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Mobile musings after the mHealth Summit

If you have a tablet, everything looks like an mHealth app. It was an mHealthiness week at the Gaylord as the NIH-sponsored mHealth Summit was convened for its third year, with 3600 enthusiasts and 300 exhibits. Walking around the non-Qualcomm and non-Verizon booths, it was one of those ‘Who ARE those guys?’ moments from Butch Cassidy. And I mean guys. Walking onto the Exhibit floor late Tuesday afternoon, there were guys everywhere and a bit of the American Telemedicine Association persona, with many devices and apps oriented toward tablet- and smart phone- intrigued doctors. And some were even for patients!  Read a great write-up by Lisa Suennen on Venture Valkyrie or check out just-the-facts iHealthBeat. The bottom line for me after a walk around and around – virtually nothing at this event (or at the ATA for that matter) demonstrates vendor interest in ‘seniors’ and chronic disease -- except these cool slippers in the Verizon booth that were developed by 24eight. That must make sense in only one sense – as of 2011, according to Pew Research, fewer than 11% of the 65+ population have a smart phone and 2% own a tablet. But oh well, no problem, notes the CDC, 80% of older adults have one chronic disease and 50% have at least two. 

TLAs and the left-hand, right-hand problem.  I am reminded of how many organizations with overlapping but non-coordinated goals there are out there – just think about the NIH, CMS, CDC, NSF, AMA, ATA – and that’s only the Three Letter Acronym organizations and their recent activities related to aging. Each is funded separately, each is trying to boost the awareness and lower the cost of healthcare service delivery.  One of the Summit exhibitors told me proudly that his organization was the recipient of 18 (count ‘em, eighteen!) NIH grants. Is that good? To mix up a few metaphors, that seems like a waiting-for-Godot level of unfounded optimism. And Godot is, of course, the future CMS reimbursement of the cost of the apps, devices, carrier charges or whatever it takes to enable telehealth, mHealth, and the other transmission-dependent xHealths. Until then, mHealth will likely elude seniors – who don’t as of yet own the base platforms anyway.

Is Fitbit a technology with senior potential?  It intrigues me when products or apps appear that could be useful to older adults, but product marketers envision a younger audience. This past year, a number of smart phone Personal Emergency Response System (PERS) apps-with-call-centers appeared at the $9.95/month level (versus the $29-and-up PERS pendant service market). Similarly, Fitbit and Philips Direct Life could be useful to seniors and instead are marketed to the Quantified Self "I count stuff, therefore I am" folk.  But this Fitbit device has quite a bit of potential to compete with more expensive senior-focused products – if it had the appropriate apps and target marketing. For example, in the senior housing arena, WellAWARE Systems tracks sleep disturbance trends through a bed sensor system and reports trend analysis about sleep disturbance and getting out of bed (and costs more than $99). Fitbit has a wrist wrap to wear at night that reports the same trend data. What if a $99 Fitbit was clipped onto the clothing of willing/opt-in residents in senior housing – let's say just folks in Independent Living, for example? What if the wearer shared information about steps and sleep with a wellness nurse, reports would show that Mrs. Smith or Mr. Jones exhibited declining activity levels and poor sleep before each felt ill enough to contact a doctor.

Philips DirectLife comes with a 12-step program that could work in senior housing. After wearing the $149 Philips DirectLife Activity Monitor for an assessment week, device owners then begin a 12-week program that monitors their activity progress and reported weight loss – which, like Fitbit, tracks 'body motion every time you move up, down, forwards, backwards and sideways.'  Now why wouldn’t an enterprising senior-focused apps vendor partner with Fitbit or Philips DirectLife and market to a large senior housing organization or hospital system that is motivated to see that discharged patients are up and around?  To me, that would put the 'mobile' into mHealth and apply it to a population that could stand to get up and go.




Dear Laurie, You just get better and better at hitting the nail on the head. I was not surprised to see you at mhealth. I was more surprised not to see some folks who I thought I would see. Where are the lines? Who is drawing them? and why won't they STOP?! Healthcare VS LTPAC (long term post acute care). Why is this stuff erecting more silos when tearing them down is the only way to build a system for savings (and dignity).

I asked a few vendors how their medication monitoring systems to keep people from being readmitted interfaced with a ride to the doctor...and got plenty of blank looks. Most of these folks have blinders on about the system they are building for. Even worse some have done so little research that they think there is a system out there! Then to add the Fitbit 'hint' shows us just how much there is to know, and who knows it. Thanks for being thoughtful and insightful.

Silos indeed...great observations and insights here! Look at putting the tech where it can do the most good! Good job!

mHealth is the trendy thing now, and let's face it, older adults and chronic conditions aren't sexy. Anything on smartphones and especially tablets are. Waiting for Godot? More like Six Characters in Search of an Author....or Dead Man's Curve.

I've included your article in a roundup on mHealth Summit over at Telecare Aware http://tinyurl.com/c9sbw2z.

Thanks for all the information over many months. I have tried the Fitbit. I find it too complicated to have much benefit for the older adult community. I am now trying the Jawbone UP wrist bracelet. It monitors activity and sleep as well, but does not require removing it to put on a wrist holder. It is starting to get close to being practical for the regular world. Take a look at it. Charging the battery for longer term use is still a struggle before it will help.


I am a big fan of your blog. I have been pondering the opportunities (and lack of movement) of technologies for seniors. I have a child on the autistic spectrum. Many of the issues regarding children to increase independence safely are virtually the same as for seniors- just moving in the opposite direction. I attended a session on technological interventions for parents of autistic teens and a few monthes later attended the Geriatric Care Managers Association conference. They were surprising similar, except that for the kids that had better interventions. I would love to pick your brain some time.


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