Laurie Orlov's blog

Tech complexity for new users is getting worse. And it’s pretty obvious to anyone who is paying attention to Apple new releases, new versions of Android phones and other apps like Spotify. And then there’s the PC that runs out of memory – just encountered yesterday. You want to see what that means by checking the manual.  How naïve.  No manual.  So you do what everyone who has just encountered an error message does.  You search the tech forums, find the example of what happened and voilà, there’s the fix. Certainly that must be what senior living residents and older adults living at home do, not to mention the of-course sizable tech staff working in senior living and elder care. Oops.

ATA’s live event return to Boston. This week the American Telemedicine Association (ATA) conference, charmingly titled “What Now? Creating Opportunity in a Time of Uncertainty,” returned to a live format event in Boston. For those wondering, the event title relates to 'reimbursement uncertainties, workflow challenges, and investments needed.' Most of the exhibitor list of companies' focused on improving the efficiency and effectiveness of provider workflow and businesses. But some offered innovation for patients, whether in virtual visits and care, vital sign measurement, and improvements to patient experience. One might note that individuals 55 and older account for more than half of healthcare spending, with costs rising with age.  Here are five from the ATA event, content from vendor websites:

Covid-19 fallout pushed the care industries into the home.  A sweeping set of changes from that time that may have appeared temporary. But a number of these changes are likely permanent.  Telehealth vs. in-person:  the Covid-19 public health emergency declaration to reimburse doctors for providing telehealth services for Medicare recipients has been repeatedly renewed. Bills are in Congress will make it permanent.  Medical practices are now offering choices to patients – in person or telehealth?  Home care vs. assisted living – the demand is for home care.    Hospitals continue to close, especially in rural areas. Acute care delivery at home for Medicare recipients has been endorsed by the American Hospital Association – and bills supporting it may pass. Finally, the CMS-created codes for remote patient monitoring (RPM) can be used for reimbursement of chronic disease monitoring services.

We are used to citing population surveys to cite trends. Tech adoption among older adults is clearly increasing. The growth has been tracked most recently in survey samples that compared the most recent with prior time periods: AARP surveyed 2063 and Pew Research surveyed 1502 adults. And Linkage Connect surveys the oldest, with a sizable sample of 2398 older adults. For all three, broadband access and smartphone ownership and use is growing. But what if tech adoption came from a sample size of 2.9 million households pulled from the 5-year census (American Community Survey/ACS) data? That was posted in November of 2021, with surveying ending in 2020 (just before Covid-19) and was made available within the last month. Good news -- seventy-six percent of the 65+ population as of 2020 has access to broadband -- and tech adoption has clearly risen since 2015. One might assume that post-Covid census data will be even more significant.

Staffing issues continue to plague senior care organizations. The news articles pile up – assisted living and nursing home staffing shortages; stranding older adults without home health care; keeping patients in hospitals longer because of lack of care; nursing home staffing crisis; Medicaid paying family members to provide care, low wages and low unemployment worsen care situation, and on and on. And the shortage of care workers is mirrored in other industries – signs are posted everywhere seeking workers in the midst of the ‘great resignation.’

Isn’t March a l-o-n-g month? So many weeks, so many blog posts to, uh, post. Note the top trends that matter this year. Many changes underway in the enabling tech categories for older adults – including the importance of tech for home care agencies – not just the apps for the workers, but for care recipients, such as remote monitoring. And for hearing aid wearers, the smartphone can carry multiple apps that improve their quality of life. Finally, the smartwatch, aka personal emergency response device, gets another entrant – and the very first mobile PERS ('medical alert') company, Mobile Help, is acquired. Summing up the month:

Design improvements that benefit all will benefit older adults and caregivers. Unlike niche hardware and software for seniors, basic Voice First platforms and software will change rapidly and without disruption for users – accompanied by a ‘What’s New’ weekly email and a few suggestions on new tricks to try – but the changes behind the front-facing features will make the most difference. With the 2018 lens to guide the market today, here are a few ways the user experience and thus the ecosystem should have ratcheted upwards:

Another long-time PERS player sees a watch, makes a watch. Rant on. Last January 2021, WaterStreet, a healthcare investment company, coughed up a mind-bending $100 million to Medical Guardian, a long time (2006) privately-held PERS provider, to ‘fund expansion.’ Medical Guardian already had a PERS watch (from Omate) – which Amazon reviewers did not love; other than HELP and telling the time, there wasn’t much to it anyway. By June 2021, they partnered with Black&Decker to offer more PERS capabilities – a wearable with fall detection, but maybe that lacked a wow factor. So the newly developed one has more features – including step-counting, a voice-assist charge warning, and communication (from the watch) with a care circle. With deep pockets, Medical Guardian can afford to develop its own device – and maybe this one's the charm for current customers, though it lacks fall detection.  Otherwise the market has moved on.

The ACS will size tech adoption – and not a minute too soon. We might learn from the upcoming American Community Survey (ACS) data release which households have broadband connectivity, own a computer or other devices – down to a level of granularity that includes that rarely surveyed category, age 85+. And we may be able to examine age in relationship to tech ownership. In 2011, as part of the Linkage Technology Survey of Adults age 65-100, the report observes that there are few surveys of technology ownership among the older adult population.

Hearing aid users need smartphones and apps. The hearing aid industry has been undergoing disruption in recent years, most notably from the Over The Counter initiative and the growth of hearables, which have legitimized the use of devices hanging from, versus hidden inside the ear.    There are some apps that can enhance the quality of life of individuals with moderate or severe hearing loss. A number of these have been discussed by audiologists in the TruHearing website. Audiologists support the use of multiple types of apps for those with hearing loss, particularly those apps that come from the hearing aid manufacturers themselves. Experts note that these apps enable the user to tailor their experience to their own needs. Beyond the manufacturer offerings, there are a number of apps that can help people with a broad range of hearing loss – hear are ten of them in alphabetical order, content from the reviews or vendors: