Snapshot of Leading Age -- brick and mortar, limited tech

AAHSA/Leading Age -- change is incremental.  As it turns out, not a big deal, skipping a year of conferences in my quest to find innovation in the use of technology for the benefit of residents among the senior housing sector. I didn’t see too much new (exceptions below). The former American Association of Homes and Services for the Aging (AAHSA, now optimistically renamed Leading Age), is a 5400-member organization of senior executives from the faith-based and non-profit senior housing sector, spanning most of the nursing home/rehabilitation facilities in the US – typically campus-based CCRCs. This year is the 50th anniversary of AAHSA/Leading Age, and they celebrated by including international organizations from as far away as Australia.

CAST is still CAST. The AAHSA/Leading Age Center for Aging Services Technology (CAST) is a sub-group of Leading Age that was spearheaded six years ago by Eric Dishman in conjunction with Intel’s long-time interest in research about tech and seniors. (The Digital Health Group that he led is now partially spun out into the Intel/GE venture, Care Innovations.) It’s a credit to the Leading Age board that it continues to fund CAST and its progress reports, analysis of state funding for technology devices, its catalog of technologies, even as the economic downturn has been challenging for senior housing occupancy.

The CAST member tech survey shed light on pilots but did not reflect momentum. Meanwhile, Majd Alwan, continues his team’s research effort as CAST’s technology champion. On the conference’s first full day, he told the (sparse) audience attending a case studies session about the response results from members about their surveyed (sparse) use of technology. With only an 18% response rate from the membership, he regretfully told folks that the survey about utilization could/would not be published. My impression after scanning the show floor, speaking with vendors and visiting the ever-beautiful, beautifully furnished (and sparingly tech’ed) Idea House is that non-responders were silent because their use of technology for residents continues to be minimal.

First-time participants exhibited and senior housing executives saw great tech.  Great Call (with well over 500,000 customers and its new 5Star Responder service) was among the first time tech exhibitors. Also first-time at Leading Age: Hamilton CapTel (telephone caption services for the hearing impaired), InTouchLink (software to simplify computers) and Telekin (an easy-to-use computer for seniors, signing up more than 1000/month). Each of these provides benefit for current and prospective residents of brick-and-mortar campus communities. But they also present an opportunity for senior housing to expand services into the community of seniors who are still (and perhaps permanently) in their homes.

New vendors enter the market. LifeShare Technologies has entered with communications technology (sharing pictures, messages, web content) that can be used at home or in senior housing. BAM Labs offers smart bed technology that can track health status (and bed exits) and offer care quality reports -- how frequently has a bed-bound person been turned by a caregiver. Status Solutions introduced CATIE – an ‘interactive multi-media touch screen kiosk’ that enables seniors to communicate with families and get updates on what’s going on in their community

Something’s got to give – Leading Age has resources, home care has growth. The hesitation of senior housing leaders (more akin to real estate holding companies like their for-profit brethren in ALFA, see May event observations) to make a serious showing in the home care business is not surprising. I suspect they are just plain fearful of new competitors, thinner margins, risk. But with their hesitation, it appears that they are willing to turn that market over to home health and companion care companies.  As care (and reimbursement) head away from assisted living, nursing homes, and rehabs into the home – the brick-and-mortar strategy will need a virtual makeover.  And for tech vendors, with adoption inside brick-and-mortar so limited, isn't it time for a well-defined home care and consumer-oriented strategy?

Appreciation

Hi Laurie:

That's a great recap of the 2011 Leading Age Conference. It's sad but true that ever since I got into the technology and senior housing space in 1997 that there has not been very much adoption of useful care and quality-of-life enhancing products or services for our industry. The early adopters are few and far between. Hopefully, once everyone gets past this current round of budget cuts, and EMR selection, we will see the floodgates open for a wave of spending focused on resident amenities. Thanks again for your report.

Berry

LeadingAge Conference Commission case studies

Hi, Laurie, I attended the Leading Age CAST commission meeting which presented the case studies. (My organization submitted one of the case studies; SASH Support and Services at Home). The Saturday commission meeting was by invitation only, which may account for what seemed to be sparse attendance. This was the first time I had attended a LeadingAge conference.

Takeaways from the LeadingAge conference Commission case studies

Challenges

Lack of integration: The inability of different technology products to work together has been the cause of frustration for many organizations. In particular, organization are challenged by the:

* Need to juggle multiple electronic record systems designed for specific care settings but unable to interface easily with one another or with the organizations' primary billing software

* Inability of different monitoring technologies, including PERS, remote monitoring and telehealth to work together in one technology platform. Several organizations have worked actively with vendors to integrate disparate systems, with some early success.

Areas of interest that were highlighted in the presentations and summary include the lack of standardization of many of the systems. I asked about this on the trade show floor with several vendors, and got some fairly vague answers… such as "You will have to talk to our developers about integrating with your system", to "Well, we provide a fully integrated system including a back-end" (which integrates with nothing except themselves… ). The best answer was, 'We support HL7"

Recommendations

1. Invest in basic technologies that can be adapted to a variety of business models. These include:

* a comprehensive electronic health record system
* wireless connectivity that is available across the campus
* tablet and hand-held computers which promise to become a standard component of future service delivery

2. Plan for larger-scale deployments
Any organization is capable of putting a few telehealth or remote monitoring units into the field, and using them well. But large-scale deployments require that the organization take a thoughtful look at whether it will rent or purchase units, how large an inventory it will keep, how will manage distribution of the units, what data it will collect and who will carry out the tasks necessary to ensure success.

Getting Real

Having followed the aging tech sector for seven years and being in the health field for 30 years, the same dismal conclusions stated in this article are apparent. Most products are ideological rather than biological in design intent. What I mean by that is that products are ideations for 'neat and clean' solutions that assume the same mental and awareness level as the designer, usually several levels ahead of most aging brains and bodies.

Almost none are naturally intuitive, in that they could be operated without deep instruction or training, usually by a paid aid who is often more frustrated in getting something to work than the patient who keeps muddling through.
What needs improvement is not the electronics but plumbing issues.
Home lifting, toileting, balance & gait rehab, comfort, and also simple related psychological needs. These are physical and social, not just guilt driven family communications and monitoring on overdrive.

Families may want to peak in on seniors (occasionally) but they don't want to share much time with them. There is little spare time these days anyway.

We keep building tech concentration camps without addressing the late-life cycle needs of aging where 90% of the cost and burden resides. Our default answer is to warehouse frail people, and hope they die off quickly. This is the sad reality.

Senior Living & Technology

Most senior living providers devote more resources into the facility/building investments. The culture of most facilities that offer independent of assisted living housing is resident focused technology is a personal choice. Similar to running an apartment complex, residents are renters. So it is a personal (resident/renter) decision for some technologies.

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