Elder Care Enters Digital Age

By Kristi E. SwartzThe Atlanta Journal-Constitution

The growing business of taking care of aging seniors at home is getting help from a powerful, but unlikely suspect: the mobile phone industry.

With rising health care costs, the soaring baby boomer population and an increased emphasis on keeping people out of hospitals for conditions that can be monitored and treated at home, Atlanta-based AT&T Mobility and other major wireless phone companies have found a sweet spot for new growth.

Marrying technology with medicine may be part of the solution to better health care and lead to more business opportunities, but there have been challenges. Concerns about privacy, how doctors get paid and whether traditional geriatric facilities — such as nursing homes — will go away as more people choose to remain in their homes, are among them.

“In the private industry, there’s a whole group of people looking at how to solve this problem,” Ralph de la Vega, chief executive officer of Atlanta-based AT&T Mobility, said in an interview with The Atlanta Journal-Constitution. “Obviously, we’re not alone in this, but we think the technology we have will allow people to be able to do that.”

Analysts say what’s known as the home health care industry — adding technology, telecommunications, smartphone applications and other equipment to make it easier for seniors to stay in their homes — could swell to between $1.5 billion and $2.5 billion because of the number of involved partners: wireless companies, technology developers, hospitals, doctors, insurers and home builders. The growth will come at the right time. Nearly 75 percent of AARP’s surveyed members say they’d prefer to stay in their current home as long as possible, and much of the baby boomer generation is more comfortable with using technology and mobile devices compared with their parents.

They also have the most equity in their homes, have more long-term savings and are willing to spend money on gadgets.

“It’s helping the wireless industry transform itself. It can become more competitive and better for the customers. That’s a big job,” said telecommunications analyst Jeff Kagan.

The business opportunities have led AT&T Mobility to develop what’s becoming a separate division called Digital Life Services that will be run out of Atlanta. The organization will be housed under the AT&T Mobility’s whiz-bang “Emerging Devices” division, which started three years ago.

For its part, Verizon Wireless has formed its own team of account managers, executives and others to focus solely on the health care industry.

“The biggest piece is that Verizon wants to play in this space,” said Rachael Nagrowski, Verizon Wireless’ associate director of strategic sales. “We no longer want to be seen as a cellphone provider.”

AT&T Mobility talked up its new suite of home monitoring services including cameras, lighting, thermostats and motion detectors, part of its Digital Life efforts, at an international mobile technology conference in Barcelona in February. The business model is for overseas only; the company has not made any announcements in the United States. Here, the company broke into the digital health care industry by selling pill bottle tops called GlowCaps, which flash and send out ringtones to remind people to take their medicine. Every time the cap is opened, the person’s doctor or family member gets notified electronically.

“AT&T’s concern in this space is really around the fact that when you look at the stats — 10,000 people a day retiring — you look at the current infrastructure in the U.S. for people that are aging, there is no way with the baby boomers and how fast they are retiring. We don’t have the infrastructure to keep up,” said Glenn Lurie, head of AT&T Mobility’s emerging devices unit. “We need to understand that people are living longer, and we need to do a better job of asking those people what they want.”

It’s rare that the phone companies will develop these mobile health care technology devices themselves. Rather, they will partner with a company that’s developed new technology for the health care industry. That device typically contains the same type of software and network elements that are in a smartphone, so it can communicate with a caregiver, doctor or nurse using the mobile phone provider’s wireless network.

The development of these devices now helps people take their blood pressure, heart rate and weight at home, for example, and upload the information to a database for a doctor to read it. Any changes in vital signs or warnings of trouble can be spotted early, and the doctor can call to change medication, ask the person to come in for an appointment or send an ambulance for emergency care.

“The focus of all of health care now is really to reduce in-patient hospital care, nursing home care, facility kind of care,” said Mark Oshnock, chief executive officer of Atlanta-based Visiting Nurse Health System.

As much as $25 billion a year is spent on hospital readmissions. Medicare estimates that 
75 percent of those readmissions could be prevented with better outpatient care, Oshnock said.

Oshnock said there was initial resistance from the visiting nurses when they first started using remote monitoring equipment five years ago.

“There were a lot of implementation issues, one of which was, ‘How can I be replaced by this little piece of equipment?’”

Not long after, Oshnock said the nurses said it was worth taking an extra 10 to 15 minutes to show someone who had just been discharged from the hospital how to use the remote monitoring equipment to check vital signs. It’s prevented people from returning to the hospital, allows nurses to check more patients and saves everyone money.

“It’s been a working solution for us,” Oshnock said.

In many cases, it’s eased the mental, emotional and often physical stress families or a spouse experience when caring for an ailing family member.

Suffering from dementia and emphysema, Jim Connelly wasn’t getting out of bed or interacting with his wife, Cackie. That all changed when his daughter, Mary McKenzie of Sandy Springs, bought a multimedia device called SimpleC. Similar to a small TV screen, the device uses photos, music and voice recordings to tap into a person’s long-term memory, helping to motivate someone who is suffering from memory loss.

McKenzie installed old family photos, 1950s music and voice recordings of herself reading prayers and psalms to help trigger memories of the family growing up.

“Dad would perk up,” when he would hear the music and see the photos, McKenzie said. Hearing the psalms would calm him at night, she said. What’s more, McKenzie said her mother felt less overwhelmed.

“This gave her a little bit of confidence, and afterward she started taking steps to get Dad more help,” McKenzie said. “I felt like it was a catalyst to get her going.”

The makers of SimpleC, which contracts with Verizon Wireless to run on its 4G LTE network, started testing it in homes last summer after installing it in 29 assisted-living centers. SimpleC directly markets SimpleC to assisted-living centers and is working with Verizon to market it to families and seniors who are remaining in their own homes.

The industry continues to work through hurdles, which include making sure the devices are made for the person who uses them and not just the caregiver, who is likely more tech savvy. Also, anything that cuts costs for patients, hospitals and other treatment centers means it reduces pay for doctors, nurses and others.

“There are numerous concerns by doctors, such as fear of punishment for authorizing home health services that [the Center for Medicare and Medicaid Services] declares to be unnecessary,” said Jane Orient, spokeswoman for the Association of American Physicians and Surgeons, a Tuscon-based physicians group. “Many physicians would be willing to make house calls if they were allowed to charge a reasonable rate. The question of the decade may be, ‘Are patients allowed to use their own money to pay for care without Medicare supervision?’ ”

Kagan, the telecom analyst, says the medical community will find a way to ensure doctors and nurses are still paid.

“Every transformation, you lose jobs, you lose investment, you lose money,” he said. “But you hire people and you make money and make investment. That’s how it works. Every 10 years, it’s a completely different world.”

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