Aging and Health Technology Watch

You see PERS news releases on occasion. PERS -- Personal Emergency Response System -- is a long-time market dominated by pendants worn around the neck. Recently Parks Associates sized the PERS market to be $1.1 billion by 2024 -- others think it is a $3.1 billion market today. Also early in the year, Vidapoint was announced as a 'global' low cost offering. LifeStation announced Mobile LTE, small and fast, a pendant linked to a sizable 24-hour call center.  Then in April, Verizon does it again, launches a PERS, this time a smart watch offering, called the Care Smart Watch for seniors.   Let us remember Verizon’s last short attention span for this space. Its Sureresponse™ PERS pendant was new in this research conducted in 2012. The quotes are from executive Jonathan Hinds who departed in 2014, not coincidentally when Verizon stopped selling it. Sureresponse was mostly erased from the Internet by 2016, except for user documentation,  online reviews, some not so hot.   

https://locatemotion.com/remote-patient-monitoring/Telehealth – the genie is out of the bottle.  In March, the government announced expansion of telehealth access, noting that it would raise the reimbursement rate for telehealth visits during the Covid-19 pandemic to match the doctor’s rate for in person visits, as Seema Verma, the head of CMS noted: ‘the genie was let out of the bottle’ and won’t likely be put back in. The regulatory change enabled "the use of smartphones, video conferencing platforms such as Zoom, and messaging services like WhatsApp; and the ability to provide care across state lines in 48 states."

The articles are beginning to appear here and there.  In the time of Covid-19 lockdowns, some are talking about an increasing use of technology in their nursing homes. Others are discussing the race to enable ‘televisits’ -- noting outreach from AARP to CMS to boost the requirement for enabling technology in nursing homes.  And numerous other articles have appeared that showed nursing homes receiving donations of technology. The State of Florida gave tablets to 150 nursing homes. The attorney general of Massachusetts supplied 750 tablets to nursing home residents. And Texas provided $3000 per Texas nursing home for tablets, webcams, and headphones. The pictures associated with some of these introductions of technology were bleak. Fortunately, some states are now allowing families to visit residents in designated areas outside.

Will results change when older adults are surveyed later this year? So we know that ‘remote care’ and ‘caring’ in its various forms, including telehealth, seem to be heating up as a priority, whether for senior living organizations, families, healthcare provider organizations, and putting more emphasis on the need for home healthcare and home care, especially in times in which the care workers hesitate to enter a home and which families are locked down and not visiting.  Here is where we were on technology adoption at the start of the pandemic, and the wave of telehealth interest heated up.  As one tech company told me, a one-year-pipeline compressed into a month of demand.  And a plethora of companies raised their hands to offer their engagement technology for free.  So if this is the baseline of adoption, what’s next when the surveys come around again?

May was an unmerry month of angst and abject failure. All around, we have been locked down beginning in March. We have been incredulous, watching older adults die alone in a nursing home, and then dying in many nursing homes. Then half of the 30 million small businesses shut down temporarily. Then hospitals limited admissions in anticipation of an onslaught – and limiting their revenue-generating business – and some shut down completely. And on and on. In May came the trickling of re-openings and beginning of renewed life, though very different from that previous life.  We wait and watch to see what will be different, especially for older adults and their access to technology, moving forward. Here are six blog posts from a May unlike any previous:

Technology usage has climbed sharply during Covid-19. Pew Research notes 53% of responders in April consider the Internet as ‘Essential’– although, no surprise, the oldest did not. And Nielsen observed that the pandemic was a catalyst for the rise of tech use for working at home and shopping, among other uses. In addition, telehealth usage has skyrocketed, with virtual doctor visits expected by Forrester Research to top 1 billion by years end. The spike has been attributed to a) the declaration of a state of emergency in March; b) introduction of Medicare/Medicaid coverage matching in-person visits; and c) encouragement from hospitals and medical practitioners.

Try staring at the NY Times list and its murky map.  The NY Times decided that tracking down and mapping the list of nursing home deaths nationwide required more than 30 contributing writers for the story. The ‘Nursing Homes in Crisis’ collection is about Covid-19 in 2020. Actually in each recent year, the New York Times has looked at nursing homes and found them to be a problem in 2017, wanting for a great deal in 2018, just a bit in 2019, then an onslaught of investigation most recently.  Amid the outcry, the negative comments about bad management, bad physical design of the buildings, bad for-profit ownership, bad Covid-19 testing, etc., etc. -- very little deep thought about why people live there and what change is likely.

Companies continue to invent and introduce technology. In the face of the devastation and economic collapse precipitated by the pandemic, many tech firms soldier on, finding opportunity, re-spinning products, and announcing new capability. It is encouraging to see this sheer quantity of free offerings, accelerated interest in telehealth, and other innovations in smart homes, healthcare and robotics that have emerged in the past few months of the Covid-19 pandemic. Here are just five focused on older adults:

How essential has the Internet been during this pandemic? Read down the April Pew report with the moniker, “53% of Americans say the Internet has been essential during the Covid-19 pandemic. Go past the concerns about whether students can complete work, past the political debate about whether the government should provide Internet access -- there are some interesting nuggets and puzzling findings. During the Covid-19 outbreak, only 31% of the 65+ said the Internet was essential; 49% said it was important but not essential, and 20% said it was not too/not at all important, with likely those with more education believing it to be essential.   Given that response, it also followed that those over age 65 were not too worried about being able to pay the bill for smartphone or broadband use. 

Is sixty-five the new eighty-five – and is ageism trendy?  Note the interesting behavior of ‘leaders’ during the time of Covid-19.  Consider the EU guidance: "The chief of the European Union's executive has warned the block's elderly that they may have to stay in lockdown till 2021 due to the new coronavirus." And in California, as seniors use more technology to communicate with others, the executive director of the Village Movement California, Charlotte Dickson, observed that EU guidance is consistent with Governor Gavin Newsom’s thinking for California and his March 15 order telling the 65+ to isolate at home: "You’re basically disappearing almost 30% of the state of California, and ageism is all about disappearing people … once you retire, you’re done. If seniors are being asked to continue physical distancing for the better part of the next year or two, divisions between generations may calcify."