With more than 3,600 companies exhibiting at CES in Las Vegas this year, there was a great deal of technological diversity on display. However, it was obvious that areas of emphasis have collected around drones, 3D printing, smart home technology, and connected cars. Fitness monitoring was also widespread, driven by a proliferation of new participants. In addition to these areas of coalescence, smart glasses and HUD development continues from companies such as Kopin, ODG, Vuzix, Recon, and Oculus, while sleep monitoring and smart shoes have reemerged.
The focus for the Healthcare Technology team at IHS was digital health and wearables, especially the identification of which new products are innovative enough to find traction in the health and wellness space. There were 1,300 companies categorized under biometrics, fitness, health, and/or wearables, representing 36% of the entire show this year. As such, it is impossible to succinctly capture all of the details, and the following notes are intended to provide insight on the topline trends as they relate to digital health.
Sleep Monitoring Technology – Clinical care devices supporting sleep diagnostics, sleep therapy and sleep interfaces is a $3 billion business and growing, with $850 million of that revenue attributed to portable devices and home devices. Most of the remaining $2.15 billion stems from fixed polysomnography (PSG) devices, but companies such as Beddit, Senviv, Shenzhen Medica, Rem-Fit, and ICON Health & Fitness (using Early Sense technology) are betting that the time is right for non-contact, direct to consumer sleep monitoring devices.
Sports, Fitness and Activity Monitoring – Fitbit, Misfit (Fossil Group) and Polar continued to have considerable presence at the show, but Chinese vendors were also well represented including manufacturers such as ZTE, EZON, and Huawei showcasing new watches with activity monitoring capability amongst other features. While it is understood that many people tend to have short attention spans when it comes to fitness monitoring, IHS estimates that 65 million sports and fitness devices shipped during 2015 with another 420 million units forecast over the next five years.
Companies such as Fitbit, Misfit, and Xiaomi are performing well in terms of activity monitor sales. Fitbit posted impressive financial results in 2014 that were exceeded by its 2015 results and not only through consumer markets, but also large deals with companies such as Target and Bank of America. Misfit was recently sold to Fossil Group for over $200 million, while Xiaomi has managed to ship millions of its Mi Band in a relatively short period of time. There are no indications of the growth slowing down, as IHS predicts that unit volumes will exceed 40 million in 2020.
At CES Withings introduced Go, the highly simplified activity monitor packing an E-ink display with eight months battery for $69. Misfit announced the Misfit Ray, which is a tubular-shaped activity monitor priced between $99-120. The Misfit Ray looks like a bracelet and is heavily marketed towards female users. Under Armour and HTC jointly released the Health Box, including the UA Band, which was supposed to be the GPS-enabled HTC Grip, but instead is a regular fitness band. The Health Box is mainly marketed to the 160 million user base of Under Armour’s Connected Fitness. IHS expects that the dedicated activity monitor product type will begin to decline beyond 2020, at which point the feature will become common in other multi-functional devices.
Innovative Sensors and Algorithm Development – Skulpt is adding further insight into advanced training with their 12-electrode electrical impedance myography (EIM) device for measuring muscle quality—seeking to replace the calipers, impedance scales and BMI charts traditionally used by serious athletes. LEVLnow is also interested in understanding your fat burning state, although through a much different method using an acetone detecting nanosensor. The level of acetone in the breath is an indicator of the amount of actual body fat burned rather than just overall weight, which could be attributed to water or muscle loss. Aterica Digital Health is launching a new EpiPen smart case system that utilizes temperature sensors, GPS, and injector removal alerts for people suffering from anaphylaxis. Valencell’s PerformTek heart rate monitoring technology was on display in earbud devices from LG, Jabra, and Sony. The Valencell booth also had several prototypes on display for in-ear and wrist-based monitoring that are planned for launch in 2016.
Withings, best known for adding aesthetics to traditional consumer medical devices such as blood pressure monitors and weight scales, revealed its latest product Thermo, a non-contact temporal artery thermometer featuring an array of 16 independent infrared sensors. By pointing the thermometer in the direction of the temporal artery, the sensors obtain 4,000 measurements in two seconds. Proprietary algorithms then correct for possible bias such as ambient temperature or skin heat loss. Thermo is marketed as a consumer product, but can easily be used in a clinical context where the user-experience could potentially increase workflow efficiency with improved hygiene. The device is FDA approved and CE marked, and will be available Q1 2016 for $99.
Smart Clothing – In addition to announcing its new HealthBox system (consisting of an activity monitor, heart rate monitor, and personal scale), Under Armour gave notice of its upcoming smart shoe due for release this February. The new UA sneaker will sell for $150 and record activity in the accompanying app. ICON Health and Fitness (iFit) also announced their Altra IQ activity monitoring shoe, which is due for release in the Spring of this year at an MSRP of $200.
IHS expects the world market for smart clothing to exceed $600 million in 2020, growing from just $15 million in 2015. Beyond the obvious synergies between clothing and wearable technologies, what justifies such a prediction? This year at CES, a number of smart clothing providers showcased products that will ease smart clothing’s way into consumers’ daily lives. Some of these are new products, while others have added functionality to further their value proposition
- Hexoskin introduced a new Bluetooth 4.1 connector to its smart shirts that will allow for connectivity with third party application such as Endomondo or MyFitnessPal, and with other devices such as smartwatches or cycling computers. The new connector also doubles up in battery life from 15 hours to 30 hours when fully charged. These improvements decrease switching costs for the consumer, which should be considered given the quantity of fitness and wellness devices and mobile applications available today. Interoperability enables further adoption, which in this case will positively impact the smart clothing market.
- Another company in the smart clothing arena, OmSignal, showcased their new smart sports bra. The bra measures heart rate and breathing rate among a range of other vital signs. Aesthetically, the bra is similar to any other sports bra, but carries a black box that is attached onto the bra along the rib cage.
- Sensoria Fitness showcased their smart sock anklet designed to capture running data (MSRP $199) and their smart bra with built-in heart rate monitor (MSRP $139). The sock features three built-in textile sensors that detect foot pressure and relay the data through conductive fibers to the magnetically attached anklet. Sensoria recently entered an agreement with Orthotics Holdings Incorporated (OHI) for a new connected brace to be marketed to healthcare providers. The new brace will track motion, gait, cadence, and stride length to help predict falls and track recovery.
- Hong Kong-based AdvanPro Limited exhibited at Eureka Park in the Sands Convention Center this year, and similar to other smart clothing vendors featured examples of smart textiles for the foot and chest. Their stretch sensor technology may be well suited for tracking respiration, and could be embedded within a bra or chest strap.
Although new products are making their way to the market, average selling prices continue to be relatively high as compared to other monitoring product types. While the smart bra from OmSignal will start at $149, many products are well above the $250 mark, which is barrier for adoption. However, IHS expects the average selling price of smart clothing applications to decrease by a staggering 7.1% between 2014 and 2020.
IHS notes that there are several ongoing trials for medical applications of smart clothing, most of which involve capturing biometric data for rehabilitative purposes. Three health-related applications of smart clothing that will likely see commercial development during the next five years include ECG monitoring, shirts with stretch sensors for monitoring respiratory rate for people with chronic lung disease, and hosiery related to wound care (with applications for those with diabetes and pressure ulcers). Smart textiles, or e-textiles, feature an integration of textiles with conductive fibers as well as electronic elements such as sensors and microcontrollers. Applications for these textiles are being considered for a range of industries including automotive, aerospace, interior design, medical and general apparel. In regard to wearables, a considerable amount of research attention has been placed on smart clothing for fitness, biomedical and safety as apparel sensors can be used for electroencephalography (EEG), electromyography (EMG), and electrocardiography (ECG). When a thermocouple is incorporated, the apparel can be used for sensing temperature, and the incorporation of carbon electrodes may allow for detection of oxygen, saline, moisture, and contaminants. Heating and cooling systems developed for space exploration and deep-sea diving have also been applied, primarily in prototype garments with limited commercial release.
Most smart clothing applications at CES 2016 were geared towards fitness apparel, but there were also products such as the Welt from Samsung, a smart belt that looks identical to a standard leather belt. Welt measures activity, changes in waist size and whether the user has overeaten. While the product itself does not feature technology that goes beyond a simple activity monitor, it does a great job at hiding its smart capabilities, which is not a bad thing. The smart belt from Samsung originates from its Creative Lab, an incubator program for Samsung employees to test out new concepts. As the smart clothing applications are simplified and adjusted to the early majority adopters of technology, referring to both product design and price, smart clothing will no longer be “smart” clothing, but simply clothing. At that point in time, the potential for smart clothing seems endless considering that the market for apparel is well above $200 billion in the United States alone.
Pain Treatment and Relief – Several transcutaneous electrical nerve stimulation devices were featured during the show, including the new patch-like TENS device from iTENS. The new device is wireless and designed for portability while measuring pain scale and tracking results. The NeuroMetrix Quell device is another interesting example of pain relief technology designed for continuous wear. The company’s OptiTherapy technology automatically adjusts stimulation intensity and can identify when the user is sleeping to adjust to a gentler mode. IHS expects the global market for TENS devices to reach $220 million annually within the next five years.
3D Printing for Healthcare Solutions – 3D Systems (3DS) showcased their end-to-end system for personalized surgery that comprises medical image processing, 3D printing, virtual surgical planning, surgical simulation, and personalized surgery. By providing accurate 3D printed anatomical models, virtual reality simulators and direct metal printing for implants and instrumentation, truly personalized medicine is a step closer to becoming a reality.
Virtual Reality – During the Digital Health Summit held at the Venetian hotel, Deepak Chopra and Rudolph Tanzi discussed brain training methods that may potentially overcome common debilitating conditions such as memory loss, anxiety and obesity. By tying neuroscience, meditation, and technology (such as technology enabling virtual reality) they postulate a time in the not too distant future when we will move well beyond preventive care to transformative care and the ability to change gene expression through actions and behaviors. IHS notes that conditions are more suited to virtual reality technology and content adoption than ever before, largely due to entertainment consumption habits, better technology, cheap virtual reality headsets, and an active start-up community. IHS estimates that the installed base for headsets enabling virtual reality will reach 38 million worldwide by the end of 2020.
Forecast for Digital Health - On a worldwide basis, IHS estimates that digital health devices and services will grow from $15 billion in 2015 to more than $22 billion during 2020, at a CAGR of 8.3%. This is inclusive of 39 distinct product types which are included in the Digital Health Intelligence Service from the Medical Technology group at IHS.