But at the end of the day, how do you design for all?
Boston, Portland area, October 3-6, October 14-28, 2016
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.