Is ‘age-tech’ a stereotype that misses the larger mark–and market?

Two thoughtful articles this week comment on the difference between the highly touted ‘age-tech’ and products and services that older people actually need and want. The first is by the Centre for Ageing Better’s Jemma Mouland, who quite ably points out that ‘age-tech’ as a category (apologies to Laurie Orlov) inherently screams ‘old’, ‘feeble’, and ‘ill’–while it searches desperately for the ‘silver unicorn’. Yes, older people (and the disabled) do need solutions that help with changes as we age, but even the things that we need tend to be couched in negatives, feel like they don’t fit in our lives, reinforce a feeling of decline, or stigmatize. (The real hot button issues are hearing, vision, and driving.)

Moreover, older consumers often feel left behind or neglected by (formerly) favorite brands or services. A recent UK retail study stated that this is the belief of over 80 percent of 55+ consumers–now edging into the older cohort of Gen X. (One observation this Editor will make is that a huge negative is current clothing appearance, fit and cut.) It’s disappointing to your Editor as a marketer–that means that this group, with 83 percent of household wealth in age 50+ hands, keeps their wallets shut.

MIT Technology Review this month is cited in Ms. Mouland’s article. Building on Joseph Coughlin’s work at the MIT AgeLab in its ‘Old Age Is Over!’ issue, he cites that old age and even retirement is an obsolete construct built on early 19th century beliefs around the depletion of ‘vital energy’ and 20th century social policy around that. The stereotype the latter built was one was either needy–needing social support, or greedy–living the easy retirement life off a pension and looking for early-bird specials.  That tends to frame how we look at older people in employment, in living at home, or in social policy as driving up the cost of care–just a problem to be solved, and certainly not productive or, in Ezekiel Emanuel’s end game, even worthy of anything other than palliative medical care or being part of the political polity.

Mr. Coughlin’s close may be a bit reductionist, but this Editor will take it. “By treating older adults not as an ancillary market but as a core constituency, the tech sector can do much of the work required to redefine old age. But tech workplaces also skew infamously young. Asking young designers to merely step into the shoes of older consumers (and we at the MIT AgeLab have literally developed a physiological aging simulation suit for that purpose) is a good start, but it is not enough to give them true insight into the desires of older consumers. Luckily there’s a simpler route: hire older workers.” And work on making your products and service meet the needs of a broad spectrum of people. Hat tip to Alistair Appleby of Optalis–whose team, in a bit of news, is moving over to Wokingham Borough Council at the end of the month.

A useful White House study released: ‘Emerging Technologies to Support an Aging Population’

Just released is the 40 page Executive Branch report on technologies with the potential to better support aging in place. Emerging Technologies to Support an Aging Population was developed by the Task Force on Research and Development for Technology to Support Aging Adults organized by the National Science and Technology Council (NSTC) and the Office of Science and Technology Policy (OSTP).

The Trump Administration has made finding solutions for an aging population–now over 15 percent of the American population–a research and development (R&D) priority to enhance the functional independence and continued safety, well-being, and health of older Americans, while reducing overall economic costs and the stress on the Nation’s healthcare infrastructure. The report identifies six primary functional areas which are critical to aging adults and which should be addressed by technology:

  1. Key activities of independent living 
  2. Cognition
  3. Communication and social connectivity
  4. Personal mobility
  5. Transportation
  6. Access to healthcare

Added to this are cross-cutting themes across two or more of these functional areas.

Each of these areas are broken down into focus areas with key functional needs. From each need, the study identifies R&D topics for developing solutions. For instance, a key functional need under both independent living and healthcare is oral hygiene, and one solution is  developing systems to support personalized dental regimens.

What is attractive about this study is that it cuts to the chase in identifying the themes and the analysis leading to the R&D–and a great deal here that’s useful for developers and healthcare organizations. Hat tip to Laurie Orlov of Aging In Place Technologies, who this week also released her 2019 Technology Market Overview

 

Tender Alerts: Staffordshire’s £70m contract, Yorkshire and The Humber test

Susanne Woodman, our Eye on Tenders, alerts us to two tenders, the first which will definitely pique our UK Readers’ attention with its size and duration. The second is for a proposal using TECS and telemedicine as an alternative to emergency services.

  • Staffordshire: This is a huge seven-year contract to create the Support For Independent Living In Staffordshire (SILIS) Service to enable older and disabled adults to age in place in their current homes. “A key aim of the Service is to help Individuals to make changes to their home environment that will prevent the need for more costly interventions, such as admission to hospital or residential care, following life crises.” The Service will improve upon existing services in Assistive Technology (AT) including referral to telecare providers.

There are six borough and district councils involved, with the potential for use by nine more. The contract is valued at £70 million to start April 2018 with renewal points, ending in March 2025. Deadline is Wednesday 1 November at noon. Much more information (you’ll need it) on TED EU-Tenders Electronic Daily

  • NHS Greater Huddersfield & North Kirklees CCG: This tender is for the provision of a technology-assisted, rapid access service offering an alternative to hospital-based A&E services. Market test site is in Kirklees for residents of a care home. Requirements are:
    • A 24/7 clinical teleconsultation service delivered via secure video link into residential/ nursing homes, that is utilized instead of patients having to be taken to the local A&E department.
    • A service that provides clinical consultation not a logarithm based approach like 111.
    • A fully managed technical service utilizing bespoke laptops with HD cameras and with 4G SIM or broadband.

The CCG may also commission an accountable care organization (ACO) for this care in future, to which this contract would transfer. Deadline is 5pm on Friday 20 October to brenda.powell@greaterhuddersfieldccg.nhs.uk. More information on Gov.UK.

The REAL acute care: hurricanes, health tech, and what happens when electricity goes out

This afternoon, as this New York-based Editor is observing the light touch of the far bands of Hurricane José’s pass through the area (wind, spotty rain, some coastal flooding and erosion), yet another Category 5 hurricane (Maria) is on track to attack the already-wrecked-from-Irma Puerto Rico and northern Caribbean, thoughts turn to where healthcare technology can help those who need it most–and where the response could be a lot better. (Add one more–the 7.1 magnitude earthquake south of Mexico City)

Laurie Orlov, a Florida resident, has a typically acerbic take on Florida’s evacuation for Irma and those left behind to deal with no electricity, no assistance. Florida has the highest percentage of over-65 residents. Those who could relocated, but this Editor from a poll of her friends there found that they didn’t quite know where to go safely if not out of state, for this storm was predicted first to devastate the east coast, then it changed course late and barreled up the west (Gulf) coast. Its storm surges unexpected produced record flooding in northeastern Florida, well outside the main track. Older people who stayed in shelters or stayed put in homes, senior apartments, 55+ communities, or long-term care were blacked out for days, in sweltering heat. If their facilities didn’t have backup generators and electrical systems that worked, they were unable to charge their phones, use the elevator, recharge electric wheelchairs, or power up oxygen units. Families couldn’t reach them either. Solutions: restore inexpensive phone landlines (which hardwired, mostly work), backup phone batteries, external power sources like old laptops, and backup generators in senior communities (which would not have prevented prevent bad fuses/wiring from frying the AC, as in the nursing home in Hollywood where eight died).  Aging In Place Tech 

It’s another reason why senior communities and housing are supposed to have disaster preparedness/evacuation plans in place. (If you are a family member, it should be included in your community selection checklist and local records should be checked. This Editor recently wrote an article on this subject (PDF) that mentions disaster and incident planning twice. (Disclaimer: the sponsoring company is a marketing client of this Editor.) In nursing homes, they are mandatory–and often not executable or enforced, as this article from Kaiser Health News points out. 

Another solution good for all: purchase 200-400 watt battery packs that recharge with solar panels, AC, and car batteries (AARP anyone?). Campers and tailgaters use these and they range below $500 with the panels. Concerned with high-power lithium-ion batteries and their tendency to go boom? You’ll have to wait, but the US Army Research Laboratory and University of Maryland have developed a flexible, aqueous lithium-ion battery that reaches the 4.0 volt mark desired for household electronics without the explosive risks associated with standard lithium-ion power–a future and safer alternative. Armed With Science

Telemedicine and telehealth are not being fully utilized to their potential in disaster response and recovery, but the efforts are starting. Medical teams are starting to use telehealth and telemedicine as adjunct care. It has already been deployed successfully in Texas during Harvey. Many evacuees were sent to drier Dallas and the Hutchinson arena, where Dallas-based Children’s Health used telemedicine for emergency off-hour coverage. Doctor on Demand and MDLive gave free direct support to those affected in Texas and Louisiana through 8 September, as well as Teladoc, American Well, and HealthTap for a longer period to members and non-members. Where there are large numbers of evacuees concentrated in an area, telemedicine is now deployed on a limited basis. Doctor on Demand releaseSTAT News, MedCityNews 

But what about using affordable mobile health for the thousands who long term will be in rented homes, far away from their local practitioners–and the doctors themselves who’ve been displaced? What will Doctor on Demand and their sister telemedicine companies have available for these displaced people? What about Puerto Rico, USVI, and the Caribbean islands, where first you have to rebuild the cellular network so medical units can be more effective, then for the longer term? (Can Microsoft’s ‘white space’ be part of the solution?)  

One telehealth company, DictumHealth, has a special interest and track record in both pediatric telehealth and global remote deployments where the weather is hot, the situation is acute, and medical help is limited. Dictum sent their ruggedized IDM100 tablet units and peripherals to Aster Volunteers who aid the permanently displaced in three Jordanian refugee camps in collaboration with the UNHCR and also for pediatric care at the San Josecito School in Costa Rica. In speaking with both Amber Bogard and Elizabeth Keate of Dictum, they are actively engaging with medical relief agencies in both the US and the Caribbean. More to come on this.

Some New York-area events of interest April-May

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/04/iCAN-Global-EBF-logo.jpg” thumb_width=”150″ /]Long-time Reader Howard Reis of telemedicine and teleradiology consultancy HEALTHePRACTICES  has advised us of two free and related events in the Westchester (NY metro) area of interest to entrepreneurs. Both are 21 April at the BioInc Incubator at Westchester Medical College, Valhalla NY.

The first is the bi-monthly iCAN NY breakfast from 8:30 to 10:30 am with the overall topic of commercialization of technologies, with talks from Mr Reis on industry healthcare trends and Michael and Stanley Goldstein from law firm Becker & Poliakoff on corporate governance. Registration via email to Les Neumann, iCAN NY managing director, at les@icanny.net.

The second is a half day ‘Pitch to the Angels’ sponsored by Westchester Angels and Westfair Communications starting at 9:30am through lunch closing at 1:30pm for local entrepreneurs (Westchester and Fairfield counties). It is a two-part event open to startups, entrepreneurs, investors and spectators. You can sign up for the morning or the lunchtime session, or both. Three or four businesses will be pitching in the pm session. Information here. Registration here. Interested in pitching? Submit to be considered here but hurry–it closes 8 April. Contact is Danielle Brody at dbrody@westfairinc.com.

d.Health Summit on 4 May at the NY Academy of Sciences in NYC is focusing this year on a worthy topic, ‘Aging in Place.’ There’s a roster of speakers from the usual journalist, payer and academic suspects, perhaps too many for one day, for your $695 registration. Unfortunately your locally-based Editor, after several fruitless attempts to contact the organizers, cannot offer any further information beyond the website or an endorsement.

Having attended the much-touted MUSE-Klick Health NY evening soireé this past Wednesday, which attempted to be over the top (High Line District! Industrial Converted to Art Space!), it wound up being uninspiring (except for 18 year old Claire Wineland, a young CF patient), barely health-oriented and embarrassingly self-referential. Circulation’s non-emergency health transportation for the 3.6 million Americans who miss medical appointments weekly due to lack of transport, beside a good idea, also had a pretty cool Mini Clubman on display. I left at the break in search of the previous two hours+ spent (at the end of a busy day in a busy week). Caveat emptor increasingly applies to events, yes?

Does current digital health meet baby boomers needs and wants?

The answer, according to health tech industry analyst Laurie Orlov (Aging in Place Tech Watch, Boomer Health Tech Watch) is…not really. Despite its massive size (76 million in the US), spending power (by 2017, 70 percent of US disposable income), breadth (1946-64) and need (despite living longer, by 2030 37 million will be managing more than one chronic condition), most health apps, especially fitness apps, don’t resonate with boomers despite over 50 percent having smartphones. The reasons are many–they’re complicated, often hard to follow, view, and abandonment across all ages is still high. Even among Fitbit purchasers, abandonment is fully one-half. As income decreases, smartphone access also becomes a cuttable budget item. Much more in this paper published by the California Healthcare Foundation.

‘Uninvited Guests’

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/07/SmartFork3-small-Superflux.jpg” thumb_width=”150″ /]Wonder what it would be like to be older and ‘nannied’ by some of the ‘whiz-bang’ devices we promote as making life healthier and better? This short (4 minute) video dramatizes how a 70 year old man deals with the smartphone-connected devices–a food-monitoring fork, activity-tracking cane, pill dispenser and sleep monitor–his well-meaning children have provided to nag and monitor Dad at a distance. Dad dispenses with these annoying ‘uninvited guests’ in his own clever way. Produced by the UK/India-based design consultancy Superflux Lab for the ThingTank project, which explores the conflicts and frictions these IoT tools in the connected home can produce with humans. On Vimeo. Hat tip to Guy Dewsbury via Twitter.

Kickstarting the 1st week of summer: news from all over

No deal yet between insurer giants. Cigna turned down a $53.8 billion bid from Anthem. According to Healthcare Finance, concerns ranged from corporate governance problems, their membership in the Blue Cross Blue Shield Association, the probable chairman’s (from the Anthem side) qualifications and data security (ahem!). Given that Anthem’s 60 million record breach was an inadvertent inside job [TTA 11 Feb], the last is perfectly understandable. But the door appears to be open for the emollient of additional money (to mix a metaphor). Extra: a tart take on this from the WSJ…..Jaguar is looking to increase driving safety by reading your brain waves to detect if you are distracted or daydreaming, via sensors embedded into the steering wheel. It’s based on technology used by NASA and the US bobsled team. They are also working on mood enhancing lighting and a predictive system to speed your interactions with the dashboard to minimize eyes off the road. But will these detect if you feel good to be bad, as their adverts say? Gizmag….The FT gets into digital health via business, profiling startups such as Lyra Health, Genomics England and Heartflow, as well as 23andme and Google X (including the glucose-detecting contact lens we profiled 18 months ago. Hat tips to Eric Topol and David Doherty (mHealth Insight) via Twitter….The NY Times looks at the dark side of ‘senior independence’ with a group of NYC homebound seniors, but other than tut-tutting the desire of older mainly limited income New Yorkers to remain in familiar surroundings, our ‘national celebration of independence’ (!) and not to be institutionalized (their words), the article doesn’t offer much in the way of solutions. And solutions are badly needed for the nearly 2 million over 65 who rarely or never leave their homes, because not all of them will be in assisted living. Hat tip to Joseph Coughlin of MIT AgeLab via Twitter…. But in Australia, they’re exploring ‘future proofing’ and ‘dignity enabling’ homes for an aging population to make them more livable and accessible, via landscaped ramps, larger bathrooms, and sensor rich floors that connect to gait tracking and analysis. Smart Homes 2.0. Sydney Morning Herald…..Neil Versel over at his new MedCityNews stand reports on Doctor On Demand‘s test of tablet-based medical kiosks adjacent to the pharmacy department at four Wegman’s grocery stores here in the Northeast. Is Weis Market far behind?….And Fitbit has a bit part in ‘Law and Order’…well, not the TV show in perpetual reruns, but in a real-life case in Lancaster County, Pennsylvania which is not all Amish farms, black carriages and the so-called Amish Mafia. The police used Fitbit activity data to determine that a local resident (and Fitbit wearer), who claimed she was raped by a stranger, staged the crime scene with overturned furniture, a knife, and a bottle of vodka in her home. ABC27 News via David Lee Scher.

‘Rotting In Place’

Laura Mitchell, who was one of the key people behind GrandCare Systems and now is a marketing consultant and healthy aging advocate, has written an interesting article on LinkedIn Pulse, now on her website, springing off an AgingInPlaceTech article by Laurie Orlov.  Like the latter’s article, it commented on the Washington Post profile of Prof. Stephen Golant, whose POV on ‘aging in place’ was mostly that AIP is oversold–that in many cases, it’s ‘rotting in place in their own homes’. It’s a highly provocative topic with equally provocative statements and Ms Mitchell does take him to the woodshed, as does Ms Orlov in a different way. Prof. Galant seems to take a more moderate tone in his book (publicity perhaps?), citing (in the Amazon summary) that “older people often must settle for the least imperfect places to live. They are offered solutions that are poorly implemented or do not respond to the totality of their unmet needs.” a statement with which this Editor finds it difficult to disagree.

This Editor will largely cite her previous LinkedIn comment with a few embellishments/edits: (more…)

Tech, approaches for caregiving at a distance falling behind

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/02/8001846820_6d2df50ffa_z.jpg” thumb_width=”175″ /]There’s plenty of telehealth systems and apps that remind older adults of their meds, appointments and take their vital signs–but where are the ones that take care of the reality of ‘aging in place’: the loneliness of the man or woman who lives alone, how that person can communicate with family with their own lives 50 or 2,000 miles away, how family members can better oversee or coordinate her care? The problem hasn’t changed when first addressed over a decade ago by the earliest telecare systems. The technology, while more abundant, is largely uncoordinated, putting the burden on the caregiver. Laurie Orlov points out that ‘finding care is not the problem’ but that the care is at extremes: either too light (daily non-medical assistance) or a move to assisted living housing (average move-in now 80+). No company has truly organized a larger solution (more…)

Now a VC concentrating on tech for older adults (US)

Don’t call it a trend yet, but Ohio’s Link-age Ventures Inc. is launching a $26.6 million venture capital fund to invest in startup to early-stage companies targeting products, services and technologies for the 55+ market. The 50 percent partner is a familiar name to those in the US non-profit senior community sector, Ziegler Companies, along with 70 non-profit senior communities (!) as limited partners. The Ziegler Link-age Longevity Fund will look to invest about $500,000 to several million dollars apiece in 10-12 companies engaged in aging in place, care coordination, disease prevention, readmission reduction and wellness strategies. An investment announcement may come in late summer. The US heartland demonstrates a different trend than the relentlessly DH3, youth-oriented West Coast and the mixed messages out of the New York-Boston corridor. Cincinnati Business Courier

Technology which resonates with the 50+ consumer

If you are a health tech developer, entrepreneur or marketer lost in the forest of the 50+ market, Laurie Orlov of Aging in Place Technology Watch and the new Boomer Health Tech Watch just handed you a map with her latest study for AARP, Challenging Innovators: Matching offerings to the needs of older adults (link to PDF). To appeal successfully to the multiple segments and sub-segments of 50+, there’s more to it than a strong belief that your tech would have been just the thing for your mum or grandmere. The hurdles like reluctant long-term care providers and tech-unfamiliar older adults are significant. Misreading the market, making the tech too complex or identifying it too strongly with ‘old folks’ usually lead to ‘lights out’. Ms Orlov’s pointers take you through testing, crowdfunding, accelerators, the right way to price disrupt, transition point mapping, partnerships and more. A recommended guide.

Over at Aging in Place, Ms Orlov serves up another idea with The ideal wearable for seniors – why not a much-modified PERS which incorporates smartwatch/fitness band capabilities such as dehydration monitoring, activity, blood pressure and other tracking, putting them up on a smartphone app.

CEWeek NYC (Part 1): health tech moves to the front

CEWeek NYC, Metropolitan Pavilion/Altman Building (@CEWeekNY)

Part 1

The Consumer Electronics Association (CEA) stages events in New York twice yearly–at the start of both summer and winter, the latter as a preview of International CES in January. CEWeek NYC is a bit of an overstatement–it’s Tuesday-Thursday. It was apparent on today’s main day (Wednesday) visit that beyond the lead dogs of ever-larger HDTVs, in-car audio/smartphone integrators and marvelous audio speakers small and large, something else was different. Health tech was right behind them in prominence, including related areas of robotics and 3D printing. (This builds on CEA’s own trumpeting of the 40 percent growth of the ‘digital health footprint’ at this year’s CES. Hat tip to Jane Sarasohn-Kahn.)

Presentations got the Gordon Ramsay treatment and were re-plated as bite-sized sizzling steak tips. Also different was the format. Instead of a long, dozy general press briefing several flights up at the huge top of the Met Pavilion at 9am, then rushing to the show floors before the crush of buyers, the floors opened to press only for a generous two hours. Then fast-moving keynotes and conference presentations of no more than one hour started at 11am in an intimate downstairs room. Alternatively, the centrally located demo stage between the show floors hosted 15 minute presentations. Other than occasionally having to wait in a narrow hall as the downstairs room emptied between presentations, both were wise moves. Very workable and very low on the Tedium Scale. Three of the eight Wednesday presentations were robotics or health tech-related, not including the closing FashionWare wearable tech show. The proportion is the same on Thursday.

Notable on the show floor:

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/06/0625141011.jpg” thumb_width=”170″ /]The latest fitness band/watch is not a brick, mercifully. Withings formally debuts tomorrow the Activité watch (left) which looks like a fine Swiss analog chronometer, not a slab on the wrist. It’s a man’s watch size on a woman, a bit slimmer and simpler than a Breitling, and connects to your smartphone using the Withings HealthMate app to track activity, swimming and sleep monitoring. You also get time (analog, yes!) and alarm clock, all powered by a standard watch battery so none of the recharging shuffle. Available in the fall at $390, but if you are a dedicated QS-er with style…. Also VentureBeat. (more…)

Is ‘mobile health for seniors’ obsolete?

Perhaps it should be. At the ‘mHealth & Boomers:  Reinventing the Dynamics of the Healthcare System’ panel discusssion at the mHealth Summit Monday afternoon, Stephen Johnston, cofounder of Aging 2.0 (and parent of the GENerator accelerator TTA 12 Dec below), and Laurie Orlov, founder of Aging in Place Technology Watch speculated on the future of technology for older adults in an aging market. The most interesting and unique conclusion arrives at the end of the Mobihealthnews article, with Ms. Orlov flatly stating that the category will disappear by 2020. “There will be no aging in place technology market by 2020,” she said. “All technology will be customizable and usable by all categories of people, and we will not have to have technologies that are marketed for seniors.” Hat tips to readers Mike Clark and Luca Sergio via LinkedIn

Losing ground: Alzheimer’s as a leading cause of death

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/03/Alz-bar-graph.png” thumb_width=”200″ /]This short bar chart (Change in Number of Deaths between 2000 and 2010) tells a story that your Editor did not realize. Alzheimer’s disease currently is the 6th leading cause of death in the United States overall–and where the opposite of progress has been made. Part of this could be better diagnosis, but in large part it is the aging population.

For those innovating health tech, there’s a big job to be done here: not a cure, but to support those with Alzheimer’s and vascular dementias in everyday quality of life (brain fitness, mental stimulation, activities of daily living/ADLs); to aid their caregivers in caring for them, as well as their own quality of life; and geriatric professionals in lengthening time at home and creating stimulating communities, not ‘memory care floors’. Not perhaps as fun as a fitness app, but potentially more rewarding and disruptive to the current distressing model. Graph courtesy of the Alzheimer’s Association (US)