While You Were Sleeping: ResMed Builds an Empire in the Cloud

Xconomy San Diego — 

Over the past 28 years or so, ResMed (NYSE: RMD) has built an empire around its respiratory devices for managing sleep apnea and other forms of “sleep-disordered breathing.”

In the fiscal year that ended last June, the San Diego maker of respiratory machines for maintaining continuous positive airway pressure (CPAP) generated over $1.8 billion in global sales.

The company says it is the global leader in sleep apnea (but declined to provide the size of its market share) and has advanced its technology through the years to make its CPAP devices smaller, quieter, and more convenient—culminating in today’s unveiling of a new product, the AirMini.  ResMed says the AirMini is the world’s smallest CPAP machine, intended for patients who are traveling.

But the debut of ResMed’s AirMini is only part of a bigger picture, according to Jim Hollingshead, ResMed’s president of the Americas. In an interview yesterday afternoon, Hollingshead said the AirMini is part of a strategic shift that began four or five years ago, when ResMed began to pivot from developing medtech hardware to becoming a provider of “connected healthcare.”

Today the company’s bedside sleep apnea devices all have built-in wireless capabilities that send patient data each night into the cloud, enabling healthcare providers to track patient compliance. As it turns out, Medicare and other payers have increasingly sought to verify that patients are actually using their CPAP therapy in order to reimburse providers.

ResMed initially used secure digital memory cards to collect such data. But Hollingshead said it was an inefficient way to collect data, and inconvenient for customers. Moving this data to the cloud in late 2013 for all ResMed devices “solved a number of problems with the whole value chain of care,” he said.

With wireless connectivity in its CPAP devices and other equipment, ResMed says home medical equipment providers can monitor a patient’s breathing, and patient adherence has significantly improved. If there is a problem, a provider can change settings and troubleshoot remotely, which has resulted in fewer house calls and improved efficiencies.

“In a matter of months, we went from a nobody in terms of remote patient monitoring to the number one leader in the world in remote patient monitoring,” Hollingshead said. (With more than 2 million ResMed patients remotely monitored daily, according to the independent tech analyst Berg Insight, ResMed claimed in February that it has become a global leader in connected healthcare.)

Jim Hollingshead, ResMed’s president of the Americas

Jim Hollingshead, ResMed’s president of the Americas, holds AirMini CPAP device (BVBigelow photo)

In the meantime, ResMed introduced myAir, an online patient support platform that enables patients to track their own treatment and get personalized health coaching tips. MyAir takes the same data sent to the home medical equipment provider and puts it into a different user interface that is more patient-friendly, Hollingshead said. It includes a score for the duration of a patient’s sleep, and can tell the patient if their CPAP mask is leaking.

“It empowers patients to manage their own care, and patients who are managing their own therapy in myAir are more adherent,” Hollingshead said. “The compliance rate is 87 percent.”

With the system collecting data from over 2 million patients every night, Hollingshead said ResMed has accumulated data from more than 1 billion “patient nights.”

“The next step is to take that data and work with payers and hospital systems to do more work on chronic diseases like diabetes and chronic obstructive pulmonary disease,” he said. According to ResMed, studies have shown that sleep-disordered breathing also is closely associated with such cardiovascular diseases as drug-resistant hypertension, obesity, and congestive heart failure.

It’s an opportunity that has gone largely untapped. In its 2016 annual report, ResMed says a long-term epidemiology study published in 2013 estimated that 26 percent of adults between the ages of 30 and 70 have some form of obstructive sleep apnea. In the United States, that works out to about 46 million people.

As for today’s introduction of the AirMini, Hollingshead said, “What we’re trying to do with the mini is make CPAP therapy way easier for patients.” The many millions of people who are on CPAP typically take four to five trips each year, and over half of them don’t take their CPAP device with them.

Hollingshead said ResMed is targeting customers who already have a bedside CPAP device, offering them a second device for travel. An AirMini smartphone app (for Apple iOS and Android) enables patients to adjust the AirMini and track their own usage data.

“We just want people to travel with their therapy in a way that’s not cumbersome,” Hollingshead said. “We have high hopes. Right now the market for a second CPAP device is small, but it isn’t because there is no demand.”