Are these dimensions or drivers of home health technologies?

It's always hard to tell whether something is observation or insight (or just plain wrong). But I've done 13 interviews in the past few months about home health technologies, with vendors ranging from A (Advanced Warning Systems) to Z (Zume Life). I am beginning to see a pattern about product offerings that seems to have three dimensions. These may be related to product success long term -- cost, capital, clinician involvement. The question -- Are these indicators simply attributes of product offerings or will they be actual drivers of market success? They appear to be:

• Cost -- from consumer-paid to reimbursed.  AARP's Healthy@Home study demonstrated that cost tolerance for health and wellness products among both seniors and caregivers capped at $50/month for a product that could help seniors remain well longer. Software-based offerings like Zume Life fit the bill with an iPhone application that consumers can use to manage their own chronic conditions and reminders, cost to use is $35/month.
• Capital intensiveness -- from none to installation. Eighty-one percent of seniors in the AARP survey agreed that the cost of installing and maintaining home health devices might be a potential barrier. Home health appliances like Intel's Health Guide or Health Hero's Health Buddy require administration within the home.
• Clinician involvement -- from exception to transactional.  Home health diagnostic information can be collected in the home either directly by a consumer, by a caregiver, or by a visiting technician or pharmaceutical delivery service. The information can be transmitted directly and following every interaction directly to the doctor's office -- a major objection by physicians.  Or diagnostic devices can be configured with parameters that specifically derive information from a diagnostic, compare it to a pre-configured parameter, and engage a clinician on an exception basis through software from firms like HealthAnywhere. 

At first glance, to win in this market would appear to be correlated with lowest cost, least capital investment, and lowest clinician involvement. But that may only be to win in a direct-to-consumer market, including as consumer both the senior and family caregiver.

It is not obvious to me that home health technology managed by seniors and families make that much sense, however. Who is willing or able to administer a week-long canister of medications, understand a healthy output of diagnostic signals, or know how to interpret answers to questions on home health appliances? And how does a change in diagnosis or prescription interact directly with a device?

Vendors also speak with guarded optimism about the uptake of their offerings by consumers who are interested in continuing with and paying for health monitoring programs outside of doctor-prescribed home health care.

On the other hand, home health technologies already have been proven by Veterans Administration studies to lower the cost of care in conjunction with a home health case worker within an overall care management approach. Vendors I speak with are frustrated by the slow pace of change to insurance reimbursement, especially Medicare, for payment for physician care that is outside of the physician's office or hospital.

So consumers are willing to pay a low price to stay or get well. Health care costs are out of control and must be reduced. This seems like a convergence of willingness, need, and benefit to all concerned -- but only when well managed.