The fear that COVID-19 has created about congregate living “is very real,” and the senior living industry must take steps to allay it, according to Nexus Insights founder and President Bob Kramer.
“The whole senior housing and care space has to win back the trust and confidence of residents, potential residents and their families. It will cause a creative disruption of the paradigms of seniors housing and care,” Kramer said Thursday as part of a panel discussion about the future of collaborative care across the long-term care continuum in light of the pandemic. His remarks came at the LeadingAge Center for Aging Services Technologies’ 15th annual Collaborative Care HIT Summit, which was held online this year due to the pandemic.
One of the major areas that the senior living industry will need to address — quickly — is healthcare, said the co-founder, former president and CEO, and current strategic adviser to the National Investment Center for Seniors Housing & Care. Senior living and the home- and community-based services provided there must transform from a “reactive healthcare model,” he said.
“One of the biggest changes we’ve seen in consumer behavior in our field is, for the first time, there is a very real fear of the hospital, the emergency room and the doctor’s office,” Kramer said. The current care model in senior living, he added, “is that we don’t ‘do’ healthcare, and we ship out our residents for healthcare services. I don’t think that model will survive going forward in the future.”
Short of only offering independent living, the industry has a big opportunity to look at healthcare from a preventive point of view, Kramer said. Actively managing the chronic and underlying health conditions of residents will become a necessity and what communities will be judged on, he said. And if they fail, they will be held accountable.
“You will have to learn to do more — and do more triaging on-site so you don’t use 911 and the emergency room as the overnight shift,” Kramer said. “It opens huge opportunities in the area of technology. How will payers drive this, in terms of plan members living in these communities?”
The answer to that question, panelists said, is technology.
Panel member Andy McMahon, vice president of health and human services policy at United Healthcare Community & State, said he’s seen a 28-time increase in the use of telehealth among recipients of long-term services and supports served by his company and a 105-time increase in the use of telehealth by customers in skilled nursing facilities and those with special needs.
Onyx Health CEO Susheel Ladwa, another panel member, said that healthcare, as an industry, historically has been late in adopting technology, prompted only by mandates. COVID-19, he said, has changed that approach.
“COVID is the key transformation officer for healthcare,” Ladwa said. “What we’re seeing is a mad rush to figure out what’s new in the market, and how do we become an early adopter to preserve revenue streams. That motivation was nonexistent before.”
Regarding older adults, he said, most older baby boomers are used to wired telephones, so the migration to social media and smaller mobile devices was difficult for many of them to make. The introduction of voice-based communication through Amazon Alexa and Google, Ladwa added, is viewed as an extension of something they are familiar with: the telephone.
“Voice-based communication is one of the most important ways seniors have always communicated through their life,” he said. “It’s a natural extension of the way we deliver care to seniors. They don’t see it as a leap into something new, but a natural progression of voice from telephone to an assistant.”
Ladwa called voice-based assistants “technology 1.0” from a senior care standpoint. “Technology 2.0,” he said, will be voice plus video. Beyond that, he said, could be augmented reality or something new.
Kramer added that, if healthcare providers traditionally are late adopters of technology, then senior living is even further behind, and the challenge is even greater because the sector was “dragged almost kicking and screaming into the modern era of digital communication.”
“We weren’t there prior to March. Now, because of forced integration of senior care and healthcare, it’s requiring senior care to catch up with healthcare, which is catching up with other industries in the use of digital and voice,” Kramer said. “The whole field is ripe for major disruption and major change that benefits older adults.”
Kramer said that whether in a senior living setting, other congregate living setting or in a traditional home, the use of predictive analytics combined with artificial intelligence will become essential.
“We’re thinking from the point of view of prevention — either preventing people from having institutional-type care, or preventing a trip to the hospital,” Kramer said. “That active management of chronic conditions requires data that is useful, informative and enables you to take preventive steps.”
Kramer said he hopes baby boomers, whose greatest fears are dementia and having to move into a nursing home, will see connections between lifestyle and what they need to do proactively for their health to be able to achieve their goals.
“Where they live matters, and what they do matters,” he said. “I do think this is the role of technology, and enabling boomers to self-direct and self-manage their own health and lifestyle, and get constant feedback that says, ‘If you want this, you’ll have to do this.’ Tie it into their goals.”
