There is an overlap between the market segments as medical alert users can also be equipped with a medication management solution or an RPM solution, and vice versa. The market is forecasted to grow at a compound annual growth rate (CAGR) of 18.3 percent during the next six years to reach 49.4 million connected care users by 2024.


The leading use case for RPM have thus far been sleep therapy monitoring. Patients that suffer from sleep-disordered breathing such as obstructive sleep apnea (OSA) are typically prescribed an airflow generator, but many patients find the device unpleasant to use and poor compliance is common. Payers thus increasingly require that patients comply with their treatment plans to be reimbursed for the device which has driven equipment vendors to connect the devices. Philips is the largest provider of connected airflow generators. ResMed follows closely thanks to the company’s decision to include cellular IoT connectivity as standard in its Air Solutions product family.


The North American market for connected care solutions is affected by several trends and developments that will have an impact on the competitive landscape in the following years. Changing demographics is driving the demand for home care, while technological developments and regulatory changes affect the competitive landscape for solution vendors. One of the major ongoing changes is the sunset of the landline telephone networks and cellular 3G networks, which forces equipment providers to upgrade their products. At the same time, the industry is becoming more patient-centric which calls for integrated systems and improved interoperability of connected care solutions. New companies are entering the connected care market and connected medication management solutions are today in the centre of attention for start-ups.

Kris Oldland, Editor-in-Chief talks exclusively to Tom De Vroy, Senior Product Evangelist, Field Service Management with IFS at the Field Service Medical conference to find out why they were involved within the Field Service Medical sector, what unique challenges he saw for field service management in the healthcare and medical sector and what key points he took away from the three day conference held in San Diego a few weeks ago.

at Field Service Medical held at Rancho Bernardo Inn, San Diego.

We also take a sneak peak at what to expect at this year's Field Service USA event being held in Palm Springs this April

 

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Field service professionals can subscribe now for free here and then simply email the subscriber benefits team on subscriber.benefits@fieldservicenews.com to get your discount code!

 

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In the first part of this feature we looked at why medical device manufacturer Elekta felt it was necessary to establish a global knowledge sharing platform, now in this the concluding part of this feature we look at how they managed the task...

In terms of logistics, Elekta took a broad approach initially with a couple of duplicated platforms to ensure that everyone had access to the knowledge. The main plan was to integrate the knowledge base within the deployment of their new CRM system, which would provide automated access to relevant articles dynamically, based on customer, service desk or field engineer requirements.

However, they also placed the articles from the knowledge base onto a searchable database as a secondary system whilst the CRM was being rolled out, leaving no stone unturned and meaning full global access to the program was achieved from the start.

The content itself was then tailored dependent on its use, with the knowledge base comprising of a mix of mediums including text, images and videos with links to e-learning snippets also embedded within many knowledge article.

Expanding on this further Gilday explained

“If the article was talking about a particular part of the machine, and one of the procedures was something that often caused a difficulty for the engineer, we would just embed a link into an e-learning module that was only a few minutes long that would demonstrate to the engineer how to do a particular procedure.”

 

“For our engineers in China or Japan or many of the other evolving countries these were really valuable because it didn’t require any translation or any language issues, they could simply look at what was done.”

Of course the global scope of this project was one of it’s key drivers in the first place and whilst gaining adoption of the program on a global basis sounds like a huge task, in reality, for Elekta at least it actually wasn’t that big a hurdle.

“The adoption around the world wasn’t particularly difficult because there was a pull from the field service engineers in the first place.” Gilday states.

“There really is quite a bit of internal competition in that the engineer that has provided the most knowledge articles or the engineer that has provided the article that is used by the most engineers round the rest of the world holds an awful lot of kudos.”

Indeed it is perhaps a phenomena of the connected world we live in where public ranking has become ingrained within our thinking.

 

As Gilday elaborated “There is a lot of pride of being a very competent technician and being able to share your knowledge. I think many years ago the approach was knowledge is power and people were less inclined to share it but today its the other way around and people are keen to be seen as experts in their area.”

Indeed Elekta play on this mentality by publishing internal league tables with 1,000 users generating on average 60 new knowledge features a month the approach is certainly working at present. It was simply a case of getting the ball rolling.

To do so they made good use of the knowledge that they had locked up in siloes across the organisation and harvested close to 4,000 articles which were put into the knowledge base initially.

They also created some video material captured at a global summit and established a training and awareness program through targeted webinars across the team.

“We did a lot of training and awareness around the whole program to say that this is everybody’s collective responsibility once it started its actually fairly self perpetuating, you just need to clean up every now and then, to focus on the areas that get a lot of attention, take out the articles that are never used.” Confirmed Gilday

“Everybody has responsibility for it and the constant peer review means you can improve the quality of the content as you go.”

Linking the knowledge directly to support

The other advantage Elekta were able to utilise by aligning the knowledge base to their new CRM system was that they could now connect this into their service desk function.

Previously Elekta had been a very product driven company, which had largely grown as a result of continuous product innovation. In such an environment often service is a secondary consideration and so it was for Elekta in the past. However, by Gilday’s own admission that is rapidly changing.

So the benefit of setting up a service desk environment where upon receiving a call from a customer and as the service desk agent is typing up a problem, a keyword search on the knowledge base which pulls up the articles that are most related to this problem, is even more widely felt.

 

By clever design the system is also continuously refining itself making it ever more efficient.

“We implemented a scoring system so as the engineers close the service call they are encouraged to identify whether a knowledge article helped them and to link it to the particular problem” Gilday illustrated “So the system essentially self learns. This further qualifies that list of knowledge articles to be able to present it in a very dynamic form at the help desk.”

So with Elekta having established what from the outside seems a very slick and effective means of sharing knowledge across their global network the ultimate question is has it had any impact on the levels of service they are delivering?

It is of course impossible to establish a true value contribution of a new service initiative unless you undertake them really do them one at a time. And to do so severely limits the speed at which potential progress that can be made. In this instance the implementation of Elekta’s knowledge base program has coincided with them up-skilling their service desk staff and also driving forward with remote support connectivity.

However, across these three initiatives Elekta have seen more than a 20% visit avoidance, which will result in quite a dramatic effect on their efficiency on service to the customer.

Looking specifically at the Knowledge Base they are getting over 2000 knowledge articles views each day, nearly half of the articles are used with service cases attached.

 

There are also over five and a half thousand knowledge articles published now. And whilst they started with a large amount of features, they are undertaking more and more clean ups, removing any articles not being used regularly or related to old products.

There is also a lot of potential value in the product base for those customers who maintain their own equipment. Generally Elekta will offer a second level support to customers in those situations, and the value of the knowledge base could potentially be leverage further amongst these clients, either as a value added proposition or even on a transactional basis.

Finally there is the benefit that bringing the knowledge to the fore can have on future product refinement, which is a real benefit for the team working in R&D.

As Gilday outlined “A lot of this knowledge goes straight back into product updates. This product intelligence form the field says if we can eliminate this particular problem this will have an x percent benefit.”

So whilst the initial project may have seemed daunting, it appears that knowledge really is power, and by bringing it to the fore, we can truly harness it a number of different ways to push our organisation forwards to ever greater heights.

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Establishing a knowledge base is a strategy that can yield numerous benefits for a field service organisation and once the initial pain of setting it up is accomplished it can become self-perpetuating. One company that have adopted this approach is medical device manufacturers Elekta...

The devices Elekta manufacture deliver radio therapy treatment for cancer care and are one of the leaders in the niche field of image guided radiotherapy. Devices such as a linear accelerator that delivers extremely accurate radiation used in sterotactic treatment for tumours are a core part of their product line. These devices capable of delivering are very high precision, sub millimetre accuracy radiation.

As you can imagine these are highly complicated devices with many modalities  and while they have many computer systems and software applications controlling the treatment planning systems and oncology information system, there are obviously a lot of electronics mechanics and pneumatics within the device as well as a vacuum system and of course a way of generating radioactivity in a very controlled way.

 

So Elekta’s field engineers tend to be extremely smart folks. Many of them are actually physicists, or bio-science graduates with PHDs and it takes a long time to train an engineer, from a relatively high level of knowledge in the first place, through to becoming competent engineers who can resolve all of the problems that might occur on such a sophisticated type of devices.

 

This of course means that training engineers can be a long and challenging process. This is becoming a particular challenge in the developing markets of Asia Pacific and Latin America, where unfortunately due to the prevalence of Cancer there is an on-going struggle to keep up with developing enough engineers in order to be able to support the growth of product sales.

Especially in rapidly growing markets like China and Brazil.

Of course for a company in such a situation the efficient training support of the engineers, becomes extremely important.

“An important challenge for Elekta has been around the tackling the questions ‘how do we share knowledge around the whole service organisation?’” revealed Elekta Senior Vice President of Service, Martin Gilday during a recent presentation at a meeting hosted by UK non-profit group the Service Community.

It was clear that this issue had to be addressed and having recently implemented a new service management application, Gilday and the team at Elekta took the opportunity to establish an automated knowledge management solution.

“Prior to deploying that system we did have a number of ways of sharing knowledge which the engineers basically developed themselves but it wasn’t truly shared. It may have been shared amongst smaller groups of engineers but it certainly wasn’t a solution that worked on a global basis.” Gilday admitted.

With the complex nature of some of the problems Elekta’s engineers face there is of course a huge amount of value in being able to share some of that analytical and corrective maintenance activity across the organisation. Fortunately for them, this was acknowledge amongst their engineers also and they were a big part in Elekta’s drive to share knowledge across the group on a more efficient and systematic level.

 

As Gilday explained “There was a real clear message from the field that the engineers wanted the opportunity to share information with their peers and to learn from other parts of the organisation, helping each other develop.”

 

This pull from the field engineers was a real plus for putting an effective means of sharing knowledge across what was not only a global workforce but also one with differing knowledge requirements.

Elekta’s service organisation’s maturity growth is closely aligned to that of the healthcare sector as a whole. The most mature area of the world being the United States, where devices tend to be top end machines, with maturity essentially declining somewhat as you go east.

In countries such as China, Malaysia, and India while they have a big need, the devices most commonly installed tend to at the lower end of the spectrum in terms of sophistication. This is partly because healthcare clients in these areas are often developing the skills for their own clinical teams.

So the aim for Elekta was to share the knowledge they could extract from those who were really experienced in seeing the more sophisticated problems and then be able to share that with other parts of the world.

“When we started looking at it there were many, many sources, which were all manual sources of knowledge across a different systems and not really achieving what we wanted.” Gilday explained

“So the objective was really to enable all of the Elekta service engineers to be able to access service knowledge for any particular product, at any time.”

No mean task, and one that was further compounded by the nature of the market they operate in.

 

Unlike many industries where there is a pull from the customer side for global consistency, i.e. international customers expect the same customer experience in the UK as they get in the US as they get in the Nordics. In healthcare this typically doesn’t happen.

 

Healthcare solutions are usually country based and a direct result of this was that Elekta  had three independent business units. So there first action needed to pull these together to form a global perspective.

“The first thing was to establish an overall project leader who was going to pull together a common way of doing things.” Gilday outlined

This involved establishing standard knowledge processes and also importantly the format of the knowledge articles themselves, essentially a one-page document that could be viewed electronically which really described what the problem was, and any advice that the knowledge provided. With this structure in place things could begin to move forward.

However, getting this right from the outset was a key ingredient in mitigating future issues according to Gilday.

“The format itself was pretty simple” he said “ What is the problem the knowledge articles are addressing, what is the solution or advise that is being given and what product is the article about. Pretty simple stuff you might think, but it is so important to get that right in order to share it with as many people as possible. “

“Bearing in mind we are dealing with engineers from all over the globe, we were really trying to take the knowledge available and put it into a standard format, a relatively simple format that could be used in all countries. Knowledge is only any good if people really see the benefit and want to pull that out and can use it easily. “ He added.

Look out for the second part of this feature where we look in detail at the logistics of how Elekta approached this task...

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