Tech: Only just begun
(Photo: Amazon . com)
Every page of this magazine for the next 12 months could be occupied with nothing but stories about all the ways technology touches senior living. And there'd still be plenty left on the cutting room floor.
If anyone doubts how tech is swarming through the corridors of every assisted living or residential community today, consider this assessment from the largest not-for-profit provider of senior care and services, and one of the country's busiest incubators: “What is most surprising is the true adoption we already have among residents,” says Brad Edwards, innovation designer for the Evangelical Lutheran Good Samaritan Society, as he reflects on the ubiquity of iPads and Fitbits.
The pace has even given high-tech companies pause. “The biggest surprise in this market in general has been how quickly it is changing,” says Tim O'Malley, president of EarlySense, a leading provider of patient monitoring systems for hospitals, healthcare systems, integrated delivery networks and rehabilitation centers. For years, post-acute care was in tech marketers' blind spot. But no more.
Still, adoption is uneven. Money is always tight, and only when it can save more of it does technology get a second and third look with many owner-operators, a fact not lost on researchers.
“Technology can be a really big driver of change when it starts impacting their bottom line,” says Kari R. Lane, Ph.D., RN, MOT, assistant professor at the Sinclair School of Nursing, University of Missouri, and a researcher for Aging in Place and Tiger Place, a large Columbia, MO-based retirement community.
It's no accident that Lane is currently writing grant proposals for the National Institutes of Health and the National Science Foundation to research sensors that monitor and detect subtle physiological changes in residents with congestive heart failure. Lane is quick to acknowledge that providers face crushing penalties for hospital readmissions, and CHF is one of the biggest culprits.
As senior vice president of enterprise strategy and innovation with AARP, Jody Holtzman has a broader perspective on the market's bifurcation and the myriad ways seniors react, respond, embrace and sometimes reject technology.
PointClickCare, a leading developer and provider of electronic health record software, recently polled providers and found laptops, smart devices (such as wearables, tablets and phones), GPS, alarms/alerts and cellphones the top five most used tech devices for seniors. When recently accompanying a close relative on a senior living community tour, Holtzman witnessed firsthand why those kinds of personal devices are an easy sell, while cost often trumps every other adoption factor with other kinds of tech, even when it's potentially life-saving. It happened during a facility representative's explanation of the fees.
“When they asked, ‘Would you like to have these sensors in your room for an additional cost?' I thought to myself, ‘Oh yes, and I'll have an extra side of monitoring with that,'” he says. “The model is wrong. The cost for much of this technology needs to be built into the overall fee and not sold a la carte.” Lane agrees, adding, “We always look at the cost factor, because if you make something that isn't accessible, it won't get used.”
Here's a brief look at current innovations.
Information technology. The electronic health record continues to mature and developers are keenly focused on interoperability issues. Majd Alwan, Ph.D., senior vice president of technology for LeadingAge and executive director of the Center for Aging Services Technologies, says the most “exciting” current developments are advanced features such as clinical decision support, quality data analytic tools and dashboards, all of which “are improving quality of care, and impacting quality measures and metrics, like five-star ratings, which are shaping referral networks as well as contracts with managed care.”
Earlier this year, Alwan says, he was “pleasantly surprised” to learn that more than 30% of the industry's largest 150 organizations have embraced the most sophisticated EHRs.
Sensors. Perhaps their most alluring feature is the ability to track and monitor things with eyes that never grow tired. And their applications are nearly limitless, especially when one considers “the big challenges for an aging population, like cognitive impairment, physical deterioration, disease conditions and medicines,” O'Malley says.
Lane believes sensors now hold the greatest promise in staving off costly and needless treatments for seniors with chronic diseases. The CHF sensors she's researching are imbedded within mattresses while constantly measuring vitals such as heart and respiratory rates and restlessness — a key predictor of impending heart failure because related issues such as lower extremity pain and weight gain prompt victims to get up at night and move around or seek recliners to ease discomfort.
“We can see those subtle changes before they even realize that they're having problems,” Lane says. Other sensors Tiger Place and other researchers have developed can predict falls through gait analysis.
Smart devices and smart homes. The market is now flooded with tech that can control locks and lights, summon help and track and upload vital health data, all through smartphone apps. Big box retailer Best Buy recently expanded its Minnesota pilot of “Assured Living,” a project that allows adults to remotely assist and monitor older relatives, regardless of location. Amazon reportedly is getting into the act as well.
Voice activation and artificial intelligence. Kristen Hanich, a research analyst for Parks Associates, says voice-activated and controlled “smart speakers,” such as the Amazon Echo and Google Home, are showing a great deal of promise. Adoption by seniors is currently low, but Hanich believes they are “potentially revolutionary,” especially for those with mobility issues.
“We likely will see a lot more innovation in this space, including tighter security based on your unique voice signature and easier language support through artificial intelligence,” Edwards adds. “Every day, voice technology becomes more simple, safe and reliable, which are critical needs of the aging population we serve.”
Alwan sees voice-activated technology becoming layered with existing tech such as telehealth, medication management and care coordination applications.
Connectedness. This dovetails nicely into the industry's transition toward resident-centered care. Seniors are becoming the focal hub inside and among the larger world outside, and devices and apps are offering up many ways of engaging with family and friends — something research now shows contributes to longer lives and delays in the onset of debilitating diseases and ailments. Alwan says CAST is now monitoring more than 40 social connectedness and engagement technologies, and the number continues growing.
Staffing technologies. As Alwan observes, “digital signage, resident portals and community apps can be leveraged to increase staff efficiencies.” In one way or another, all of the above are now finding applications to address one of the most vexing problems that dogs providers of all kinds — staffing attrition and turnover.
Just ask Travis Palmquist, vice president and general manager for senior living at PointClickCare, which has employee engagement and customer experience tools that “are giving providers the ability to manage employee engagement, improve resident outcomes and achieve a stronger bottom line. Through employee engagement and customer satisfaction tools like this, providers are able to improve organizational culture, reduce staff turnover rates and increase staff satisfaction, which will ultimately help improve quality of care and customer satisfaction.”
Hanich believes automation promises to “fill in the gap in care staffing via the connected medical home and different types of remote care monitoring” and is “just now beginning to see increased traction among payers and providers.”
Smartphones and apps not only help understaffed facilities multitask and schedule work more efficiently; they improve morale. Myriad IT innovations are streamlining charting and reporting. “In the future, voice recognition will allow staff to automatically log required work as it gets done through a biological signature like facial recognition,” Edwards says.