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Configuring the baseline of activity for older adults

Less movement and non-movement matter.  The Washington Post ran an article recently about GreatCall's partnership with an AI company so that patterns and changes in behavior could be reported to family members from its wearable PERS device.  Of course, tracking and reporting about changes from baselines -- that's nothing new for sensor-based home monitoring systems.   But it is a surprisingly big deal in the PERS industry -- where even those who once supported pattern-detecting big ideas dropped them like a hot rock -- in favor of the transactional PERS world -- press the button and someone will come.   The most radical changes in that industry over five years, fall detection and GPS tracking, have still been transactional -- Mrs. Smith, we are responding, are you okay? -- versus, I'm Mrs. Smith's device, and based on her behavior changes, she is not okay.

Business intelligence from wearables is a tough upsell -- but by now, it should be a given. Even the health care industry is gun-shy about the concept of configuring a baseline -- let alone have your volumes of information dumped on doctors or their unsuspecting nurses and assistants.  PERS is a pretty big market -- $1 billion or more.  Think about the numbers and price points in the PERS industry, assuming you can find the data -- they are mostly in the $29-39/month range. Buy the device, open the box, call to start the service, and done. But as the Frost and Sullivan report observes, PERS is a gateway to in-home and connected home offerings -- even complementing other health and telehealth deployments -- and fitting nicely with sensor-based monitoring.

Solve pattern detection -- and families will be reassured.  We are a long-distance family world.  Adult children worry.  Older adults want to stay in their homes -- families cannot get them to move. There are plenty of tips and suggestions to address long-distance caregiving (did you know about the Carrier Alert program of the USPS?) but nothing that really gets to the inactivity, pattern change and non-movement aspect. So if 45% of women aged 75+ live alone -- does that mean we're counting on the mail carrier to notice if something changes?  And what if a woman at that age lives in a shared mailbox community -- will someone notice if the mail is not picked up?  Or does the post office worker just move that mail into a larger storage box?  

AI is a fancy term for detecting, recording and making sense of patterns. We're not talking about IBM and Watson -- just the collection of elements of usage and comparing that usage to a baseline pattern.  Step one, of course, record the baseline after purchase. Step two, determine a price uplift for tracking changes to baseline -- at an agreed-upon interval that cannot be every minute or even every hour. Decline in activity is a pattern -- researchers get that.  Absence of activity is a pattern -- the fitness wearable folks get thatNot wearing a device -- that's a non-transmitting, but very trackable incidence, but after multiple days, it is a pattern. Store the data somewhere -- monitor over time, analyze and compare.  Combine it with room-based sensor information.  If it is useful enough, actionable enough, and cost-avoiding enough, healthcare providers and insurers will wish to detect it. And for far-away family members of the frail and alone, it represents an improvement. 

Comments

Laurie, thank you. Thank you for, again, going right to the heart of the target. Another L.O. bullseye. I'm a fan of passives, of silently monitored ADL pattern shifts, even future gait imaging as an indicator. One day, along with ADL-watch, valuable physological indicators will be quietly measured, algorithms will flag changes, quiet, private flags sent to local & remote caregivers.
If current penetration of PERS is a starting point, OK, let's get on with a passive, non-transactional enabler for aging-in-place boomers.

The wearable is a hot topic but it won't work for the old PERS users, as 83% of them wear the device less than 3 hours per week, or do not wear it at all, according to research. My company designs automatic safety and security monitoring which can be placed in home to provide hassle-free protection:
1.No wearing of device
2.No need to push stress call button
3.Not camera, not motion sensor
4.Record daily activities for behavior analysis and health management
5.Optional caregiver remote-viewing function
6.One system covers entire house

I am not mentioning my company's name as this is not a sales pitch but information exchange. Please contact me if you are interested to know more.

I think we're on the same wavelength if my "safely aging-in-place" is your "hassle-free protection.

And thanks for identifying a fundamental shortcoming of PERS. Best is a safety/security system enabled 24/7 w/out requiring conscious activation by user. Your list of six capabilities sounds like a straight-up surrogate for a live-in human care giver.

Even if not human, optimistically one that non-intrusively takes measurements, records & saves those measurements and that has the capacity to infer changes in those parameters measured. And then, based on pre-established thresholds for each metric, one that also has the capacity to report change or progression to a short list of interested persons.

Meeting the challenge for successfully observing day-to-day shifts in acivity pattern (and key somatic measures if a health care professional is engaged). Continuous, silent monitoring of known ADL indicators, no buttons to push, and near-zero false positives for the system's fall-detection feature. In my opinion, that reliable bundle returns high value for successfully forecasting trends in competency of a loved one safely aging-in place.

You leave me intrigued how a non-camera, non-infra-red system delivers satisfactory safety and security? Pleased to learn more in your reply.

I appreciate your feedback. For your specific questions, do you mind contacting me at echo.chang@agesafesystems.com? Meanwhile, if you like to check our website at agesafesystems.com you will find an illustration of how the system works. Thanks.

Hi, On 26 Nov. I was unable to open illustrations after successfully viewing the 4 block face page.

Hi, Sorry about that! Are you using Android or iPAD/iPhone? We just realized that the text-hover-over-image function embedded in the 4 blocks can only be viewed by PCs or Mac. Could you try again? Thanks.

OK, I will access it elsewhere as my tablet cannot open it.

Hi, Yes, Android tablet here. My 27 Nov attempt was unsuccessful, although each of 4 blocks reliably displayed a new momentary color shift when tapped. The 03 Dec trial produces some progress; a new text block, distinctive descriptions at each of 4 blocks. Each text block prompts to click on "top left of page" to understand how AgeSafe System works. On 03 Dec that fails each time, at any block.

As a physicist I know that even very trust-able measuring device may mislead. This is because the physical signal measured by the sensor may come from a different source in the neighborhood. I got the impression that too many developers of inexpensive PIR sensors trust them more than they should. That's for we develop ADL based on robotic agent based technologies and come to decisions based on advanced AI decision making systems. I would very much appreciate collaboration with knowledgeable caregivers, open minded to push state-of-the-art technology to rich a fully autonomous system, aimed to alert without diagnosing and call 911 without human approval. In our view it is not accepted to have false alarms, which may be in real life make 911 broken into a "quite sleeping aging person". Human supervision is still mandatory, but can't be provided to hundreds of users on the current on-the-shelf technology. A fully autonomous AI based system should provide the basic supervision and replace non existing low-paid non-professional labor.

@Passive monitor.
It is correct that we have similar thoughts and attitude toward seamless monitoring to detect changes in elder people moving and vital signs behavior. We definitely use PIR sensors, which are passive infrared sensors.
We analyze acquired data more carefully than usual understanding that not only sensors may not be perfect but there are several other changes in heat in the area of detection, which would activate these sensors.
We learn directly from real elder tenants measured data to find out the significant reads.

I would also like to note and bring to public knowledge that EU initiated a call PHC 21 under Horizon2020 dealing with early detection of risk factors. An International collaboration of at least 3 countries is required. We would cooperate with interested parties to submit a proposal, as the subject needs multidisciplinary solution as well as involvement of caregivers and other professionals in the aging related industries.

Only 5 weeks to the EU deadline for PHC21 submissions, 24 February. I believe this Horizon 2020 initiative (see link) is an excellent stimulator for international collaboration on topics & technologies for healthy aging, while at the same time I think it encourages collaborations among/between, at minimum, 3 EU-only member states. What is the North American equivalent of PHC21? If none, why none?
Thank you.
http://www.technology-development.eu/horizon-2020-health

I agree with Echo Chang's comment and would be pleased to get in contact. I initiated several years ago a Special Interest Group in which caregivers and engineers meet to discuss the need- solution related questions.
I also opened a LinkedIn Group called Technologies for Aging Well.
In my belief the problem of Aging Well is huge and requires multidisciplinary experts' collaboration. The Group on LinkedIn or any other suggested forum may serve the interested community.
Any supporting activity is well come. granot@perlis-aal.com

Good night,
I was interested in knowing more about this device, because I agree with the no-wearing factor . How exactly does it work? Thank you

We appreciate your interest. Please check our website agesafesystems.com and contact me directly for further questions. Thank you.

I agree with some preceding comments that ultimately (once technology and automatic data curation because sufficiently advanced) passive systems will be favorable, but I would like to add to the conversation that *active* systems can be of two general types: Senior initiated or third-party initiated. In my role as an Emergency Medicine physician I encountered many seniors who had a medical alert system of some sort but either weren't wearing it or couldn't operate it when the need arose. That led me to believe that until totally automatic systems could be created, many seniors could and would benefit from a daily safety check initiated by a third party. So I created such a service: It is an active system that is initiated by us, but it is passive for the senior, in the sense that "if the senior does nothing (ie doesn't answer the phone for their daily safety check) then we will contact their loved ones and eventually 911 on their behalf if necessary."

Hi, Dr. Mohseni:

The value of 3rd-party checking surely is recognizable--- it not only provides a safety check but also a people contact. The concern is emergency between scheduled calls. However, one thing is for sure---with more varieties of products/services available, the different needs of older adults in different age groups/health conditions can be serve better.

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