Acute shortages of home health aides and nursing assistants are cropping up across the country.
Boston, Portland, ME May 1-May 15, 2017
Washington, June 1-5, 2017
Toronto, Ontario, June 21-23, 2017
Seattle, WA, July 11-12, 2017
The GE-Intel alliance -- with an associated $250 million of joint investment over the next five years -- announced this past week could get everybody in the tech industry excited. Even the business pundits that watch them are all aflutter about the possibilities for aging in place technology. I think some perspective is in order, though. Let's place this into a larger context.
Like many alliances in the tech world, and especially in this tech world, research efforts can disappoint and alliances of tech companies can underwhelm with results (see this Google-IBM analysis). On the other hand, it's good that the firms noted the overlap between the need for home health monitoring and a projection of the US aging population, 71.5 million people by 2030. Oh well, they stopped just short of saying that the investment was about seniors and aging. But this is GE-Intel, great, right? Well, nothing is perfect.
Investment is tiny and nearly inconsequential. According to GE-Intel: The market for "telehealth" and home health monitoring is forecast to grow from $3 billion in 2009 to an estimated $7.7 billion by 2012, according to GE and Intel. But apparently, GE does not plan to dominate the market near term. The giant firm reported $183 billion in total revenue in 2008. $17 billion was in healthcare -- medical equipment including CT, PET, MRI, nuclear, and X-ray imaging systems, sold to hospitals and medical facilities. Home healthcare is mentioned nowhere in their guidance to investors about what they're doing. Of course on the plus side, QuietCare can now be located on their website. So that's good.
Intel -- lots of research, one product. Intel, with more than $40 billion in revenue, announced one health-related product, Intel Health Guide, in November, 2008, priced at around $1200, not reimbursed by insurance, after several years of research and numerous partnerships. Although the product is expected to be used by doctors to help remotely monitor patients, if other tech adoption by doctors is an indicator, uptake on this may be slow, significantly slower than the government-injected funding for electronic medical records, currently adopted in a small percentage of medical practices -- not necessarily saving money. And, as the Times article in February noted -- doctors are still skeptical, waiting for a study on home monitoring to confirm usefulness.
Seniors -- today -- need more tech help - think about hospital readmissions. So this has been a bleak week for health-related news about seniors. Readmitted patients, or 20% of all Medicare beneficiaries, need to be readmitted to the hospital within 30 days of discharge, costing $17.4 billion in 2004. Oops, not only were they not monitored at home, but apparently more than half didn't leave the hospital with follow-up doctor appointments.
Seniors -- today -- need more tech help - telephone monitoring is a failure. So how did it go in the demonstration program of telephone-based monitoring of Medicare (read senior) individuals with chronic diseases? Not so hot -- none of the programs reduced Medicare expenditure. Advice from those who studied these 'underwhelming' results? More in-person visits and coordination of care with the doctors. I would argue that contact does not mean 'in-person' and that coordination of care from the doctors' office does not mean that the doctor has to be on the phone with care coordinators or with the patient. Think differently and...
Pick up the pace -- GE, Intel, Microsoft, Cisco, IBM -- you can do more with more. So let's imagine a scenario of all Medicare beneficiaries who lived in independent living apartments, assisted living, continuing care communities, retirement homes. Let's picture these homes with a wireless network in their broadband-capable apartments, where home monitoring sensors were a given -- passed through as Ecumen does in the WSJ article as part of the cost of the unit. Let's assume that home monitoring vendors -- like GE's QuietCare, but also vendors like Healthsense (eNeighbor sensors), Halo Monitoring (fall detection), GrandCare (home monitoring), Zume Life (chronic disease) or Philips (medication reminders) and low-cost PCs or and easy-to-use PC interfaces actually enabled the Internet -- and its self-help guidance to be available to boomers and seniors. Somehow, I imagine that readmissions would be fewer, that Medicare cost curves could flatten with enough determination and behavioral incentives.
If everyone waits for the baby boom, boomers are doomed. Hidden in the other bad news this week was the not-so-pleasant article about the risk of hospitalization-incurred blood clots. So it turns out that these clots are fatal 30% of the time, that risk is highest between age 41 and 60 (gee, that sounds like boomer to me), and that risk is greater if you have a hospital procedure that lasts more than 45 minutes. And let's not get me started on the risk of MRSA or C-DIFF infections while you're in there. Now call me gloomy, but the pace of investment in technology for remote monitoring of seniors, including those discharged from a hospital, of course, seems to be paced for the baby boom to have fully boomed into old age. But seniors are in trouble now, and as we near a hospital, we're all in trouble.