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From 101,000 to 422,000 -- mostly women.

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Our future mobile health opportunity, oversized and underdeployed

Apocalypse and opportunity -- the bet is that we're not going to age well.   Our favorite gloom-and-doom source, CNBC, has offered up today's Doomsday Boomer Prediction. Those boomers are going to be a healthcare nightmare: "They visit the doctor more, they consume more services, and they aren’t afraid to use their $7 trillion in collective wealth to improve their quality of life. From physical therapy, to cosmetic surgery, to the latest in life-saving technology, Boomers just aren’t built to grow old gracefully." So inventions of every type are being crafted to help us in our quest to fight this gracelessness and support us as we get old enough to really take that predicted 8% Medicare spending bite out of the GDP by 2035. 

Hold onto your hats -- mobile health will save the day. GSMA, the global mobile industry trade association, according to Mobile Health News, has discovered 'mHealth' as a growth driver, and they have some numbers for us: worldwide savings of $175 - $200 billion for effectively managing chronic diseases -- $21 billion in savings in the US. Says the CMO for GSMA, Michael O'Hara (formerly with Microsoft): "mHealth devices and services will enable providers to diagnose disease, manage complications and intervene ahead of acute events, such as a heart failure, through remote monitoring and also improve compliance with treatment programs like medication reminders, care giver alerts and smart pills." In that same article, "O’Hara also pointed to locator devices for dementia patients as a key example of mHealth."

And spending on mobile health -- that's going to go up too.  According to MobileHealthWatch, a Harris poll indicates that 80% of Americans want "mobile healthcare services delivered from smart phones, wearable bio-sensors and disease monitoring devices." So I hope someone nets out the spend and the savings -- spending on telehealth "mobile apps and services is expected to grow to $6.1 billion by 2012" according to Data Monitor, although, sigh, the general telehealth category still has not yet reached broad adoption by medical practitioners.

Have we been here before? Have you ever noticed that when an industry category or particular product doesn't succeed, it is renamed and re-launched as new and exciting -- hopefully not to be associated with the previous name or dashed expectations? And further, the 'new' category sweeps in the prior generation of products that still have utility? Thus goeth telehealth which maybe has too much 'tele', not enough 'health,' more likely too associated with limited adoption and growth.  Enter eHealth, broad enough to encompass all of health information technology (HIT), and mobile health (mHealth), the subset that is all wireless, whether in the home tracking us, out the door tracking us with our wearable devices, or notifying us or our doctor (dream) about what's going on at home. 

Not the future -- products are here, now.  Remote monitoring, tracking of dementia patients, caregiver alerts (from activities, changes in condition, or emergencies, as with PERS devices), medication reminders, these have all have been introduced and around for some time now. Maybe as mHealth products and services, they will be reimbursed (dream) or be clustered at the end of the aisle in Best Buy or Walgreen's (perhaps another dream), where we consumers can pick one up.  Maybe there will be an online shopping environment where we can easily locate them, either for ourselves, or for family members.

A plea -- let's stop sizing the future and commit to the present.  What is the plan to take all of this mHealth and deploy? Our senior population needs help now. They are at risk of falling in their homes, they struggle (even inside independent living, assisted living, and nursing homes) from isolation and most importantly lack of monitoring when they are alone in their bathrooms, their bedrooms or en route in between. The result is danger, disease, and suffering. What's the plan to put all these smart mHealth brains together and get cheap, easily configured, useful, wearable, mobile health devices together bundled together into a solution to save them -- now?

Thoughts welcome.





Good thinking, and -as you said- the products are not science fiction.
One of the key aspects for elderly is usability/userfriendliness.
I'm convinced that mass 'consumer' products (and NOT 'medical' products) will very soon offer lowcost and userfriendly solutions for elderly. Reimbursement might not be an issue as solutions will be affordable.
Sure you'll products like these:
Shamelessly plugging (overview of mhealth solutions + trends):

Thank you for the very informative links.

I think the iMonSys product will really catch on...once it is succesfully used by local QAIP initiatives.

I think there are a couple of things that will help make technology more widespread in the senior services/lifetime wellness space:

1. Long-Term Care Financing: I think the CLASS Act (long-term care insurance), which is in the Senate and House health care bills will help elevate the need/understanding for Americans to plan for how they want to live and how to pay for it. No one wants to live in a nursing home. With the CLASS Act, more people will have dollars for supportive services. Where are they going to put their dollars? Toward things that will help them live more independent;y. Most people right now are clueless as to how this stuff gets paid for - many think Medicare will just pick it up. The CLASS Act begins to change that paradigm nationally.

2. Senior Services/Technology Collaborations: If there's a technology product that provides huge value for the customer, senior services providers are going to be all over it. Because if we have something that totally sets us apart from competitors we're apt to use it. Take those life alert pendants, for example, we all use them. Quietcare from GE or other health sense products... some of us use them. But it has to sell, it can't be just a gee whiz thing that would be cool, but at the end of the day provides little value in the customers' eyes.

3. Integration of Acute Care and Sub Acute: At some point, America or individual states have to say - we can do chronic care differently. For example, nursing homes could become chronic care centers/medical homes and likely limit expensive bouncebacks to the hospital. As there is more collaboration between hospitals and senior services providers, there will likely be more use for technology to benefit the person - and likely real showings to government that this helps limit health care costs, thus more sane, more rational reimbursement for results.

I'm an optimist, but innovation in senior services and accompanying technology will get better or we're all in a world of hurt.

Eric Schubert

In reply to your question:

"What's the plan to put all these smart mHealth brains together and get cheap, easily configured, useful, wearable, mobile health devices together bundled together into a solution to save them -- now?"

There is no plan. No one with vision has stepped up..taken a "holistic" view of the diverse quality aging needs of (soon-to-be babyboomer) seniors and their caregivers..and produced a cogent, inclusive, actionable "aging in place" model/plan.

Everyone is busy in their own hive/silo..and few, if any, are "system modeling" an ideal quality aging in place path for local communities around the USA. Such a model would encompass existing and emerging aging in place ("AIP") ideas, services, products into a prescriptive AIP model.

Better integration and performance of existing local eldercare resources, universally designed new homes, home-modification assistance, "smart homes' built for mHealth applications-all should become part of a "Quality Aging in Place model ("QAIP") which
rationalizes and integrates the entire aging in place "space".

For starters I recommend wannabe visionaries brush up their systems thinking by reading THINKING IN SYSTEMS by Donnella H. Meadows who was the lead author of LIMITS TO GROWTH.

A review of the book can be found at

I'm assembling info pertaining to a QAIP model now and I intend to begin some field research in southern Utah in May.

Thanks for the interesting blog post, but you need to appreciate that Mobile is the newest and least understood mass media.

Before mHealth can reach its potential and advance the Healthcare process providers and patients must utilise the new abilities it offers us (just as TV allowed broadcasters and advertisers to utilise new techniques to do something different from what had been done before on the Radio).

On my blog I've summed up the 8 Unique Abilities of Mobile as the newest Mass Media and given rather simple examples of how they can be used to advance the healthcare process:

Hope you find it opens your imagination!

Hi Laurie,

I couldn't quite work out in the end whether or not you are complaining about the proliferation of terms. It seems to me that this phenomenon is typical of an industry in its early stages of evolution, when people are thrashing about with new concepts and trying to position their products and services in a shifting scene. (I must admit I've had a bit of fun lately pointing out the different adoptions of the concatenated term 'telehealthcare'. Search Telecare Aware for it if interested.)

However, I heartily agree with your plea to "stop sizing the future and commit to the present" but I do think this tendency, fuelled by consultancy companies with expensive reports to sell, is a rather culturally conditioned US phenomenon, driven by Americans' obsessions with health care costs and desire to make quick (and large) bucks.

In the UK I suspect we have a more laid-back view of these things based on our experience of trying to introduce it into the NHS: telehealth technology (as in remote patient monitoring) works, but the stumbling block to uptake is lack of knowledge or downright resistance on the part of the people in the healthcare system who would have to adopt it and make it work for patients. We therefore tend to be cynical about predictions of rapid speed of uptake and its scale. I read the other day that it took 10 years for something as simple as the use of statins to become the accepted norm in medical practice. That puts the telehealth adoption problems into perspective for me!

The 'cure' for this, as you said, is to focus on 'now'. To get stuck into providing what we have now to people who need it now.


Editor, Telecare Aware

To add on to Steve's comment, I'd agree that the cycle of adoption both by consumers and by professionals has been frustratingly long, much longer than anyone anticipated in those bright sunny days only a few years ago. You couple this with the general investor/VC mindset of a quick and profitable turn on investment with the corresponding pressures on company execs--and the two do not match up. (I doubt any difference on either side of the Atlantic!) There's a longer haul here than anyone anticipated. One of the results is half-hearted, poorly funded and uneven sales and marketing when it's needed most. Another observation (not statistically tested or clinical): both entrepreneurs and VCs seem to have a fair dose of ADD. So the 'workable now' winds up at the side of the road and it's on to the next bright, shiny, sexy thing.

Re the statins--my observation is that about 10 years ago, the large pharma companies also succumbed to short-term thinking and pushed the top end 'blockbuster drugs' at the expense of R&D. Now there's little in the pipeline and a great deal of risk avoidance (what's new is often 'acquired' or licensed from smaller companies who take on the risk). Meanwhile the FDA is slower than ever, insurers, medical practice are still quite slow to adopt.

Editor, North America, Telecare Aware

The modern day lifestyle and stress has increased the incidence of dementia and Alzheimer’s patients all over the world. As more and more elderly get affected by these memory loss related diseases, they become a growing concern for their caretakers. Whether their caretakers are their children or individuals from various NGOs or senior care centers, keeping track of such patients is always a task. Some of the most prominent issues with taking care of patients suffering from Alzheimer’s or dementia are keeping track of their medication and location. Especially, as a slip in either of these could lead to fatal results. The Vyzin Empowered Security And Guidance (VESAG) watch offers a practical solution to both. The VESAG watch is not only a wireless health monitor that keeps a track of the patient’s key health parameters, but also offers the ability to set customized medication reminders and has a GPS tracker.
The watch helps monitor the blood pressure, blood sugar, heart rate, pulse, temperature, etc. of the patient and also sends alerts when these parameters reach alarmingly high levels. The medicine reminders give such patients a sense of independence and confidence, as they do not have to be constantly reminded about taking their medication. It also assists caretakers in providing effective health care. The in-built GPS tracker is especially useful when such patients wander away. Their whereabouts can easily be tracked by placing a simple call to the 24/7 support team of VESAG.
In addition to alerting emergency response teams when the patients are distressed, the VESAG team also informs the caretakers of the situation. Since the watch stores vital health related information such as the blood group of the patient, surgery history, allergies, etc., it becomes easier for medical teams to act in case of an emergency. The VESAG watch, thus, not only helps monitor such patients, but gives them a sense of security.


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