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Since the start of the Covid-19 pandemic, tech nice-to-haves have become critical.  Between boosting the deployment of telehealth technologies, once-delayed initiatives became instantly late. Consumers are on board with telehealth, and engagement technologies like smartphones and tablets are offered through Medicare Advantage, plus a wave of other pandemic-related tactics and free offerings appeared.  Thousands of smart speaker devices have been delivered to senior living communities.  Note that PACE programs for frail and low-income elderly are now directed by CMS to use remote technology for "activities that would normally occur on an in-person basis," such as scheduled and unscheduled participant assessments, care planning, monitoring, communication, and other activities.”

That was then… In early 2020, focus sharpened on market categories of aging and caregiving. AARP published a new report that showed growing interest in technology among those aged 70+. The 127,000 CES 2020 attendees in January saw exhibit areas and innovations focused on older adults and what they need. Cambia Health released a survey of caregivers, 64% of surveyed caregivers use at least one digital tool to help them with caregiving. The National Alliance for Caregiving surveyed caregivers including their use of technology (surprisingly low), and Samsung, Best Buy and Amazon now group offerings that could be helpful for older adults and those who care for them.

During Covid-19, do older adults take their prescribed meds?  Not necessarily. Medication non-adherence has long been a topic of concern, with the cost of poor adherence amounting to $177 billion each year, 50% of treatment failures, and as many as 25,000 deaths. And according to the Pharmacy Times, Covid-19 has made a problematic situation much worse.  Some pharmacy experts express concern about the pandemic’s side effects of isolation, job loss/loss income, medication costs, missed or unavailable doctor’s appointments, or issues with package delivery.  And the CDC has expressed concern about risks and modified procedures for older adults and pick-up of prescriptions in pharmacies.

Covid-19 sharpens the benefits of teleaudiology. Half of those aged 75+ and one-third of the 65+ have hearing loss. During the pandemic, telehealth use grew sharply in the care of older adults, enabled by CMS reimbursement changes that likely will be permanent.  It’s also likely that teleaudiology (the utilization of telehealth to provide audiological services) will gain additional importance when face-to-face visits are worrisome, even impossible in some locations. As with other market segments, the hearing health market saw the opportunity to promote their teleaudiology (or tele-audiology) services for those who already own telehealth-capable hearing aids that may need adjustment. Some may require a smartphone app and in-office guidance from the audiologist to get started with it, or at the least, read an explainer about "merging face time with FaceTime." Here are five examples – content is from the vendors:

June -- it was the worst of times.  Who can comprehend that 43% of Covid-19 deaths are linked to nursing homes? Who could have imagined the economic impact of job loss and (almost all) business shutdown?  Who could have speculated that senior living organizations would have occupancy levels nationwide below 88%? Who would have thought that telehealth definitions would include phone calls and Facetime?  Most importantly, as so many families were reminded, their aging relatives had not adopted any of the devices and software that would enable face-to-face communication. Or that high speed internet would not be available in nursing homes or the dementia care units in assisted living where their relatives now lived. Let’s hope July is better! Here are the five blog posts from June 2020:

Reading about big tech controversies can make you sigh.  Rant on. You may remember when the browser arrived.  Maybe you knew about Mosaic in 1993 or Netscape Navigator in 1994.  But you probably did not try them unless you were a geek -- because there wasn’t much to look at then on the so-called World-wide-Web.  Apple’s Safari did not appear until 2003 and Google Chrome in 2008 – eventually these dominated the browser market, though three cheers for the existence of privacy-oriented browser Brave (2016) and search tool DuckDuckGo (2008). No doubt both will disappear into acquisitions. As for social media, things really got going with AOL Instant Messenger in 1993 -- then all was pretty quiet until 2003-4, when LinkedIn, MySpace, Skype, and Facebook all arrived. 

You see PERS news releases on occasion. PERS -- Personal Emergency Response System -- is a long-time market dominated by pendants worn around the neck. Recently Parks Associates sized the PERS market to be $1.1 billion by 2024 -- others think it is a $3.1 billion market today. Also early in the year, Vidapoint was announced as a 'global' low cost offering. LifeStation announced Mobile LTE, small and fast, a pendant linked to a sizable 24-hour call center.  Then in April, Verizon does it again, launches a PERS, this time a smart watch offering, called the Care Smart Watch for seniors.   Let us remember Verizon’s last short attention span for this space. Its Sureresponse™ PERS pendant was new in this research conducted in 2012. The quotes are from executive Jonathan Hinds who departed in 2014, not coincidentally when Verizon stopped selling it. Sureresponse was mostly erased from the Internet by 2016, except for user documentation,  online reviews, some not so hot.   

https://locatemotion.com/remote-patient-monitoring/Telehealth – the genie is out of the bottle.  In March, the government announced expansion of telehealth access, noting that it would raise the reimbursement rate for telehealth visits during the Covid-19 pandemic to match the doctor’s rate for in person visits, as Seema Verma, the head of CMS noted: ‘the genie was let out of the bottle’ and won’t likely be put back in. The regulatory change enabled "the use of smartphones, video conferencing platforms such as Zoom, and messaging services like WhatsApp; and the ability to provide care across state lines in 48 states."

The articles are beginning to appear here and there.  In the time of Covid-19 lockdowns, some are talking about an increasing use of technology in their nursing homes. Others are discussing the race to enable ‘televisits’ -- noting outreach from AARP to CMS to boost the requirement for enabling technology in nursing homes.  And numerous other articles have appeared that showed nursing homes receiving donations of technology. The State of Florida gave tablets to 150 nursing homes. The attorney general of Massachusetts supplied 750 tablets to nursing home residents. And Texas provided $3000 per Texas nursing home for tablets, webcams, and headphones. The pictures associated with some of these introductions of technology were bleak. Fortunately, some states are now allowing families to visit residents in designated areas outside.

Will results change when older adults are surveyed later this year? So we know that ‘remote care’ and ‘caring’ in its various forms, including telehealth, seem to be heating up as a priority, whether for senior living organizations, families, healthcare provider organizations, and putting more emphasis on the need for home healthcare and home care, especially in times in which the care workers hesitate to enter a home and which families are locked down and not visiting.  Here is where we were on technology adoption at the start of the pandemic, and the wave of telehealth interest heated up.  As one tech company told me, a one-year-pipeline compressed into a month of demand.  And a plethora of companies raised their hands to offer their engagement technology for free.  So if this is the baseline of adoption, what’s next when the surveys come around again?