The notion that seniors will not embrace technology is outdated.
To illustrate how far we've come in senior living tech, consider MatrixCare, which is working with Microsoft to embed its artificial intelligence engine into its clinical decision support tools and is even exploring virtual reality as a means of remotely providing therapy services in the near future.
And don't forget private social network pioneer Connected Living, which is on an ambitious crusade this year to connect one million seniors and their families together with public and private partners as it promotes an innovative platform that will help operators capture new revenue streams.
Then consider OptimizeHealth, a large information technology managed services provider, which recently found itself having to teach caregivers in a remote rural Texas community how to use a computer mouse during an electronic health record rollout.
No doubt, as senior living operators find themselves literally awash in ever-morphing tech from wearables and wireless monitoring to sophisticated medical software, widespread adoption of anything is understandably spotty. Which makes it even easier to understand the resolve of Connected Living's CEO and co-founder Sarah Hoit, who proudly declares, “There is a mobile revolution, and we're about to change the game significantly.”
Large players sign on
Make no mistake: Hoit and other tech leaders in this space are quickly winning over a large core of believers.
In its recent annual report, the LeadingAge Ziegler 150, aptly named for the 150 largest not-for-profit providers, declares a greater proportion of communities and operations (on average, 80%) adopted EHRs in 2015 compared with 2014. The report notes similar widespread adoption of electronic point of care/point of service documentation systems, care/case management and coordination software, personal emergency-response and wander and medication management systems. Other tech gaining traction includes telehealth/remote patient monitoring and telecare/telemonitoring/behavioral monitoring technologies, which the report attributes to burgeoning provider partnerships with accountable care organizations, hospitals and managed care plans.
Indeed, technology slowly is changing both the business and care sides of senior living, in some remarkable ways.
John Shafaee, president of ALIS by Medtelligent, moved into an assisted living facility for two weeks while developing his company's latest software tool. The experience taught him volumes about workflow inside the community. “I learned that time is everything in senior living, which focused us on integration and trust: between care facilities, across activities and procedures, and between clinical and non-clinical functions,” Shafaee says. “Lack of coordination and data visibility cost senior living facilities real time and real money, whether it is poring over incompatible records or not charging when care is provided.”
For some vendors, the landscape has a personal side. Glenn Paul, vice president of marketing for Gentell Inc., talks of two projects he hopes to one day produce. Paul and his wife have curated a gallery of 500 of the greatest paintings in history, which can be displayed on large-screen TVs with USB ports. Paul, whose father is a resident in an Alzheimer's community, believes the gallery would be very engaging for many residents and is offering to test it in the first 50 facilities that request a copy. Another project is a website that enables residents' children who live far from their parents to trade visits with other residents' children who live nearby.
In January, MatrixCare announced that it will deploy its CareCommunity LTPAC Population Care Management and Care Coordination platform on Microsoft Azure, one of the first hyper-scale cloud computing platforms to achieve the coveted HITRUST CSF security certification. CEO John Damgaard says MatrixCare also hopes its new partnership with the computing giant will lead to the addition of powerful new analytics capabilities. The company also is looking into incorporating Microsoft's artificial intelligence engine, Cortana, into its decision support tools. “One doctor can read a medical journal maybe twice a month,” he says. “Cortana can read every cancer study published in history before noon and by 3 p.m. is making patient-specific recommendations on care plans and improving outcomes.”
Greg Nicholas, managing partner of OptimizeHealth, has witnessed the transformative effect EHRs have had on the admissions and transitions processes, and how they have vastly improved care. Ironically, he also has learned how technology sometimes can be disruptive, literally. Recently, he piloted a new physician charting program at a large senior living provider. Physicians made their rounds at the facility and when done were invited to a private lounge where they used high-end voice recognition software to do their charting. It was a hit, saving physicians an average of 30% of their total time inside the facility.
“It wasn't as expensive a solution as I thought it would be,” Nicholas says. “More important, it gave not only the patient but the doc a better experience. And the quality of notes and patient-physician interaction improved greatly when we removed the computer from the patient interaction.” Moreover, the physicians were more willing to refer patients to that facility because of the positive experience, he adds.
Competing for dollars
Although no data prove it, the pace of innovation today is dizzying. Some technologies such as EHRs, as well as many business office tools, essentially are viewed as “must-haves,” and for good reason. Other technologies, such as monitoring software, undoubtedly are making senior communities safer and thin staffs more efficient.
Still, a huge chunk of emerging tech is being driven by competitive pressures. Consider the relationship between resident mix and where operators are investing their tech dollars.
“Assisted living operators today are scraping the cream of the crop in terms of private pay,” Damgaard adds. “All of these communities are competing for private-pay residents, and they are pretty high-end products. If you walk through an assisted living community, they look like resorts.” This in part explains the healthy adoption among the biggest communities.
“The reality is the senior living market today is a real estate-driven market,” Damgaard says.
“Technology is starting to make a major impact in some of the most critical phases of the senior living industry by addressing marketing and communications, labor, resident care and satisfaction, and overall asset value,” says Gustavo Sapiurka, senior vice president of OneSite Enterprise Solutions. Such solutions are better at minimizing risk, increasing revenues, improving services and are a “major factor for owners that have a buy-operate-sell corporate strategy,” he adds.
“As much as we want to say it's converted to a medical model, it's not yet in the operators' purview,” Damgaard says. “So technologies related to real estate upkeep and staffing are big deals, which is why things like point of sale technology ensures that ancillary revenues are getting captured to augment the rent. That's a hot seller. You have salons, food service, concierge, extra activities, lots of things residents can tap into and a lot of times that revenue falls on the floor. With point of sale, you can make sure every dollar gets dropped in the bank.”
Richard Nix, regional director, senior living for Yardi, says the company's RENTCafé Senior Living portal allows residents and family members to log in from anywhere and manage their accounts, make payments, review billing and see if their loved ones are participating in any wellness activities. “When communities introduce RENTCafé to residents and their families, it enables better communication and allows the community to respond quickly to requests and criticism,” he says. “Ultimately, this technology allows communities to improve the level of care they provide, which helps build revenue, retain staff and increase resident satisfaction.”
Garnering new business is at the heart of Connected Living's Home Connect app.
“There are new emerging revenue streams and technology is positioned to capture them,” Hoit says. “Many CEOs are talking about extending services beyond the walls of their senior living communities, but I don't think many have been able to actualize that yet.”
Connected Living is partnering with “best of breed” companies such as Sodexo, Philips Healthcare and ride-hailing service Lyft and inking other agreements to include them in its full technology offering, mobile app, and Home Connect to serve seniors living both in around senior living communities. Hoit envisions operators using the application to engage broader aging in place communities. One idea is to use the application to introduce “constituents” (including seniors, their families and vendors) to their senior living communities in various kinds of engaging activities and social events, services and dining.
The strategy also is a win for vendor partners. “Companies like Sodexo say they not only want our technology in all of their locations but also to have the app distributed to their constituents so people can have visibility into their services,” Hoit says.
Damgaard says MatrixCare's high-end platform offers a “premium experience” to residents and their families, who, for example, can gain family portal access into the EHR and use it to see whether their loved one took his or her medications, attended activities or had a change in health status. Meanwhile, on the Medicaid side of senior living, technology currently is “an operational efficiency scale game,” where the focus is on driving down things like overhead and labor costs.
“What will happen and what is happening is, the market will eventually bifurcate,” Damgaard adds.
“There's only so many people who can afford $6,000 a month to live in one and we're going to run out of those places very soon.”
That doesn't mean cash-strapped operators should hold off on key tech investments.
As more and more of the senior living landscape evolves under managed care, “the name of the game is keep them all as healthy as you can and keep them out of the hospital,” he cautions.
Putting it together
“Those senior living providers who haven't invested in EHR technology will be caught with their pants down. They're going to need those digital backbones to manage health and wellness or they're just not going to be able to survive,” Damgaard says.
With so much technology competing for operators' attention these days, it's no wonder many heads are spinning.
That integration a key buzzword in the near future.
Bill Briggs, vice president of business development for Prime Care Technologies, says his company believes operators will continue to seek efficiencies of operation and care via suites of “super apps. More and more, they will need tools that connect the various disparate apps and consolidate them into one ‘pane' of glass or view for leaders to maintain an accurate pulse of the business, allowing rapid and appropriate adjustments to the business,” he says. “Couple that with automation that will provide transparency and real-time visibility into both resident care and operations, and the industry really makes a steep jump skyward.”
Obviously, technology is no good unless a lot of people are using it. So accessibility will be key.
“We are going to keep breaking down barriers between all levels of senior living, from assisted and independent living to skilled nursing,” Shafaee says. This means common data, unified interfaces and the ability to adapt to different data formats and state regulations. A continuum of care requires a continuum of data, particularly as resident acuity levels continue to increase.”
Integration will continue to be paramount. “Skilled nursing facilities in particular are looking for technological advancements that will improve their facilities, but at the same time be seamless and integrate with a homelike environment,” says Maayan Wenderow, director of marketing for EarlySense.
People like Hoit and Steve Robertson, chief technology officer for CareWorx, see mobility as the leading driver in tech innovation going forward. “We are now seeing mobile devices being used in foodservice, maintenance, activities, nursing care and administration, to name a few, and a significant increase in demand for tech support and guidance on how to build a roadmap for new initiatives,” says Robertson, who also believes senior living app development “will touch every area of caregiving and convenience.”
“I really believe in five years everyone will have mobile devices, and shame on you if you don't, because there's no reason not to,” Hoit says. “If my grandmother is in the advanced stages of dementia, there's no reason an iPad isn't next to her bed so kids are sending pictures and inspirational messages. We see so many technologies where people are building different boxes or wheeling in the same old stuff. Talking to people instead of with them. Mobile is what can bring all of these emerging suites of technologies alive — whatever stage of living you're in.”