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If you have an XHealth hammer, everything looks like a nail

So if you think about an aging 'tsunami' -- doesn't it just make you think of mHealth and iPhones? Rant on.  I was on a call yesterday about an upcoming 'caregiving' and technology event -- as the call proceeded, the topic turned toward low-cost mHealth applications, ubiquitious at a Price Waterhouse tolerance level of $5 per month. [Side note -- PWC doesn't like 'mHealth', so they have renamed it 'Healthcare Unwired']. This week's Health 2.0, next month's Connected Health, not to mention eHealth, telehealth, wireless health, healthcare unbound or unwired -- now that's a tsunami. Note the $2.2 billion of new investment into biotech, medical devices and health IT -- just in the 2nd quarter of this year. 

Health IT investment hype has a Déjà Vu dimension. Apparently investors believe that 'better information technology is critical to health reform because it can minimize waste and reduce errors by caregivers.' Let's reflect on a quote from 2007: "If all hospitals had an HIT system including Computerized Physician Order Entry, around 200,000 adverse drug events could be eliminated each year, at an annual savings of about $1 billion. Most of the savings would be generated by hospitals with more than 100 beds. Patients age 65 or older would account for the majority of avoided adverse drug events." Unfortunately, it's still an ongoing problem, despite the 2004 strategic imperative for consumer-centric and information-rich health care.

When tech is the topic, an aging 'tsunami' is about the future, ever-moving from where you stand. One commentator on the mHealth hype recently noted that if one wanted to, there was something m-healthy to attend every week from early September to Christmas. What a thriving event business. And just today, as part of the rolling future-perfect visions for the use of EMRs, the "Surgeon General says they are a must!" EHR, PHR, and the XHealth tech movements all describe a transformational reduction in cost and error, just an all-around healthier world, on top of that sucking sound of money -- emptying the pockets of investors and the multi-tiered health care system for lo, these many past and future years. What they mean when they think of an aging 'tsunami' is a future world in which the patient is old, the diseases are many, and the hospitals are filled with folks that overwhelm nurses, ICUs, specialists, admission and discharge processes. The solution? More tech investment.

What these conversations are not about -- struggling caregivers, isolated and frail seniors of TODAY.  So while all this amazing and ongoing fascination with 'Xhealth' investment swells into a tsunami, most business investors and innovators don't seem to think about how to use technology to help real caregivers with their balancing act. Or focus their energy on technology solutions to help mitigate loss of memory, compensate for declining motor skills, tackle the increased risk of forgetting or wandering, monitor care recipients while caregivers take a break, or reduce isolation for the frail or aging. For those, we have research projects like the Carnegie Mellon MemeXerciser -- years away from being a useful product, along with home-care robots and other whiz-bang projects from this-and-that graduate program from here-or-there university. Meanwhile, there are numerous vendors out there searching for funding, struggling to train senior care referral organizations, working to gain the attention of buyers and slow decision-makers and influencers in the senior-related industries.

Today's seniors aren't m- (or X) anything.  Forrester Research's latest survey of 37,000 consumers outlines the generational technology gap we could have guessed: only 4% of the 66+ population surveyed have smart phones -- 37% of that 4% have iPhones -- that's just 547 iPhone users in the 37,000 consumer survey set. So I'm just guessing, but I bet those iTunes health apps aren't reaching the older consumer. And let's just not talk about those tiny BlackBerry keys, where I delicately try to isolate a tiny shift key so that I can enter my zip code. Ironically, according to the Forrester survey, seniors use quite a bit of tech in their lives:  67% of them have cell phones, 44% have a digital camera, 26% have a laptop, 51% have a desktop PC, and 41% have a high definition television. In fact, 24% have more than one PC.  But those health-related apps? Nope -- 35% are looking at photos, 36% are playing free computer games, 30% are managing finances/taxes, and (how unfortunate) a whopping 34% are scanning for viruses, spyware, or adware. 

If it's always about the future, the future never arrives. If we redirected some of today's investment dollars to the present population, investing in their awareness of infrastructure tech and tech-enabled apps and services, the future would result in more empowered older adults and a more viable marketplace of vendors to serve them than we have in the present. So, oh investors and innovators, all of you XHealth types racing to seize the opportunity to help lower costs by providing technology for patients and their self-management of chronic diseases. Siphon off just a trickle from that boatload of money. If first you could boost today's seniors' usage of infrastructure technologies like those noted above in the Forrester survey, the future could be different than the history of health IT investment.  Maybe the overwhelming tsunami of future aging populations and the struggle to care for them will turn out to be a drop in the bucket -- because we figured out how to mitigate issues today.

Rant off.


Excellent observation Laurie. Do you know of any vendors, caregivers, Assisted Living Associations, Hospitals or Universities who utilize a "Seniors User Group" for all seniors to add thier two cents? I wonder what they would really say about many of the products out there today.

Maybe it is time to start a new blog for Seniors and Care Givers to share their wants and needs and determine the real value of technology. One video call from a grandchild can change the world of a senior. One video call a week from a distant caregiver could help reduce caregiver guilt, reduce use of sick days and non paid days off and enhance the life of the senior. Outside seminars on yoga, flexibility, grieving,art, religion, politics, attitude and motivation just might replace one of the bingo, domino, card game sessions and add value to the social aspects of seniors.

Keep up the good work.

Ah yes, the tsunami of terminology, not action! And only two or so years ago, the challenge was to keep the 'teles' straight.

Funny how we are distracted by the future--maybe because it's simpler to look at a distance than to deal with the absurdly complicated present and concentrating on this non-glamourous problem. We've been in 104 card pickup with 'health reform' for two years and in my view that's a large part of reason why. EHR--another reason. It's all tied to the disease model and yes, it makes money.

Having written three rants on two days over at my website on how we are misapplying resources in the present, and overly focusing on the future, I'm as appalled as you. All the smoke and fog is a great excuse for the players NOT to commit, not take action...after all the future will have something better. And providers and insurers continue to dodge away...and go to conferences. Helluva way to run a war.