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Personal Emergency Response Systems: Moving beyond fear

PERS – A long-time tradition. The Medical Alarm Systems and PERS (Personal Emergency Response Systems) industry is long-standing and largely unchanged from the days of Lifeline, prior to its purchase by Philips.  This business segment has historically focused on the at-risk individuals who are 65+ with a typical user in the 75-85 range. Today, the industry is variously estimated from $1 to 2 billion in North America, largely based on monthly service plans that guarantee the immediate availability of staffed professional call center response. Those staff members contact relevant and local emergency responders such as EMTs, family, or 911, pre-configured in their systems once the device is activated.  Traditionally, the devices transmit from the wearer to a base unit nearby.

Market transition is underway.  Recently new mobile entrants, recent industry mergers and acquisitions (e.g. Tunstall/AMAC, Verizon/Hughes, MobileHelp/Halo), and notable changes in technology mean that a once-stable industry is facing a future competitive landscape from multiple sources. These include, but are not limited to smart phone applications, wearable chronic disease monitoring devices, major health systems and insurers, as well as communication carriers – any and all adjacent business segments that view baby boomers and their parents as a market opportunity. And if the industry has been profitable at $29/month or more, what is the price threshold for a more comprehensive solution?

The technology times – they are a-changing. The technology world around these pendant/watch devices has changed dramatically and the industry is at an inflection point in history due to the growing availability of the following capabilities, moving down the stack from unique applications and becoming expected infrastructure components:

  • Fall detection.  Now available (embedded in the Philips auto alert offering) but is also a basic characteristic of smart phone accelerometers, and could be a required feature. 

  • Mobile. mPERS has been introduced and is steadily gaining customers and large vendor interest (for example SecuraTrac, GreatCall’s 5Star Responder, and MobileHelp), Verizon’s SureResponse, or likely future offerings from AT&T, T-Mobile, and Sprint.

  • GPS tracking (available on all smart phones). This includes the ability to position customers on online maps so that they can be easily located.

  • Vital sign monitoring. Today this is a growing and largely separate mHealth, eHealth and telehealth market. Some aspects, including fitness/cardio tracking, have the potential for becoming basic PERS requirements. Consider the Weight Watchers-endorsed Philips ActiveLink, Fitbit, or among numerous players in the emerging wearable health device segment.

  • Smart phone PERS applications such as Guardly and vSOS have been introduced, today targeting the worried young, but as smart phones become easier to use and penetrate the 75+ population, what was hardware-based may increasingly migrate to software.

A stable industry will fragment – broader solutions will take its place. We all want access to an emergency response solution – for ourselves, our children, our aging parents, to reassure families, to guarantee help when it is needed. But another word for the historically stable industry might be 'inflexible' – and the PERS industry has stuck to its knitting for too long. For seniors, is it really the fear-driven "I’ve fallen and I can’t get up?" or is the scenario more complex? Is the target user an 82-year-old woman -- or is this solution not about age at all? Perhaps a person thinks: "I am alone, it is depressing, why bother going out, taking my meds, or properly managing my chronic disease? Who will notice?" Is the only way to get attention to press a button on a pendant, have a brief and timed conversation with a friendly rep, hopefully in my own language, who asks me if I am okay? If I say yes, this nice rep says a very friendly goodbye and quickly moves to the next call.

We are asking -- and will seek answers to these and other questions. Underway now, LinkageConnect is fielding a survey of 1000 or more adults age 55+ about their perspective on PERS. The survey has been launched -- expert interviews have begun, insights are emerging about future technology possibilities and trends, and potential for change. We will post a summary of the research when it is completed during the first quarter of 2013.  If you also have comments about the future of this market, please post. The more we learn, the better the result. 

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The technological advances you speak of here, Laurie, are amazing. Add another one to your list, from a company named Care Technology Systems, (www.caretechsys.com) which launched an active PERS at the mHealth Summit early this month with the potential of predicting -- and therefore preventing -- falls. Exciting times.

PERS are one of the most important things we (Northstar Care) recommend during our assessments. I'd like to see fall detection universal across the market. Its difficult to recommend a service without it. This has been the Achilles Heel of PERS for ever. Something that detects sharp physiological changes beyond a programmed threshold is needed. Consider a sitting person having a massive stroke unable to press the button.

Thanks for your article.

-Mark (Zilberman, LCSW)

I think Mark is right but we, at hip-hope, think that detection is not good enough and prevention is called for. Our R&D team is working on a wearable belt (almost the size of a standard belt)that will detect fall during it's occurance and inflate personal air-bags that will reduce considerably the impact on the hip.
Of course SMS or any other signal is sent to the PERS



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