[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/03/Boots-Main-Logo.jpg” thumb_width=”150″ /]Boots has entered the direct-to-consumer PERS business with Home Assist, supplied by Tunstall Healthcare. It’s a conventional (non-mobile) base unit and pendant with 24/7 response to Tunstall’s call center and a temperature sensor that will alarm at cold temperatures. The basic PERS is priced at £34.79 ($49) inclusive of VAT for the unit and a £19.99 ($28) monthly charge. Adding fall detection, the prices rise to £46.79 and £25.19. The most expensive option adds a smoke detector, reassurance calls and a bogus caller alarm for £58.79 and £31.19. Some end users may qualify for VAT-free pricing due to a qualifying disability or long-term illness, which lowers rates by £7-9. According to our former Editor and occasional contributor Mike Burton, this is a first for any High Street chemist and ups the game for all PERS and alert systems. It’s also a natural move, given that the US outpost of the Walgreens Boots Alliance has direct sold Tunstall (and earlier, AMAC) PERS units for 10 years. (Walgreens’ base monthly rate is about the same at $29.99 monthly for the same unit, but no unit cost on an annual contract.) Home Assist website (Tunstall UK/Boots). The in-store leaflet link on the Boots website features Boots locations in London and Leeds only, along with a full application.
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/03/elderly-smartphone.jpg” thumb_width=”150″ /]Laurie Orlov’s updated view of technologies that assist home caregiving/living, and her observations on trends for both boomers and those well over 65, is hot off the (virtual) presses and available here
on her website. It is US-market oriented, but the trends explored here will be of interest internationally. The focus in this study is home-based systems for safety, alerts, activity/location tracking (telecare), home care/caregiving tools and what this Editor would call ‘health monitoring light’–med minders and logging apps versus medically-oriented telehealth (vital signs, save for AliveCor
) and telemedicine (virtual visits/consults).
- In communication, internet non-usage among 75+ has declined to 50 percent over the past 15 years.
- The tablet form factor is losing ground as smartphones get bigger. Older adults and smartphones are beginning to ‘get along’ partly as they grow larger, but also that feature and simple phones are becoming less available.
- Also losing ground is senior housing–residents are delaying entry to assisted living until they are mid 80s and frailer. Savings and debt in the boomer group is low and high, respectively.
- Investors are caring more about home care, with large investments ($80 million) in three regional home care worker startups: Honor (San Francisco), Home Hero (Los Angeles), and Hometeam (New York/New Jersey), caregiving apps and chronic care management (CareSync, with an $18 million raise).
- Dementia care support tools are (finally) developing into its own category.
Surprising conclusions: PERS alerting stays strong, but changes to be mobile-enabled and more cosmetic; a lot of convergence of categories and forms; and the term ‘health tech’ will replace ‘digital health’. Oh my!
The increasing awareness of abuse of older people by their caregivers, whether at home or in care homes/assisted living/nursing homes, invites discussion of the role that technology can play. This presentation by Malcolm J. Fisk, PhD, co-director of the Age Research Centre of Coventry University, in the BSG Ageing Bites series on YouTube looks at technologies viewed by level of control and intrusiveness:
- Social alarms, which include pull cords (nurse call) and PERS–what we think of as ‘1st generation’ telecare: high level of control, low intrusiveness–but often useless if not reachable in emergency
- Activity monitoring, which can be room sensor-based or wearable (the 2nd generation): less control, slightly more intrusive–also dependent on monitoring and subject to false positives/negatives
- Audio and video monitoring, while achieving greater security, are largely uncontrolled by the older person and highly intrusive to the point of unacceptability. (In fact, some feedback on tablet-based telehealth devices indicates that a built-in camera, even if not activated, can be regarded with suspicion and trigger unwanted reactions.)
The issues of consent, and balancing the value of autonomy and privacy versus factors such as cognitive impairment, personal safety and, this Editor would add, detecting attacks by strangers and not caregivers, are explored here. How do we ethically observe yet respect individual privacy? This leads to a set of seven principles Dr Fisk has published on guiding the use of surveillance technologies within care homes in the latest issue of Emerald|Insight (unfortunately abstract access only) Video 11:03. Hat tip to Malcolm Fisk via Twitter.
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”150″ /]Another press release from Tunstall Healthcare Group
is also about Tunstall Americas
, in this case the acquisition of Syracuse NY (Central NY State)-based Health Care Monitoring Systems (HMS)
. This continues this year’s strategy of purchasing or partnering with local home care providers. Like Mountain Home
and Kupuna Monitoring
(previously in TTA), HMS’ website prominently features a competitor–Philips Lifeline
. Notable in the spare release is that the HMS founder notes “strong relationships with referral partners and government agencies.” Release
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”125″ /]Tunstall Americas continues its home care provider-centric strategy through an expanded product marketing relationship with Apria Healthcare. Apria, in addition to home care services, markets directly to customers a range of medical devices and durable medical equipment; they will be selling Tunstall’s brands under their medical alert category. This is the first we’ve seen in the US the Tunstall Vi and iVi pendant, along with the CEL cellular PERS unit. Tunstall will also be providing Apria with custom branded products, along with call center, ordering and fulfillment services. Apria is the US’ fourth largest home care provider (2014 Home Care Market Outlook) with 1.6 percent of a highly fractionated market. Our sources tell us that the initial relationship precedes the Tunstall acquisition of AMAC. PR Web
A noticeable trend in telehealth has to do with focusing less on the generic virtues of at-home vital signs monitoring for routine patient care and more on managing specific high-cost populations to avoid or reduce costs. Some of the impetus in the US has come from new regulations by CMS (Center for Medicare and Medicaid Services) intended to move Medicare fee-for-service (FFS) patients into a reimbursed chronic care management (CCM) model. Banner Health is Arizona’s largest private employer (which does say something about Arizona as a retirement haven) and since 2006 has been experimenting with remote monitoring since 2006. Starting in 2013 Banner piloted Philips‘ post-discharge program now called ‘Hospital to Home’ as Banner iCare, combined with Philips Lifeline PERS, but made it available to those only with a stunning five+ chronic conditions–the top 5 percent that is reputed to account for 50 percent of healthcare spend. Banner combined the tech with intense support by a multi-layered care team. At ATA they announced the following results with the initial cohort of 135 patients, now up to 500:
- 27% reduction in cost of care
- 32% reduction in acute and long term care costs
- 45% reduction in hospitalizations
The article in Forbes is a bit breathless in profiling the program and the ‘superusers’ of healthcare (with a windy but false analogy from John Sculley) but provides a level of detail in the program that most articles do not. One wonders how Philips makes money on supplying what is at least $2,500 worth of kit, with peripherals that must all be Bluetooth LE. It’s also not stated, but the TeleICU and TeleAcute programs also appear to be Philips’. Video
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/04/MonitorGO-cropped-small-232×300.jpg” thumb_width=”150″ /]Guy Dewsbury of the eponymous Gdewsbury
independent research consultancy brought to this Editor’s attention his recent commission for West Yorkshire-based MonitorGo
in evaluating their new smartphone-based personal alarm. He analyzed the device’s features here
in a comparison chart and writeup, versus what is commonly available in the market. If it reliably does what it says it does (our normal caveat), it could be a big step beyond the Ur-Pendant, addressing our (and Neil Versel’s) concerns earlier this week on the persistence of ‘ancient history’ PERS [TTA 31 Mar
It goes well beyond common mPERS as well. There are 12 features, including GPS location, hard fall detection and 24/7 third-party help line monitoring (via Medvivo), but the key differentiating features are the soft fall detector, unconsciousness/inactivity detection and false alert detection/response–as well as usability as a simplified smartphone with unlimited calls to UK landlines and 250 mobile-to-mobile minutes. (more…)
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/03/Fallen-woman.jpg” thumb_width=”150″ /]Something to think about. How many families and older adults are aware that the traditional PERS emergency pendant, which has been around for at least 40 years, is sadly outdated and in fact inadequate for those at greatest risk? While major advertisers on US media such as Life Alert, Life Call, ADT and Philips Lifeline present crisis situations where the older person is on the floor and is rescued after pressing the pendant button, they barely advertise their other available products that incorporate passive fall detection and cellular, even if somewhat inadequate for soft falls or unconsciousness. Families unwisely feel ‘protected’ when paying for traditional PERS, not realizing that more advanced technology is readily available and not that much more expensive. Moreover, and only mentioned in the context of his grandmother’s fall while in senior housing, there is a distinct recalcitrance of senior housing executives to rid their apartments of the (cheap) old pendants and replace them with (pricier) passive/cellular assistance systems, much less more advanced wearables/RFID systems or mobile/watch combinations. This Editor also notes that the major drugstore chains also sell PERS; while they trumpet wellness in their advertising, they are as behind the curve in this area as senior housing. Neil Versel in MedCityNews.
For our Readers: can we compare/contrast how the UK, EU and US are still wedded to traditional PERS after 40 years, and if more advanced forms are starting to take hold? Click on the headline to see comments, including this Editor’s opining on traditional PERS as ‘cash cow’.
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/03/Unali-Kanega-new-iteration.jpg” thumb_width=”175″ /]The UnaliWear Kanega
assistance watch [TTA 18 Feb
] on Wednesday closed its Kickstarter crowdfunding
over the top at $110,154. It has several features to promote safety for older people or the disabled, with fall detection, GPS and stand-alone cellular/Wi-Fi connectivity, but the most unique is voice recognition and command/response. Its latest prototype is half the case size as previously, with a more attractive analog watch face, which makes it a lot more MAYA (most advanced yet acceptable–Raymond Loewy), and a major improvement in form over your typical PERS or most GPS watches. With our usual caveat (if it does what it says it does in production), we applaud Jean Anne Booth and her team for their achievement–and we’ll be watching.
[grow_thumb image=”https://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…)
One of our most popular articles ever on TTA has been Tom Doris’ analysis of accelerometers in fall detection. His point of view is as a developer in digital health technology. For your consideration, we are posting this extended response from an executive experienced in deployment of both traditional PERS and now PERS with accelerometer-based fall detection in older adult populations.
Andy Schoonover is President of VRI, a leading provider of PERS, MPERS, and telehealth monitoring services founded in 1989. VRI currently actively monitors approximately 110,000 clients in the US–and a long-time TTA reader.
Tom Doris wrote a post on September 17th, laying out the problems with the use of accelerometers and fall detection devices especially in regards to PERS. After reading Tom’s post I felt compelled to respond with the following five points on why it’s important to continue to promote fall detection within PERS and MPERS.
1) In the 1 out of 100 case that my grandma falls and can’t physically press a button (sudden fainting due to hypoglycemia for example) would I prefer she have a regular PERS, which definitely won’t indicate a fall, or a PERS with fall detector which will more than likely indicate a fall? If it were my grandma I’d go with the “more than likely” option.
2) If my grandma had too many false positives then I’d ask her: you can use regular PERS with no fall detection or you can use PERS with fall detection where you will get called a couple more times per month. Which would you prefer? Hint: she’ll say fall detection. About 5 percent of our customers are annoyed by the false positives. (more…)
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/09/Lively_safetywatch_captioned_June-2014.jpg” thumb_width=”150″ /]The Lively
home telecare system, which uses a series of passive activity sensors wirelessly connected to a cellular monitoring hub, announced a ‘safety watch’ addition to its system. The wristband has a watch form factor, is waterproof and contains an emergency button with analog/digital option on its time/date watch face. The smartwatch-ish features are medication reminders and a pedometer for step tracking. When out of home, the wristband tethers to an Android (only) smartphone. Battery is good for about six months. If the button is pushed, there is a ‘countdown’ during which a call center attempts to reach the user by phone (watch is not two-way voice) prior to dispatching emergency (more…)
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.
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/Guardian-Angel-necklace.jpg” thumb_width=”150″ /]Out of Singapore is a pretty silver necklace or bracelet that does more than adorn: with the press of its small silver button, it can help the wearer get away from an uncomfortable or harassing situation in a public setting (like the workplace, a bar or party) by sending that ‘nick of time’ fake call to your iPhone by Bluetooth LE. Or if held down for over 3 seconds in an emergency, it sends an SOS text, coordinates and a Google Map link via the phone to designated recipients (not law enforcement.) The Guardian Angel
pendant was developed by ad agency JWT Singapore to support AWARE (Association of Women for Action and Research) in Singapore through a 10 percent per unit donation, and is available at local retailer My Room Retail or internationally via their website
for US$120 (UK£71) plus shipping, handling and optional bracelets. What isn’t clear is if a smartphone is needed–the website indicates that an app must be downloaded from the Apple AppStore but the Daily Mail article
says it works with any phone. Also PSFK
review, ABC (US) News
. What’s a little disappointing is that the first function (‘get me away from this creep’ self-call) is being more widely touted than the second (‘the creep is coming after me with handcuffs, and he’s not a cop’ SOS). This Editor also wonders how reachable the necklace in particular would be in a truly dangerous situation. But it is certainly better than the alternative. Hat tip to Editor Toni Bunting.
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/03/first_sign_clip-1.jpg” thumb_width=”120″ /]In TTA 6 March we covered another ‘fashionable safety’ item, the First Sign hair clip, which is more violent crime deterrence and recording-oriented. It senses impact and sends audio/video/GPS location to monitors plus designated recipients along with a pre-recorded announcement that it is gathering evidence. It succeeded in its Indiegogo financing round and is available for pre-order here for estimated November delivery at $50-75 plus monitoring. But so far, fashion hasn’t made its way into the maddeningly institutional PERS design (though Chubb has given it a whirl with its Glasgow competition recently.)
Surprisingly in the tech-addicted (and young-skewing, based on subject matter) Gigaom is this short piece on how health tech companies are missing the boat by targeting the young, healthy fitness addict or plain addicted-to-the-data Quantified Self (QS) market, rather than those over 50 and their families. ‘Simple’ and unobtrusive are the keywords, especially for what the late and much missed MetLife Mature Market Institute termed the ‘old-old’–those over 80. Mentioned are home activity monitoring systems such as Lively, BeClose and GrandCare Systems supplanting the PERS pendant (Lifeline) and the additional alert capabilities offered by GreatCall/Jitterbug. (This Editor will also mention a new telecare system entering the European and Americas markets, Essence Care@Home, which premiered at Mobile World Congress 2014. More on this in the next few days.) What’s notable about the article is the emphasis on the market size (via expert Laurie Orlov): $2 billion now, ten times that in 2020. What’s incomplete about the article is no ‘look-ahead’ to how devices like smartwatches (and watch-like forms such as AFrame), sensor-based wearables which connect to smartphones–and sensor-equipped smartphones, tablets and even Glass-type devices with simple apps which can help with self-or group-monitoring, prompts for those with cognitive difficulties, and more. Worldwide, we are also running out of carers [TTA 24 April]. Who will crack the code on tech for seniors?
Following up on our 28 March story of Chubb Community Care sponsoring a competition at the Glasgow School of Arts to redesign the traditional telecare medical alarm (PERS), the five winning entrants and teams were announced today (23 April). They are:
Element: Craig Meakin, Kayleigh Nelson, Eilidh Gibson and Ramsay Black
Pebbl: Gordon Ritchie, Francesca Stephens, Jordan Smith, Erin Wallace and Heather Walker
Bodyguard: Steven McCauley, Harry Hutton, Kim Stendahl, Matias Rinne and Andrew Robertson
Lumeo: Nadia Bassiri, Robert Turner, Harry Opoku Agyeman, Helen Campbell and Jonathan Thomson
Suit: Michael Tougher, Hannah Kirkbride, Euan Spalding and Tristan Stoner
The winning teams will share a £2,500 cash prize, and their designs were publicly presented at Municipal Buildings in Forres, Moray in the north of Scotland. The Glasgow Arts teams worked with Moray residents who currently use PERS and their carers to determine design and functionality factors. According to the release, Chubb is using the designs to complement the work of its own engineering teams, and thus at this point the concepts are still under wraps. We hope these concepts gain wider exposure. Release link to come.