Among the factors influencing how the ecosystem will change over the next ten years are the relationships between market suppliers. Peripheral device suppliers, which include blood pressure (BP) monitors, glucose meters, etc; gateway suppliers, which include health hubs and mobile gateways; and data transmission-service providers, which include plain old telephone service (POTS), cellular, and broadband systems, are effectively collaborating at the current moment. However, as the market undergoes greater convergence, it is likely that direct competition between suppliers will increase.

A case in point is the relationship between gateway and peripherals suppliers. As fixed gateway suppliers increase their subscriber numbers, they are projected to increasingly compete in the peripheral device market by supplying their own BP monitors, weight scales, and other peripherals. This will allow them to control device interconnectivity and add an additional revenue stream. On the other hand, open standards adaptation will abate concerns over device interconnectivity, improving interoperability between different suppliers’ products and reducing the need for such vertical integration.

The biggest changes will fall within the data transmissions market, where cellular network providers clearly overtake POTS and Broadband. In 2010, telehealth data transmission via cellular networks only accounted for 17% of total transmissions from gateways; in 2020 this is forecast grow to 47%. AT&T, Verizon (New York, NY, USA) and Sprint (Overland park, KA, USA), have already taken their initial steps into the telehealth market. As the use of smartphones for gateways increases, so too will the importance of cellular networks and mobile phone manufacturers in the telehealth ecosystem. Broadband suppliers are also projected to become increasingly involved in healthcare and increase their collective share of telehealth data transmissions – a projected 13% by 2020.

“The important issue in the telehealth competitive landscape is that telehealth is not a device or product - it is a system. It is hence inherent that devices can be seamlessly integrated, in order for the system to operate successfully,” said market analyst Theo Ahadome, of InMedica. “Standards will be crucial and alliances such Continua Health, Bluetooth SIG, and the ANT Alliance will be important in this respect. However, we also know that where collaboration is paramount, there is also a market for vertical integration, leading to direct competition between previous partners.”

The Continua Health Alliance is an international nonprofit, open industry group of nearly 240 healthcare providers, communications, medical, and fitness device companies created to develop a system to deliver personal and individual healthcare. The Bluetooth Special Interest Group (SIG) is the body that oversees the development of Bluetooth standards and the licensing of the Bluetooth technologies and trademarks to manufacturers. ANT is a proprietary wireless sensor network technology featuring a wireless communications protocol stack that enables semiconductor radios operating in the 2.4 GHz spectrum to communicate by establishing standard rules for coexistence, data representation, signaling, authentication and error detection.

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