Emerging Technology Aids Aging Adults
Who are the Hard Hitters in Aging Technology?
by Laurie Orlov
For engineers and visionaries – a grandmother inspires. I hear it so often – the entrepreneur’s grandmother, father, mother inspired the inventor to move forward with inventions – that includes long-time players like GrandCare Systems, It’s Never Too Late (IN2L) or Eric Dishman and Intel – are good examples – but it also includes brand new entrants like myLively and Serality. Or, an inspired and wealthy founder with a long history of entrepreneurship and business tries something new – GreatCall (from the telecom industry) and now CareZone, founded by an ex-Sun executive.
The corporate opportunity – seen, attempted, and sustained. Fujitsu doesn’t quit – this week’s mention in Engadget of their prototype of a new GPS cane not only provides directional guidance through visual symbols – no multi-lingual speaking required -- but it alerts if heart rate is out of whack or it enables a remote administrator to set a directional course. Philips of course, has as one of its missions to innovate and distribute technologies for older adults. Qualcomm has sustained interest in providing platform-level innovations and seeds many startups, including Lifecomm – which then seems to have rolled into another big company (and its role in an NCOA foundation) Verizon.
The grants – getting things started. Between the NIH, NSF, and CMS innovation grants, not to mention specific small grants for an on-campus entrepreneur here, and an enterprising startup there, grants get things going for many companies, including AFrame Digital or MedSignals. For reasons that are not entirely obvious to me, the grant-funded companies often seem to continue down that path, playing a technology role in lengthy studies to determine efficacy – and perhaps awaiting that single study that will drive committed CMS reimbursement. Otherwise, there seems to be no rush for the grant-funded to find a specific corporate opportunity to scale through those partnerships into the broader market.
Organizations whose mission is to help older adults are missing in the innovation action. Washington is filled with associations whose charter it is to help older adults – the Social Security Administration, CMS, AARP, Administration on Aging (AoA), NCOA, N4A, the Long-term Care Coalition, the National Alliance of Caregiving Coalitions – the end of the list is simply because this paragraph was becoming unwieldy. Which of these organizations sees its mission to guarantee that technology innovation for older adults is funded, developed, distributed, successful, and collects input from those experiences to recommend other technologies?
Which of these organizations sees an opportunity to lead the others into encouraging Fujitsu or Philips to create just-right technologies and tech-enabled services that their mission-based constituents need and expect? Given that we are in the 21st century, that this is 2013, that the technology has already been invented, why not play a leadership
Learn more by visiting Laurie's Aging In Place Technology Watch.
Published March 8, 2013
Mobile Connected Smoke/CO Alarms? http://www.firetext.me
~By David Doherty
What's hot in new health care tech for aging at home:
How is the information collected, monitored, aggregated, displayed to staff /experts / caregivers, reported and passed along for medical record reporting or further acted upon for professional response? Aging in Place can also mean "Patient not Present" when the data presented requires a professional response. Not all PERS systems are situated to handle the data or the added work (even though a PERS system can collect and transport the data).
I think it may be better to break the tools out of the patient market and into the health and wellness market both to drive down cost and familiarize people with the use of the tools in their own care. Health people, people at risk, people with chronic conditions can make use of some of these tools, long before professional monitoring and intervention is needed. These tools are appropriate for peole involved in self care.
~By Tarkus Murphy
As I speak with companies that make these solutions I hear the big problem that remains is what is the business model. Reducing costs and improving health is wonderful but who pays what?
~By Mike Jablon
I’ve been familiar with CES from the days when it was also held in Chicago.
One large problem with the notion of a continuum of care is that large healthy, at risk and early chronic / multichronic populations are not part of ANY care setting. People presenting in a care setting for a first time may often do so in advanced stage of chronic illness. At that time, significant responses are required at the time of first hospital contact (often at the ER), hospitalization and continuing through transitions of care settings.
One focus is the reduction in hospital readmissions. Both the meaningful use of EHR/HIE and Aging in Place 1 & 2.0 includes a collection of evidence-based health care practices to use current best evidence in individual patent care decisions. Rather than wait until people become patients, the effort of proactive care should be to prevent first admissions. Health & wellness initiatives can make use of data collection systems that can be self assessed. Most costs of collection and aggregation are not high cost (and do not have to rise to the level of medical or patient records). Individual data collection cost and “sensor fusion” data may be new concepts in the medical industry, but well known in other markets. Even an obsessive focus on intake, exercise, data points, etc. are rather insignificant with respect to the amount of data to be collected, aggregated, fused and transported. Creating systems that cost hundreds of dollars per month to gather data from digital tools makes no sense when analog equivalents are inexpensive.
Developing tools for the larger pool of healthy, at risk and early chronic / multichronic populations helps to drive down cost of managed care tools by developing a commodity market.
Far from a “dream,” the US market (separated into 50 States, protectorates, regions, sub regions, etc.) and a population of a little over 300 M people with a relatively small amount of data points would not result in a complex data warehouse. In fact, it is the creation of such warehouses at regional and State levels which have evidenced that large segments of each State’s population have (or at risk to develop) a variety of diseases that respond well to self management or professional assistance.
If I run across systems with “dreams” it is the groups that want to charge hundreds of dollars (per patient) for the convenience of being in an alternate care setting. Moist of the cost is tied up in the use of systems that were not designed (or are not ready) for an information loop tied from a care facility to a patient’s residence.
I’ll be revisiting with principals of the Center for Future Health, later this month. I’ll look into some of the new developments with respect to Body Area Networks (BANs) Home Area Networks (HANs), ad hoc wireless environments, sensor networks and other applications which apply to use in homes. Most of the aggregation systems are not much more than systems attached to 2G cellular or copper alarm line systems. Without broadband inside the same homes, web based dashboards returned from distant medical record systems, patient HD videoconferencing and other professional / caregiver systems. In an urban setting, obtaining sources of broadband are not difficult. The same cannot be said for rural areas.
Who pays, is a much easier question if the solution is to reduce cost by evolving a commodity market and maintaining a focus on available infrastructure.
Not a dream, just good network discipline and practices from other professions that have already faced the traffic issues. Corporate wellness challenge systems already have scalable databases that could be extended to dashboard presentation systems.
~By Tarkus Murphy
Amen to that. I decided to start thinking about the networks first and going back to the customers later. The networks exist, but the traffic is between the networks.
New medical services tend to be about OPM/OPN (other peoples money / other people's networks). There are already 50 regional networks and they are first in line to get access to a new (annual) pool of $ 400 M (not affected by the sequester), but just TRY and get service at the medical offices across the Street from the "Community Anchor Institution" or worse, yet, a facility with patients or a home.
Although many technology barriers have fallen, the model of service delivery is both flawed and incomplete. The difference in Telemedicine is with the hubs and fixed sites (ready for service, short on equipment and people) and "non fixed sites" (equipment can be moved but is not designed for mobile communications).
The NEW problem (a possible flaw with Aging in Place 1 & 2.0) is that the patient does not want to remain in place. Independence also means mobility. Mobility is possible (in fact, preferred) for a larger population seeking health and wellness services. It is very good for a patient to remain mobile and engaged in an active lifestyle, no matter what their age. Wireless systems make that possible and M2M systems make it possible for mobility to be self monitored or remotely monitored.
The infrastructure needs to be tailored to the individual, but the design philosophy for most networks is geared towards the (Community Anchor) Institution. The notion that Community Anchor Institutions have a history of interoperability (as opposed to similar missions) and technical knowledge just does not match reality. The arrival of new services often comes without equipment or the people who would know how to use the equipment. The notion of outreach to extend new services into the community could be either naïve or premature. IT took our community ten years to design, fund and complete one of the first community “middle mile” networks. It took several other years for some of the new Medical Networks to evolve, and some of the hospitals on one network are not on the other. Without end to end throughput (not just broadband), the systems experience latency (resulting in jitter & pixilation [video] or flutter & “robot voice” [audio]).
By Tarkus Murphy