Market Overview for Technology for Aging in Place

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CASTing a bit of light on technology adoption in senior housing

Senior housing organization set a survey baseline that worries leaders.   At a 2011 presentation at LeadingAge’s conference in DC, not long after the organization dropped the AAHSA moniker, a technology adoption survey was presented and prefaced with an apology about the low (18%) participation rate in the survey. A month later, the organization published a series of case studies about early adopters ("Pioneers in the field") -- several of them presented at that LeadingAge conference.  Okay – these were tech enthusiasts -- the Evangelical Homes of Michigan stood out then and does even now -- but overall, not too much was happening at the time.

Looking forward – Ziegler surveys LeadingAge member CFOs. In 2012, LeadingAge/CAST asked the senior housing investment banking firm, Ziegler, to conduct surveys – the first public output queried 81 CFO responders about their tech investments in 2012 as well as their planned investment categories for the next year. Topping the list was tech to help the organization keep up with changes in regulation and resident population -- network infrastructure, EMR, Point of Care and Wander Management. Plans for the following year were aligned with 2012 investments – three of the four categories were at the top – although health information exchanges as a category was added (as a result of ACA), and wander management was replaced with user-activated PERS (not really viable for wanderers, but whatever). Otherwise, technologies for residents were low on the priority list.

Okay – that was last year -- let's forget about CFOs. Apparently not able to do the exact same thing two years in a row, in 2013 the 6000-member LeadingAge asked Ziegler to focus on the largest 100 organizations – defined by inclusion criteria explained in 2011 -- and promising that the LeadingAge 100 would serve as a baseline to help with future trend tracking. (I hope so.)  "If the organization implemented a technology in at least one of its communities, it was counted as adoption…this approach may produce a higher perceived adoption rate than the actual adoption rate at the community or campus level." Although the responder could have been the CFO, the survey hedges what job categories represented the actual survey responders.

Anomalies – but no real light. Given the qualifiers – what does it mean really about tech adoption in senior housing? Not much. More surveyed organizations have Point of Care systems than have EMR, which seems odd. Although organizations were asked whether they use technologies throughout their full set of communities, the survey counted positive responses from 'at least one' of their communities and perhaps only one. What was prioritized? Wander management, user-activated PERS (I can believe that those devices are handed out at move-in), and automatic fall detectors. Really, seriously, 41% are using automatic fall detectors? That seems really odd. I can believe that fewer than 1 in 5 are using any telehealth/RPM and telecare-telemonitoring. Okay – given adoption that low means that incorporating data into an Electronic Medical Record is not in the current cards. Finally, 91.7% of responders are providing access to the Internet, portal and senior networking sites – but that 'access' could be a device like a single computer and monitor in a common area - usable by one person.

For next year – provide more examples and illustrations. Why are surveys like this so important? First, they tell the vendor community which technology categories are viewed as important in this particular market. Next, the investments in safety technologies paint a profile of the residents – and the biggest and most profitable growth area of the business - dementia care. Finally, they imply (but design of questions could influence this) what move-ins and family members may consider important enough to demand as services. Next time, please ask about these categories in more depth – how many communities have high-speed networks deployed in all of their independent, assisted, memory care or skilled areas?  Have IT administrators on staff or on call? Promote resident use of social technologies like Facebook, YouTube, Gmail or Skype? Are running apps designed specifically for senior housing residents with dementia? 


Its been my experience over the past 5 years in senior housing that "providing access to the Internet" means a single WiFi hotspot,a common area computer, or residents have the ability to purchase their own through the local cable or phone company. The single hotspot is especially true when a community touts that it "has WiFi".

This is starting to change in communities as they see the operational value for WiFi when they also are adopting EMRs. This is largely limited to SNFs and CCRCs, since AL and IL don't need an EMR. However, AL and IL residents are the ones that could benefit the most.

The lack of true property-wide WiFi is especially troubling because it is a key stepping stone in being able to innovate and adopt new technologies. The most rapid innovation is happening around technologies that rely on Internet connectivity for their full value. Once they have WiFi, you suddenly see a proliferation in other technologies that become possible. But until we see more adoption of WiFi, we won't be seeing much for widespread "innovation".

Not only is the lack of building-wide WIFI a current problem, an even bigger challenge is that the majority of today's current buildings do not have the proper infrastructure to allow for data to move about quickly.

There are not enough power, ethernet or coaxial outlets throughout these buildings and short of breaking down walls there is little chance that these necessary items will be installed. Further, new construction has not provided proper conduit space so as to grow with the future technical equipment advances required in buildings managing all care types.

This poor infrastructure planning is forcing Operators to look to various wireless options which are significantly more expense and less productive that "wired" solutions. This increased cost is resulting in lower technological adoptions by operators and lower levels of service to each resident.

So what's the solution? I'm not sure, but I think more strategic planning needs to go into the physical development of new and existing housing so that we can lower information costs in a secure manner and get back to focusing on resident care (instead of paperwork).

From Senior Housing Forum The CAST Survey provides no valuable information -- and what they should ask next time.


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