The Case for Intelligent Implants
With advancements in sensor technology and remote patient monitoring (RPM), implantable devices are at the top of our list for technologies nearing an inflection point in 2025.
What began with cardiac rhythm management devices has expanded to include an array of technologies with potential to enhance patient care and improve clinical outcomes. The applications are far-reaching and may reduce healthcare costs, if applied properly.
This week, let’s explore the history, advancements, and future possibilities of sensors and RPM for implantable medical devices, and the numbers driving this shift.
Brief History: Cardiac Rhythm Management Devices
While the history of RPM for implantable devices begins in the late 20th century, the story starts with the advent of implantable cardiac rhythm management devices — i.e., pacemakers and defibrillators.
In the 1960s, Dr. Wilson Greatbatch introduced a battery-powered pacemaker in the United States, which marked a major turning point in cardiac rhythm management. Building on the shoulders of giant innovations in pacemaker technology, this invention allowed cardiac patients to regain their quality of life outside the hospital.
The 1980s brought another breakthrough with the production of the first implanted Implantable Cardioverter Defibrillator (ICD). These devices combined pacing, sensing, and defibrillation functions, offering more comprehensive cardiac rhythm management.
Now, in the 1990s, enter trans-telephonic monitoring (TTM). TTM was implemented into implantable cardioverter defibrillators (ICDs). In 2001, BIOTRONIK became the first company to introduce an FDA-approved wireless remote monitoring system. Their CardioMessenger? transmitter was a little larger than a cell phone and communicated wirelessly with an implantable within a 2m radius.
Following Biotronik’s lead, 波科 , 美敦力 , and St. Jude Medical (now 雅培 ) introduced their own remote monitoring systems. These devices allowed patients and physicians to remotely track meaningful device data, including battery life, lead quality, and therapy delivery.
The evolution of these technologies reduced hospital visits, improved patient adherence, and enabled earlier detection of potential complications.
Expanding RPM to Meet Unmet Needs
As sensors become smaller, more efficient, and more sophisticated, RPM has slowly expanded into new therapeutic devices. Today’s implantable devices leverage Bluetooth, AI algorithms, and cloud-based platforms to deliver actionable data to providers. Early innings of the RPM revolution have shown promise to:
Reduce healthcare costs
Introduce new revenue streams
Address looming challenges in care delivery
The Numbers: A Case Study for the Potential of RPM
To understand the reinvigorated interest for connected devices beyond historical approaches, let's look at Canary Medical Inc.
In August 2021, the company received an De Novo classification grant and authorization from the US FDA to market Persona IQ, a smart, personalized knee implant produced in a partnership with Zimmer Biomet .
According to LSI ’s Global Surgical Procedure Volumes database, an estimated 1.3M total knee arthroplasties were performed in 2024. These procedures are also seeing significant growth as the elderly demographic in the U.S. and globally expands.
On average, a single TKA patient in the US can expect 3-5 follow-up appointments in the first year. This is already a significant cost per patient in the initial year following surgery.
Using the aforementioned cost per appointment to the healthcare system, this translates to approximately $795 - $1,325 in appointment costs.
If we continue with this analysis, if all TKA patients in the US receive the average number of follow-ups, this costs the healthcare systems in the US approximately $1.72B.
Tremendous cost means tremendous opportunity.
Bill Hunter , CEO of Canary Medical, presented at LSI Europe and painted a picture for the future of RPM and connecting major medical devices in this space.
He described how Canary turn's the data collected from the 3D gyroscopes, accelerometers, step counters, and other sensors "into a range of motion to tell doc not just that [their] patient took 1000 steps, but if they were limping or walking normally, and, if they were limping, why were they limping?" He explains that if they're limping because they've lost extension, for example "the physiotherapist everybody knows what to do with that and how to manage it."
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Once you have this data at scale, as Bill says, "you're able to do more elaborate things...tell what's normal, and what's abnormal...are now our docs are starting to use this information to identify the patients that are lagging, bring them in and get treatment to them before they have a more significant problem. The next step of this to have the doc look at their phone on a Monday morning and see the four or five patients that are the highest risk."
Back to the revenue case, Bill also describes the new stream created via RPM and their integrated platform. "The clinician can bill an extra $100 per month for remote patient monitoring... a lot of our docs are doing 300-400 knees a year, $1,000 per patient and monitoring follow up is meaningful to them."
You can watch Bill's full presentation on our website for additional insights.
Emerging Markets for Smarter Devices
Emerging research points to exciting possibilities for RPM in new device categories, particularly for cardiovascular and orthopedic implants.
Monitoring Stents and Valves:
Orthopedics and Spine
Neurostimulation
Challenges and Opportunities
While the potential here is huge, challenges remain. Ensuring data security, achieving seamless device interoperability, and addressing patient privacy concerns are critical hurdles to overcome. Additionally, the cost of implementing these technologies must align with healthcare care delivery pathways to ensure widespread adoption.
Despite these challenges, the benefits of sensors and RPM are undeniable. By enabling earlier intervention, reducing hospital readmissions and unnecessary specialist appointments, improving patient engagement, and offering new revenue streams, RPM is here to stay in many therapeutic areas.
More From LSI Market Intelligence
Until next week,
All data in this article is sourced from LSI's Market Intelligence Team
Good insight! Tiny sensors and actuators are adding smarts to take so many health care tools to the next level. Also enabling RPM across several applications.
The 1960's saw scientists and engineers at NASA put sensors (astronauts) into outer space, land on the moon and return safely to earth. This incredible endeavor proved what was once thought impossible, become possible! The incredible results and accomplishments were not only "Tang" the powered orange flavored fruit drink, but this adventure was the base of a technology revolution that is the core of many of the technologies we use and count on today. Todays engineers and scientists are working on a new race, very similar to the outer space one of the 60's. it is now "Inner space". The same challenges that needed to be overcome before like, deployment, retrieval, hostile environment, powering, communication and many unknowns, are now being overcome by teams like mine at Cambridge Consultants. We work on projects from class III implants to satellites, using the knowledge and know how we have accumulated over the past 65 years. Bluetooth encrypted communication for deep smart implants was refined and defined by our team almost 15 years ago. We have many other accomplishments in this space since then I am proud of the engineers / scientists at Cambridge Consultants who push the edges of the impossible everyday in this new frontier.
Healthcare and MedTech Innovator @ Cambridge Consultants | Biostrategy, Biomanufacture
1 个月I could not agree more, developing cutting-edge wearable and implantable devices, focuses on miniaturization and advanced materials for discreet, durable designs as well as seamless integration of sensors and electronics for precise monitoring.
Co-Founder and CTO at Deerfield Catalyst
1 个月I like to think that RPM is a low hanging fruit for AI. Everybody is keen to delegate?those, but cumulative impact can be huge.
MedTech Marketing | Commercial Strategy | Navy Veteran
1 个月GREAT write up!