Laurie Orlov's blog

Vacations and out of office messages – it must have been August.  Some have said that there is no point in attempting a business meeting, even online, for August. Perhaps you were one of the 5 million visitors to Cape Cod, roaming the hillside vineyards in California or attending an antique car auction on the coast of Maine.  Having managed to pull off two of those three in the same month, it’s not that crazy. But there were issues, disruptions and sizable opportunities worth noting in August, the biggest one was Best Buy's purchase of GreatCall, just six weeks after Amazon acquired PillPack, the latest big company acquisition -- part of a to-be-continued series important to families and providers of care to seniors. Here are the blog posts from the month:

Investors continue to salivate over health tech.  Rant on.   So the first half of 2018 saw $3.4 billion invested in Digital Health (which means whatever you want it to mean.) And even when investments or company roll-ups are specifically about the Medicare population – frothy writers cannot bring themselves to use clear wording. So Optum acquires DaVita Medical Group and Humana acquires Kindred Healthcare. Gee, what do they do? Yes that is vertical integration in the continuum of care – specifically for health services to elderly Medicare recipients.  And the $146 million that went into PointClickCare – that is software for long-term post-acute care (LTPAC), another euphemism for what it really is – care of the elderly, generally in nursing homes.

Reading the employee microchip article – does it make you shudder?  Observe the development and evolution of modifiers for the word technology.  Words like sustainable, appropriate, autonomous all come to mind. With the micro-chipping of employees – the convenience argument is ultra thin. But why would one think about a microchip for an ailing relative, aka an older adult? (Some say we will all get chipped eventually.)  Consider that these "chips will offer a convenient way to track people — especially those suffering from Alzheimer’s and dementia."  But who will opt in to being chipped and tracked in that example?  Employees could opt out – but can a person with dementia opt out?  How different is being micro-chipped from wearing a band with identifying address information? For whom is the 'convenience' of micro-chipping offered?  And because it is possible, should it be deployed?

​As summer winds down, innovators rev up.  August is winding down -- the calm before the autumn slew of activity.  Nonetheless, new milestones and partnerships were announced this month, including Embodied Labs becoming a finalist for the Top8 XR Education Prize sponsored by the Bill  Melinda Gates Foundation,  MedMinder reaching 1433 on the Inc5000, the acquisition of GreatCall by BestBuy, and MobileHelp announcing a partnership with LifePod.  And four companies released new offerings to help professional and family caregivers improve monitoring and well-being among older adults:

Many years ago, when the phone rang, we eagerly picked it up.  That was then. For good or ill, families want to text, message and chat. And the phone call has turned into a source of harassment and scams. Robocalling is a modern torment, sometimes multiple back-to-back dials from the same source, often spoofing our own cell phone numbers – where answering the phone puts us on a ‘sucker list’ sold to other scammers. Is it Rachel from Cardmember Services or the IRS Phone Scam,  a fake carpet cleaning offer or worse, the disabled veterans scam, or the grandparent 'this is your grandson' scam? 

First take – this links together multiple Best Buy initiatives, starting in 2011.   Look at the history of Best Buy. First a dabble with the now departed Wellcore in 2011 – clearly the time was not right – the oldest baby boomer turned 72 in 2018, but at 65 in 2010, consumers could not comprehend the utility of a wearable fall detector. But Best Buy executives saw the opportunity and decided to learn more.  More significant in 2011, Best Buy became a founding consortium member in a ‘living lab’ Charter House in Rochester, Minnesota (along with Mayo Clinic). "We believe technology has the potential to foster healthy, productive lives by enabling easier access to information and medical care," says Kurt Hulander, then senior director of health platforms at Best Buy.  

Voice First technology – triaging the healthcare opportunity.  This week’s Voice of Healthcare Summit in Boston offered up some intriguing attempts to create new Voice First interfaces that inform patients, streamline work, and demonstrate potential (like Answers by Cigna) in versions 2, 3 and beyond.  One of the most intriguing presentations – KidsMD – a Boston Children’s Hospital ‘accelerator’ initiative begun in 2016 and is winning over the staff.  The organization is clearly committed to using Voice First interfaces for patients, for internal questions (“Who is the Charge Nurse on 7 South?”), for hands-free operating room checklists, for post-discharge guidance and for home health (100,000 interactions to date).  They’ve added a skill called AskICU that highlights the potential for ‘hands free, eyes free’ questions that have easy (but difficult to find) answers, like available beds on a floor, or detailed answers like “Medication dosage details from the Code Cart”.   The other hospitals in Boston are well aware of the innovation at Children’s, but other than experiments (like one at Beth Israel Deaconess), nothing of the scope of KidsMD has materialized.  In other blog posts from July:

Google discovers seniors (sort of) and thus a market is maybe born. There was a breathlessness to the CNBC article on July 23, 2018 – Google is mulling older adult applications for its Nest product line – particularly in senior housing settings, hopefully at less cost per installation than its website pricing.  And gee whiz, one of the uses is pathway lighting to find the bathroom – presumably replacing motion-sensing night lights for $7.97 from Walmart. Up next, predicting life-threatening falls, perhaps as an alternative to Philips CareSage or BioSensics Frailty Meter, for example.  Google execs qualified our enthusiasm, per the article: “The ideas are only in the discussion stage and may not find their way into shipping products.” Since his role at Google is to do “something interesting” -- perhaps this may not turn out to be.

You saw the headline – America is running out of family caregivers.  The numbers are daunting.  Says Ken Dychwald in the WSJ article:  “We’re going to have to look to nontraditional care,” says Ken Dychtwald, CEO of Age Wave, a consulting firm.  "Older adults, he says, may have to take in boarders, who can help with shopping and repairs, or rely more on monitoring devices and delivery services.”  This latest article was based on a recent study (part of a series) from Merrill Lynch and Age Wave.  But is the issue low growth in potential family caregivers?  Or is the real issue the low growth of population in the appropriate age range (45-64) of people to provide care to people who are aged 80+?

Voice First is changing health and wellness offerings today. Already the predicted capability to speak a request or instruction without having to type or tap on a device – known as Voice First – has transformed how we interact with technology. If we can speak a command to play music, control the lights, or open the shades benefits accrue to the elderly who live alone. This technology can help those who are blind or have macular degeneration, and it can help those with disabilities. AARP and Optum have initiated pilots to determine if this technology can help mitigate social isolation and improve health outcomes for the elderly. And note experiments and pilots for applying Voice First technologies for health and wellness. So what’s intriguing?