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Six observations from Tech-Enabled Home Care 2017 Research

Tech-enabled home care -- what does the interview research reveal? The report will be posted later this month, but specific insights emerged after speaking with 21 leaders in the home care business and technology segments.  The interviews are completed and the report is drafted. Here are six predictions that are drawn directly from that process:

  1. A continuum of care will have a continuum of contracted partnerships.  Hospitals are striving to reduce the risk of readmission through discharged-to-home-care programs. Rather than manage multiple and fragmented relationships, these programs will be formalized with home care companies, who in turn will partner for the service elements they cannot directly provide, such as transportation, meal and supply delivery. 
  2. Viewable information and tools for families will be service differentiators. In its 2016 Caregiver Innovation Frontiers report, AARP presented six categories of technology that would be needed to support family caregivers. Care coordination was one of those categories – and supporting care coordination software is a relatively recent market category.  According to AARP, “only 2-3% of patients with chronic conditions have reported receiving support from a care coordinator” – representing a strategic opportunity recognized by the home care industry.
  3. Wearables and sensors will become standard in both home and home healthcare.  While the use of Personal Emergency Response System (PERS) devices has long been accepted, the use of the next generation of so-called fitness wearables and in-home motion sensors will likely be recommended by doctors and checked by in-home care providers – checking vital signs, but also whether the patient got up from a chair and walked.
  4. All home care aides will be certified to provide a standard of care. The government reimburses for home health aides, they are required to have “successfully completed a training program approved by the Secretary.” The federal overtime rule in home care may trigger a national standard certification for home care workers and a set of standards applied to care.
  5. Tech-enabled home care services will be self-funding and profitable.  While startups launched in a wave of venture capital investment, they will ultimately need to become profitable -- or be acquired by companies that are profitable.  Becoming profitable will be dependent on managing the right mix of work between in-home direct care with tech-enabled oversight and services.
  6.  Standard check-out home care procedures will be paperless and include checklists. Home care agencies have long been familiar with home safety checklists – looking for ways to help the care recipient stay safely at home. Moving forward, other home care agencies will review the Harvard study that demonstrated the utility of an interactive voice response (IVR) health status checklist and adopt the checklist approach as a way to help avoid hospital readmission of clients.


Yes, but what do the metrics say about reduced costs, improved quality of life and reduced caregiver burden? The research literature does not yet provide strong support for the economics of technology to aid home dwelling older adults. Even home technology for chronic disease management has mixed results. Formalizing home care management is an excellent goal and dovetails well with personalized medicine. But, the tangible benefits of home monitoring with IOT remains difficult to demonstrate. 


Let's not forget that not everyone aging in their own homes will be ambulatory.  Not just about walking but also sense if someone has successfully transferred/toileted, etc.  Innovative home medical equipment companies have a real contribution to make here.  The good news is that AAHomecare, a trade association, has formed a Hi Tech Work Group to explore new technology and payment models. http://www.hmenews.com/also-noted/aahomecare-forms-tech-workgroup

I think point #5 is huge......especially getting the optimum, cost effective mix of hands on and technology enabled.

Regardless of where funding comes from, the domestic servant/agency paradigm yields very poor labor utilization rates and is inherently un-scalable.  It is a good starting point for innovation.  One day, not soon enough, there will be a care services ecosystem that uses integrated digital and automation technologies for in-home care service delivery. Caregivers, care consumers, machines and devices will work together making life better for older people.  

But there are two missing fundamental enabling conditions for large scale in-home digital care ecosystem growth:  1.) For each care consumer (and any other person or operator involved) there must be an effective digital representational presence, and 2.) There must be an effective digital care communications network.

Without these we should expect zero-sum disruption and incrementally slow progress. It is not just about medical care. The potential for annual system wide savings from reduced waste and improved productivity in the aging care consumer system is several hundred billion dollars.  How do we operate an open, safe, private and transparent care network using the internet and web technology? How do we gain control of our personal data? How do we use technology to empower aging care consumers? Is it worth the effort?


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