Post CES reflection on role of technology and Alzheimer's.
Boston, mid-May, 2016
Forbes says health IT is hot -- although not yet profitable. A title of a Forbes article caught my eye recently: "Health IT entrepreneurs, now is your time." It went on to note that "the sector is being energized thanks in large part to government subsidies which reward doctors and hospitals for buying electronic health records (EHRs)." The article then talks about VC investment plans, who's investing, and offers a few examples of startup ideas. Think about this request from the "government's Health Data Initiative, which invites entrepreneurs to develop applications based on their mounds of health data collected by the government." Oh yeah, that would be extremely helpful to the government -- perhaps to refine rankings focused on hospital readmissions -- which really are about seniors -- heart attack, heart failure, pneumonia readmissions that cost Medicare $12 billion per year. But think what it means to have better reports, more rankings, more granular punishment to providers. That's good for the government -- under the theory that if one reports and punishes at the far end of the health care process, perhaps the beginning of the process of care will just fix itself.
The tail cannot wag the quality of life dog. I'm reading Jane Gross's new book, A Bittersweet Season, about caregiving for her mother in her last three years of life, reminding me of the misery for those seniors behind the heart attack, heart failure and pneumonia readmissions that cost Medicare its $12 billion per year. Entrepreneurs are hopeful people: let's help them put quality of life for seniors as a sub-topic under 'Health IT'. Behind the EHR/EMR and hospital quality reports are people receiving the care -- and families trying to manage that care from afar. Imagine, if you will, the admission and abrupt discharge of one of the 11 million seniors who lives alone in the US. Or one of the 900,000 who live in assisted living (average age 86). Or one of the 1.6 million nursing home residents, half of whom are age 85+. Or contemplate a similar number on hospice care. Okay, now that you have them squarely in your mind, now imagine them en route to/from the hospital, most likely alone. Now imagine that you are one of the 50% of baby boomers who doesn't know what meds a parent is taking and has no 'care plan'.
What will make investors sit up and focus on quality of life before/after the hospital? Mandates would help, but more research, not so much. On the one hand, health IT is 'hot'. On the other, research on 'future' tech for future baby boomers "is a race," says Eric Dishman, to see who can deliver tech for the future aged 85+ baby boomers (hopefully not living alone, not in a nursing home, not in assisted living or on hospice care). That's 20 years from now! Meanwhile, the existing vendors of each of the technologies described in that article soldier on in an emerging (not hot) niche -- they are the ones discussed all over this website. As the ORCATECH article on 'future' tech notes, Medicare funds none of these monitoring and communication technologies.
Label your quality of life technology as health IT. After years of study, grant after grant, it is still a world of follow the money/mandate (EMR, hospital readmission penalties, etc.) There is no mandate for having a good video link between grandparents and grandchildren to chat. Nothing for checking whether you fell in the bathroom and didn't emerge. Well-intentioned entrepreneurs who care about closing the communication gap emerge, redirect, disappear. Anyone remember Vidtel's Videophone from 2009? (Bet not.) Now Vidtel wisely focuses on video conferencing. And despite the newsworthy charm of robots that run into the coffee table, does anyone seriously think that's how Dorothy Rutherford would Skype with her daughter if Intel and ORCATECH weren't doing this project? I mean, seriously?
Meanwhile, back in the reality of today - help widen the Health IT tent. Your mother, your grandmother, may both live past 85 for another not-so-fun 6 to 8 years, as the Jane Gross book illustrates. Why even the health IT investors' grandmothers or mothers may live past 85! Create a government challenge, oh Medicare folks, to find and fund entrepreneurs who make those years well-connected, well-monitored, and a well-informed 6-8 years for seniors, families, caregivers, homecare and senior housing professionals. We believe that tablets and smart phones improve the quality of life of our communication-obsessed and media-oriented selves -- and we're willing to spend a boatload of money on them. Maybe your mother or grandmother in Florida could benefit from an invention that would be easy to use, require nothing much in the way of equipment in the house, but it might vastly improve the quality of life beyond wishing-you-would call, be in the ambulance, or nearby in the ER -- even if you can't drive there this minute. Feel guilty as you mull the back-end reporting, the near-term uselessness of Health IT investment prospects. And if you are one of the entrepreneurs focused on improving the quality of life of today's seniors, please, please, call what you're doing 'health IT'. It can't hurt.