The US-medical device manufacturer Medtronic is planning to extend its presence as a telemedicine provider in Europe the company announced in Switzerland recently. “The wave of telemedicine is now hitting the medical devices industry, and Medtronic will take a lead”, said Peter Steinmann, vice president for distance monitoring at Medtronic Western Europe. CareLink was introduced in Europe in 2007, but so far in pilot projects only. This will change in 2008, according to Medtronic’s CEO Bill Hawkins. He said 2008 will be the year for Medtronic to get into Europe with its telemedicine solutions on a bigger scale: “We will launch an entire series of new products in Europe in 2008 that will all be tailored for remote monitoring.” The company presented its telemedicine plans at its European headquarters in Tolochenaz, Switzerland, on 1 April. At the heart of the company’s telemedicine initiative is the CareLink platform, an internet-based solution for remote medical device monitoring and remote patient monitoring. “In 2007 the number of CareLink users has more than doubled to a total of 230,000, mostly in the US”, said Medtronic CEO Bill Hawkins. CareLink has been available in the US since 2004. The platform is currently used for the remote monitoring of patients with implantable defibrillators (ICD) or pacemakers and for web-based continuous blood glucose-monitoring. In both cases, the physician can check patient or device data remotely via the internet. The new product line-up includes new generation ICD- and pacemaker systems that are capable of wireless data transfer without the need of an antenna to collect the data. The devices will also have an automatic alert function for pulmonary edema, which Medtronic refers to as ‘OptiVol’. It measures electrical currents in the thorax and generates an e-mail or short message-alert for the physician in case a pulmonary edema is developing in the patient. Wireless glucose sensors for diabetics and insulin pumps are also made compatible with the CareLink telemedicine platform so that a fully automatic transmission of blood glucose levels into the internet platform is possible. Medtronic’s patient management director for Western Europe, Keyne Monson, said that the main obstacle for a quick implementation of CareLink-based telemonitoring in Europe is reimbursement. “There is the question of who pays for the patient’s equipment for data transmission. But even if Medtronic decided to give this away for free, there is still the issue of who pays for the remote diagnostic procedure.” Medtronic’s vice president and deputy general counsel, Herb Riband, made it clear the huge differences in the reimbursement in different European countries. “Germany, the UK, and Portugal are heading the crowd. They do cover remote device checks for cardiac implants already or will do so soon. In general, though, there is a lack of incentives to use remote monitoring throughout Europe.” In France, for example, there is now a two-year-assessment of remote versus in-office device checks in 1600 patients from 30 cardiac centres underway. “The goal is to make the new technology broadly available in 2010. This is very straightforward, but, frankly, it will take more than two years to have the results,” said Riband. He added that the picture was also of cautious progress in Italy and Sweden: “In Italy, there is a government-backed project in the region of Lombardia, and in Sweden, too, there is a government-backed initiative.” Most other European countries are far behind that, said Riband. Efforts are also underway to make the CareLink-network more attractive, particularly to physicians. The website will undergo a relaunch later this year, offering different user interfaces for different medical specialities. “This will make it easier for different physicians to offer remote monitoring for the same patient on different conditions”, said Monson. Medtronic will also include electronic communication tools into its platform for doctors to communicate directly through CareLink. Finally, new connectivity software is under development that will gather data from different devices and feed this data into clinical information systems.