Just getting started

As Netsmart marketing executive Jeremy Mercer puts it, technology adoption in long-term care is a story of how providers and owner-operators are holistically adopting technologies to drive efficiencies, provide a safe and secure environment, and stay competitive.

Few can take issue with that assessment. But there are widely varying opinions about where the industry is on the tech evolution timeline. It seems innovation continues to outpace adoption, but at some point, most agree, the industry will catch up.


Experts may debate the value or popularity of one type of technology over another, or the level at which adoption is occurring, but one indisputable fact remains: technology is at high tide right now.

The epicenter is the C-suite, asserts Trisha Cole, COO of Medtelligent, who believes C-level executives are “often the visionaries of the company who see high technology as a way for their communities to operate efficiently and stand out from the crowd of competitors.”

Behind the C-suite are sales and marketing departments focused on managing the “complex” relationships of referral networks in their zeal to keep census high. Bringing up the rear, according to Cole, are staff members — “the dark-horse advocates of technology” — who are constantly pushing social and resident engagement with relative ease because such solutions involve “very little red tape.”

Majd Alwan, Ph.D., senior vice president of technology for LeadingAge and executive director of the Center for Aging Services Technologies, believes electronic health records and point-of-care technologies, including touch screen kiosks for documentation of care, conducting regulatory assessments and submission of claims electronically, still lead in terms of adoption.

“What’s interesting is how broad-based the interest in new technologies is,” observes Mike Webster, CPP, director of senior living, fall management and security solutions for Stanley Healthcare. Not only is it a major discussion point at all industry events, but organizations such as Aging 2.0 have emerged in the past few years specifically focused on promoting the development of new technology solutions for senior living.

“The demand for cutting-edge technology is really across the board, Webster adds. “Cutting edge doesn’t have to mean complex. In fact, one of the advantages of newer technology is that it is often less complex, taking advantage of standards that do away with a lot of hard wiring and proprietary devices. A small memory care facility still looks for the latest technology for an established application such as wander management, for example, because newer technology is cheaper, easier to use and has more functionality, he adds.

Broad adoption trends aren’t lost on Jim Rubadue, chief customer officer at OnShift, who sees data mining as a primary motivator. “Many senior living providers now have teams of data analysts looking at their data from a holistic viewpoint, so managers and others can more easily take action based on this information, ideally in real time,” he says. Data collection also is highly valued by real estate investment trusts, which use data to drive efficiencies and improve facility operations.


Experts say tech adoption varies by facility type or settings. Assisted living seems to be embracing resident-centered tech more broadly and faster than nursing homes, whereas nursing homes may have an edge on clinical applications such as EHR and full-building wireless coverage because they were required to adopt those technologies, notes Sara Haskill, director of marketing-senior care for CareWorx.

Even facility types tend to embrace extended EHR technologies differently, according to Dawn Iddings, senior vice president of post-acute strategy for Netsmart. SNFs, for example, are now focusing on more sophisticated technologies around electronic referral management, analytics and connectivity, whereas assisted living and home care settings are now delving deeply into interoperability issues, she says.

Meanwhile, those like Paul Larson, vice president of new product development and engineering for RF Technologies, believe adoption is no more brisk right now than in memory care, where vendors “see many advances in this area, such as using interactive media for mental stimulation to improve cognitive function and innovative community design to improve both comfort and safety levels for residents.”

Some believe the size of an organization is directly proportionate to the level of broad tech adoption.

David Carter, LNHA, campus administrator of Sentara Nursing Center and Village Virginia Beach in Virginia, asserts that larger, more full-service operations with multiple licenses to manage broadly embrace technology.

That’s because “the more services, the more data sources are required to manage and integrate in order to get clear visibility into the patients and the organization,” Carter says. “EHRs are simply not enough, especially when they can’t get their data when, where and how they need it.”

Jeremy Spradlin, CEO of CareServ Technologies and Consulting, believes larger organizations, like chains that can pool resources and negotiate better discounts, will embrace technology more easily.

“Because of their size, they often receive better economies of scale when purchasing infrastructure or software solutions,” he adds.

regulated states such as Washington, Ohio, California and Florida “tend to be more progressive with technology” simply because the rules more aggressively incentivize them to accept and provide care to Medicare beneficiaries.


Most observers believe technological innovation in senior living as a whole is still in its infancy.

“We are just on the cusp of a larger technology demand that is going to arrive with baby boomers,” Spradlin says. “Baby boomers are not only going to put additional pressures on senior living communities to use technology to provide better care, they are also going to demand access to technology for their own personal use and comfort. The next generation to arrive in senior living communities is tech-savvy and thus, they are going to expect their community and caregivers to embrace technology.”

Meanwhile, some think adoption overall remains stuck in push mode. “My experience has shown that senior living companies are reactionary in their adoption of technology,” observes Ray Costello, founder and CEO of bmrbnb.com, a company that has built hospitality software that allows operators to provide short-term stays and booking services for prospective residents touring their communities. The lack of initiative can cost them to lose valued managers or even residents, he adds.

That said, providers and operators across the long-term care landscape have myriad priorities that are shaping their interest in, and acquisition of, technologies of all kinds.

Cole believes the primary motivators are operational efficiencies, regulatory compliance, resident safety and risk mitigation.

“Senior living companies are growing and building at an incredible rate. Pens and paper cannot keep up,” she says. “Providers are extremely busy, and it has become increasingly difficult to stay on top of the needs of a single community let alone a growing portfolio of communities. An operator just said to me the other day, ‘Our staff is great, but relying on a busy care team to notify us of everything important just isn’t working.’”

Alwan and his team at CAST have seen shifting consumer expectations, experience and quality of life push providers to invest in consumer-facing technologies such as Wi-Fi, technology-enabled concierge services, social connectedness and engagement applications, as market differentiators.

Laura Wasson, director of healthcare for Tech Electronics, agrees. “In our industry, senior living operators are most accepting of fall detection/prevention and mobility technologies, as well as technologies that reduce overall costs,” she says. “Having technology that increases mobility by sending alerts from residents to phones instead of to a nurse’s station can reduce response time. There’s also a need for fall prediction and reporting technology that can assist chief nursing officers and executive directors in family and personnel issues.”