Many experts attribute the current tech tsunami in the senior living industry to the confluence of two major trends: the “Internet of Things” and the push toward resident-centered care.
Technology has produced miracles in this sector for decades — from helping 70-year-olds defy the curse of failed hips and causing bone-deep pressure wounds to heal, to protecting mind-ravaged residents from wandering forever into the night.
For practically every challenge the field has faced, technology has answered the call, even as the so-called “continuum of care” gets longer, broader and more ambiguous and diverse with each passing day.
It's also keeping more and more of the elderly away from institutionalized settings like nursing homes. Thanks to modern medicine, people are living longer while staving off disease and infirmity. Today, technology is helping residents live more productively and joyfully, while giving those who care for them tools to not only provide better care, but work more efficiently.
As the lines become more blurred between care settings and seniors have more choices — from aging in place to retirement communities to “hands-on” settings like assisted living — technology's influence only gets more disruptive. And innovation sometimes comes from the most unlikely places.
Consider the 12-by-24-foot MEDCottage, a parallel to the current “tiny house” movement in America, which some seniors are opting for as a way to stay close to adult children while remaining “independent.” Conceived by a Virginia minister whose parishioners felt loss after placing their parents in nursing homes, the sardonically dubbed “granny pods” come standard with such low-tech ergonomic features as hand rails to higher-tech add-ons like defibrillators, interactive video, bed- and bathroom seat lifts, physician- connected sensors that monitor vital signs and glucose levels, toilet seats that record and upload weight and body temperature, medication reminder systems — even floor-level cameras that record and send alerts when falls occur.
A NEW ERA
The tech tsunami the senior living industry is currently swirling in has reached landfall, in large part, from the confluence of two major trends: the “Internet of Things” and the push toward resident-centered care, a once nascent movement boosted by healthcare reform.
We find ourselves drowning in a dizzying array of interconnected mobile devices and sensors, flooding the airwaves and the ether with data. In their nexus: seniors. “It's all about persistent connection,” says Mike MacLeod, founder and lead strategist of Status Solutions, a high-tech situational awareness solutions provider. “That makes all the difference. Whether you're 5 or 75, the ‘Internet of Things' can help everyone. While the issues a 5-year-old is concerned with are quite different, the technology doesn't care.”
Even five years ago, you'd be hard-pressed to see a 75-year-old swiping her thumb across a smartphone screen, much less a tablet PC. But no more. Many of the 78 million “baby boomers” today are doing just that, according to Pew Research. And they're entering senior living communities with those devices wanting to stay connected with the world they left behind.
And tech has responded in spades.
Take wearables — the newest fad in personal sensors that collect, analyze and upload biometric data and send alerts to designated individuals when bodily functions go awry. IHS Technology predicts that sensors in wearable electronic devices will riseby a factor of seven through 2019. HL7 Standards, a healthcare software company website, predicts that 5.5 billion people around the world will be attached to some kind of personal monitoring device by then.
Tablet usage among seniors rose 125% in 2014 alone, according to Mobile Smith, a Raleigh, NC-based mobile app platform developer. And the number of “apps” driving them is growing exponentially by the minute.
Major shifts in healthcare regulations are, in part, fueling it. As of this writing, more than 40,000 medical- and health-related apps for seniors and others were available for Apple's iPhone alone, according to Bankrate.com. One app, aptly title “GetMyRx,” will allow users to scan a prescription into their smartphone and have the medication delivered to their front door in hours.
Even organizations like LeadingAge are getting into the act, recently running a two-day “Hack- Fest” programming event recognizing the winning app that helps residents set activity goals, says Josh Malbogat, senior living director at TheWorxHub by Dude Solutions.
Observers say senior living settings are ideal incubators for tech innovations to thrive, in large part because most residents are at a relatively high functional state.
Many are also tech savvy, and very receptive to things like social media and mobile health technology.
The focus today is on making that technology accessible and easy to use.
For example, Philips Healthcare, a provider of cloud- and device-based digital health management solutions, reportedly announced it was working with MIT AgeLab and Georgetown University to better learn how older adults and caregivers interact with technology.
“The kinds of new tech considerations in elder living aren't leaving behind old guys who never learned how to type,” MacLeod says with a chuckle. “They eschewed email. So we've made it easy with touch screens and other tools so they can easily stay in touch with their grandchildren. Those things matter.”
That is precisely the impetus behind Telikin, a 6-year-old company that developed a line of touch screen PCs bundled with proprietary software that allows seniors to email, access the Internet, share photos and videos and place video calls through Skype and other social media sites.
Assisted living is a prime target for Telikin's devices, says Fred Allegrezza, founder and CEO. “We did a survey of potential customers and found that about half had experience on Windows computers in the past but got frustrated with all the software updates,” said Allegrezza, who built his systems on the Linux platform known to be immune to viruses and other glitches.
“Our team is really focused on understanding seniors, not treating them like patients or talking down to them. It's heartening for me to see a daughter in Ohio and her mother at an assisted living facility in Florida light up when they're connected by Skype,” the 35-year computer engineer beams.
One of the biggest challenges senior living operators face is how to manage all that data flooding through the pipes.
For example, growing participation of long-term and post-acute care providers in accountable care organizations and other bundled payment programs is bringing its own unique data sharing challenges, says Doc DeVore, director of clinical informatics and industry relations, Answers on Demand, a residentcentric integrated clinical and financial software provider.
“In order to make well-informed decisions on resident health, senior care organizations need to be able to easily access health information with secure exchanges,” he adds. Another major concern: resident privacy.
Philips Healthcare's HealthSuite application collects, compiles and analyzes clinical and other data from multiple devices and sources across various senior living settings. The Dutch firm, meanwhile, announced its collaboration with Amazon Web Services to enable an “ecosystem” for new types of connected and personalized digital health solutions. Yes, Amazon.
McKnight's Senior Living interviewed many tech companies recently to gauge their thoughts on the current state of innovation. Here's a quick summary of what we learned:
Mike MacLeod, Status Solutions
“The former situation in assisted living was not great. They had pretty good tools but not great ones. Now they're getting great tools and are making great use of those tools like having the ability to see if someone is getting lonely, what meds they're taking, or how often they're interacting with their families. Technology gives greater visibility and more real-time awareness to all those things.”
Josh Malbogat, Dude Solutions
“Assisted living tech is being used to keep residents independent for longer periods, compared to skilled nursing, where technological innovation tends to focus more on managing illness and service delivery. He added that innovation is brisk in the area of remote monitoring tools for ADL, resident tracking and medication management, as well as increased interest in family portals showing resident health status, and motion sensors that take residents through a series of goal-oriented exercises.
Marina Aslanyan, CEO, SmartLinx Solutions, a software-based workforce management and business analytics company
From her perspective, software solutions that improve staff productivity are helping to stem turnover rates that are reaching critical levels. “One area we see a lot of momentum in use of mobile devices, and particularly employee self-service. Continuity of staff is important because routine is critical for many residents who prefer familiar faces to high turnover. If a provider is constantly churning and burning employees, it obviously creates a more tumultuous environment in senior living.”
Martha Abercrombie, vice president of strategy, Vikus Corp., a dedicated online staff hiring platform for senior care providers
Much like Aslanyan, Abercrombie believes technological innovations that help senior living providers “find and keep the right staff is becoming more and more of a focus for senior living.”
Marcia Conrad-Miller, senior director, business transformation, Philips Healthcare
Conrad-Miller believes that while investment in technology is brisk in assisted living, it's too focused on the basics right now. “For example, investment in high-speed Internet and resident access is high, yet innovations that can ride on top of that technology, like brain fitness apps, are lagging. One “exciting” technology, meanwhile, is a device designed to automatically detect falls (Disclosure: Philips makes such a device.)
Rachel Owens, vice president of product management, PointRF Solutions LLC, A provider of real-time location services and healthcare data analytics
Owens, a big proponent of “gamechanging” wearable tech, astutely points out that so many technological innovations now “consumerized” and cropping up in senior living were seeded in acute care environments. A popular example is health monitoring devices. Owens said PointRF is currently in the process of bringing “FDA approved” health sensors to the sector “in a way that will reduce time spent with and errors related to data entry to allow staff to focus on their residents while automating the capturing of necessary and valuable health status information.”
Dave Wessinger, co-founder and chief technology officer, PointClickCare, a cloud-based software provider of EHR and solutions related to billing and revenue capture, and referral, dietary and medication management
It's no surprise Wessinger believes analytics is one of the brightest innovations to reach senior living, “thanks to the advent of big data.” For example, wellness coordinators can now use iPads or smart phones to easily provide updates on a resident, allowing the data to be recorded and stored securely in real-time “so the right people have access to the right information at the right time, and can act on it without delay.”
FUELING POSITIVE IMAGES
Everyone agrees on one thing: Senior living tech can and does influence consumer decisions about placement.
To better understand how senior living operators are meeting resident and family expectations, PointClick- Care and LeadingAge's Center for Aging Services Technologies led a joint market assessment survey last June that found nearly 70% of them believed investing in technology paves the way to achieving a competitive advantage in today's market, making technology a top priority, Wessinger tells McKnight's Senior Living.
Malbogat says he thinks such trends will be self-evident in the next generation of seniors to move into senior living and other settings. “The baby boomers that communities are prepping for and that are currently helping their own parents move into these communities expect technology to make their lives easier and enable more choice on how they want to live within those communities,” he says.
For self-proclaimed “strategists” like MacLeod, those not-so-subtle differences are staring him in the face. “Assisted living communities are essentially extended stay hospitality settings and the technological amenities you have absolutely matter,” he says.
“If I'm coming in to check out your facility to see if it passes the sniff test in terms of the technological amenities I want for my parents, then, yes, it's a huge and relevant differentiator,” he adds.
“My folks are in their late 80s,” MacLeod says. “They are as tough as a two dollar steak. They're the silent generation so named because they don't complain. They were the last ones to get air conditioning and cable TV. However, I complain a lot. We're spoiled compared to our elder parents. Me as an adult child making decisions for my folks is very different than my folks making decisions for themselves.”
With all of its promise and buzz, senior living tech still falls a bit short. For tech companies, that only spells opportunity.
Here's a look at some of them:
• Data analytics. Conrad-Miller believes we have a ways to go in learning how to use all that data around a person's health, patterns and activities for predictive analytics “to recommend when particular services can be provided to ensure health and well being.”
• Big picture stuff. “The long-term post-acute care industry is in transition, faced with new challenges and new opportunities unlike ever before,” says Wessinger. “Providers across all care settings are feeling the impact of this shift and looking really closely at the role technology plays in helping drive their business forward. As the demographic shift in the senior population unfolds, technology becomes more necessary to push for the efficiencies that senior living providers require. Strategic technological solutions are essential, and even more, finding the right technology partners will be key in sustaining business.”
• Resident and family connectivity. Yes, seniors have smartphones and tablets, but just how connected are they really to caregivers? “The key missing piece now is reciprocal communication between residents, communities and family members,” says Malbogat. “This means giving visibility of the overall health and engagement of the resident and providing them tools to engage as they choose with the community — everything from being able to go online and put in a work order to signing up for activities to tracking what medicine the resident is taking.”
• Stopping the bleeding in staffing. Turnover will continue haunting all kinds of elder care settings. No one disagrees with that. Abercrombie cites a recent University of Tennessee at Chattanooga study of over 300 providers, among whom half of the 94% posting jobs online to find staff believed their recruitment process was going to help them meet their turnover reduction goals. “In other words, technology is being used to reach applicants, but not to select the right person,” she adds. “There are many solutions offering a better mousetrap to automate the hiring process, but they are not creating quality outcomes for staff or for residents. Instead, they create a revolving door where staff are hired, leave, and are replaced, usually within their first 90 days.”
• Telehealth. They've been talking about it literally for decades. The technology is there. Someone just needs to get on board, some say. Telikin's Allegrezza tells McKnight's Senior Living he is conducting telehealth trials in three locations to determine the feasibility of incorporating it into his bundled hardware and software devices in senior living settings. “This would be beneficial for people even in assisted living who have challenges with transportation or who aren't feeling well and need low-level medical care,” he says. “We're starting to see a lot of traction in this area now. It just takes someone to start doing it at a very basic level.”
MOVING ‘THE HERD'
A recent article posted by Brookdale Senior living stated it succinctly: “Technology shows no signs of slowing.”
Indeed. In certain instances, it's too much, too soon. Take robotics. While they've shown remarkable efficiencies in manufacturing, assembly and production, we still have a way to go before caregivers feel threatened. In its piece on the subject, Brookdale noted a Human Factors and Ergonomics Society study that found seniors little receptive to robots for anything other than housekeeping help and medication reminders.
For inventors like MacLeod, it all comes down to identifying a need and finding a plausible and acceptable way to fill it.
“The whole thing about technology innovation is, it's never over,” he adds. “It just started the last time you checked. What you think of today won't be as good as what we think of tomorrow. If someone in assisted living or any other space wants to go from the current situation of standing in the sun to the desired position of being in the shade, the trees won't move toward them. They have to move toward the trees.”
The key for MacLeod and other tech companies is getting providers to move forward.
“The herd needs to get some prodding and poking,” he says, tongue-in-cheek. “The thought leaders lead. The fast followers follow. And the herd moves. A lot of people who own and operate communities are procrastinating right now. It's time for them to get in the game.”