Technology will help ease, but not replace, rising workforce demand in long-term care: UCSF study

A just-published research paper by researchers at the University of California, San Francisco Health Workforce Research Center on Long-Term Care, has come to the not entirely unsurprising conclusion that the current technology targeted to the LTC area is helpful but won’t displace any workers from their jobs in the immediate future. The qualitative study evaluated 13 current health tech technologies in 14 areas for their potential impact on the care of older persons as it affects LTC workforce recruitment, training, and retention. 

Some key findings were: 

  • Technology will not even come close to replacing the LTC workforce. At most it will aid LTC workers.
  • Tools such as data collection and remote patient monitoring systems that distribute data to the care team can improve staff’s understanding of client behavior and manage day-to-day tasks
  • Technology can also address workforce recruitment, retention, and staffing efficiency, such as predictive analytics used in identifying candidate suitability, improved staff management in shift scheduling, work location, and clientele, and real time location tracking, can improve the work environment
  • Technologies that monitor health and activity measurements, integrating with predictive modeling, can benefit clients, family caregivers, and care teams, but may suffer from complexity and duplication in their category. 
  • Educational tools also improve care delivery by instructing on proper caregiving techniques, increasing knowledge on medical or behavioral conditions, and by promoting sympathy/empathy

Some of the barriers included:

  • It comes at a cost which LTC is reluctant to pay
    • Initial and ongoing cost with lack of third-party Medicare/private reimbursement
    • Dependence on unattractive long term subscription-based models 
  • Threats to privacy and the security of health data
  • Potential differences in product specificity or acceptance among diverse racial and ethnic groups
  • Technology lacking user-centered design and not developed/tested in conjunction with real-world LTC 
  • Funding: only two US VCs fund LTC tech is a bit of an exaggeration, but the pool of interest is shallow nonetheless

The overall conclusion struck this Editor as less than enthusiastic, perhaps because We’re Not There Yet and it’s still so far away.

The appendix lists the 13 companies surveyed with summaries of each health tech company interviewed: Alma’s House (Sweden), Arena (staffing/recruitment), Canary Health (education/caregiver education), CarePredict (wearables/alert monitoring), Clear Care (management). Embodied Labs (education), Intuition Robotics (ElliQ), GrandCare (monitoring/client engagement), Honor (staffing), La
Valeriane (documentation), LifePod (voicetech/monitoring), UnaliWear (wearables/monitoring), VisibleHand (documentation/EHR).

The study was supported by the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS).com. UCSF summaryThe Impact of Emerging Technologies on Long-Term Care & the Health Workforce (full text)  Hat tip to Laura Mitchell of GrandCare via Twitter

In-home video monitoring acceptable to 90 percent of dementia carers: Age NI study

What used to be the ‘third rail’ of caring may no longer be. The idea of cameras in the home to view activity of an older family member was so abhorrent to caregiving relatives that it was a key in selling purely sensor-based monitoring systems from the early 2000s on, such as QuietCare, GrandCare, Alarm.com Wellness, Healthsense, Lively, Tynetec/Legrand and many others. Today, in the age of selfies and video on social networks, video surveillance doesn’t seem so foreign. Age NI‘s study conducted through Ulster University had the surprising finding that over 90 percent of participants in several focus groups supported it, with two important caveats; that there was initial consent from the older person being monitored, and that only family members could view the video. With that, they found it ‘useful’, ‘ethical’ and ‘moral’. It would support the person’s safety in aging at home longer, and provide peace of mind for carers. Hat tip to Toni Bunting of TASK Ltd. PharmaTimes, Ulster University News

Can technology help to bridge the Loneliness Factor?

The Guardian’s impassioned article on how common and harmful loneliness is among older adults led to some reflection by this Editor on how difficult and ‘multi-part’ an approach to help can be, even if you call it ‘The Campaign to End Loneliness’. “Studies have found loneliness can be more harmful than smoking 15 cigarettes a day, increases the risk of premature death by 30% and the chances of developing dementia by 64%. More than one million people aged over 65 are thought to be lonely – around 10-13% of older people.”–statistics from the article and AgeUK’s press release on their recent study, ‘ Promising approaches to reducing loneliness and isolation in later life’.  GPs see a lot of them, and some more for an ‘event of the day’ than actual medical need. Loss of hearing, sight and mobility further isolate the older person, particularly those in rural areas where everyone and everything is at a distance requiring driving, creating dependency among those who can no longer. Even among the middle-aged, loss of hearing reduces engagement in social situations. (And the article does not include the disabled.) It closes with suggestions that councils need to budget for and organize programs to reach out to lonely adults, including carers, and that not one approach can fit all, but emphasizes more personal approaches such as groups and one-on-one support. Hat tip to Malcolm Fisk via Twitter

Is a way to fight the Loneliness Factor located in technology, even remote patient monitoring? That’s been the primary reason for some systems such as GrandCare, but even in RPM, whether hub-based or smartphone/tablet based, the reminders and active clinician monitoring part of chronic care management can and do engage. Older people are using smartphones and tablets–perhaps not as fully as a 40 year old, but they are using Skype, calendaring and social media (Facebook, LinkedIn and news/opinion sites). A big help here, according to Laurie Orlov, would be voice recognition and integration into safety/alarm technologies. This Editor also sees proactive alerting to changes in condition as a still-untapped area.  There’s $279 billion of potential in ‘silvertech’ as estimated by AARP and Parks Associates–it’s a matter of getting young techies/entrepreneurs excited about it, and the Sand Hill funder crowd realizing that yes, it’s sexy too. Long Term Living

‘Déjà vu all over again’ or critical mass? NYTimes looks at older adult care tech

“It’s like déjà vu all over again” as Yogi Berra, the fast-with-a-quip Baseball Hall of Fame catcher-coach-manager once said. About 2006-7, telecare broke through as a real-world technology and the tone of the articles then was much like how this New York Times article starts. But the article, in the context of events in the past two years, indicate that finally, finally there is a turning point in care tech, and we are on the Road to Critical Mass, where the build, even with a few hitches, is unstoppable.

Have telehealth, telecare, digital health or TECS (whatever you’d like to call it) turned the corner of acceptability? More than that, has it arrived at what industrial designer Raymond Loewy dubbed MAYA (Most Advanced Yet Acceptable) in keeping older adults safer and healthier at home? The DIY-installed Lively! system keeps an eye on a hale 78 year old (more…)

Life expectancy up, but so is death from falls (US)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”175″ /]The Gimlet Eye falls outside the box, and is writing this from recovery. Our companion in curmudgeonliness, Laurie Orlov, whacks us upside the head with first the good news then the bad. US life expectancy is up: if you are 65 today, on average you will live to 83 (men) and 86 (women), even with the rise in chronic conditions that affect quality of life, such as diabetes and heart disease. But the bad is that death from falls is also up. This is despite all the systems and gizmos the Digital Health Industry has concocted to detect falls beyond 1970s PERS technology. Once upon a rose-colored Telecare Time we thought we could infer falls purely by sensors detecting lack of activity (the basis of QuietCare, GrandCare, Healthsense, the late WellAWARE). Then with accelerometers, fall detection would be automatic, (more…)

The CES of Health: post-scripts

It’s Everywhere, Everyday, Disruptive, Not Impressive and Still ‘Bicycles for Fish’.

Neil Versel’s first major article recaps the Digital Health Summit ‘Point of Care Everywhere’ panel with Dr. Joseph Kvedar of Partners HealthCare/Center for Connected Health, Walter De Brouwer, founder and CEO of Scanadu (the tri-corder everyone’s waiting for) and Laura Mitchell, VP of business development at ‘grizzled pioneer’ in telecare and telehealth GrandCare Systems. The key is integration–for Dr. Kvedar, making it ‘about life, personal and social’; for Mr. DeBrower, bringing digital health into the home; for Ms. Mitchell, persuading long-term-care providers that technology provides useful, actionable information. Some surprises here: Scanadu will be shipping 8,800 units in March to its Indiegogo supporters and is going into a Scripps Health clinical trial; Dr. Kvedar admitted that the latest CCH startup, social wellness site Wellocracy [TTA 30 Oct] is “still searching for its audience.” The headline is “Mobile health has a lot of power, but it’s raw and new”–but is that helpful in positioning it to the Big Users–payers, pharma, providers–who are not all that daring? Mobihealthnews 

Everyday Health with the Digital Health Summit announced on Thursday their 2014 awards for innovation to five US companies for ‘achievement in technology innovation aimed at improving health outcomes.’ They include Scanadu but also four less heralded companies: (more…)

Telecare as entrepreneurial platform (US)

Telecare ‘grizzled pioneer’ GrandCare Systems, which extended some time ago into both telehealth and socialization, is profiled in this Milwaukee Journal-Sentinel article on local entrepreneurship and the relationship of intellectual capital to economic success. CEO Charles Hillman, COO Gaytha Traynor and VP Marketing Laura Mitchell are interviewed in the video (05:26).

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/04/Lively.jpg” thumb_width=”150″ /]But telecare has attracted a new entrant, Lively (or Live!y). It’s an in-home behavioral monitoring system which uses neatly-designed motion sensors and M2M connectivity. It strongly resembles to this Editor QuietCare as originally positioned for older adult independence and safety in the home, but developed out in a version 2.0 or 3.0. Activity information feeds over to a web/smartphone platform which generates alerts when something is off the routine (again, like QuietCare). Pricing is right with an equipment cost of $149 (same as the original QuietCare) but with a far lower per month subscription of $19.99–lower than PERS which averages around $35-45–and unlike QuietCare, it is fully self-install. The connectedness overlay is (hold the presses!) direct mail–a ‘LivelyGram’ every two weeks which turns friends and family photos, news and updates into a booklet. The sticking point may be the usual–the older person finding this intrusive and ‘I don’t need this.’ Their Kickstarter appeal has unfortunately started off slowly even with initial discount pricing of $99 for the system; as of 23 April, $11,534 pledged of a $100,000 goal with 21 days left. Neil Versel reviews at Mobihealthnews.