When thinking of yesterday's tomorrows, baby boomers (myself included) have given up on ever owning the jetpacks popularized by the Jetsons cartoon series. Nevertheless, yesterday's dreams of automated homes are very much alive in our minds and are informing the decisions being made by providers of long term services and supports (LTSS) for older adults. Changing client preferences, increasing costs and regulatory pressures are driving providers to seek solutions from the application of aging services technologies (ASTs).
In November 2011, the Center for Aging Services Technologies (CAST) at LeadingAge published an insightful report of case studies from 19 organizations offering services and supports in a variety of settings (e.g. CCRCs, independent housing, assisted living and skilled nursing centers, etc.) located in urban, suburban and rural markets. The vision of these forward thinking care providers, is nothing less then fundamentally changing their business model. As pioneers in the field of applying ASTs, their respective journeys in delivering ASTs are succinctly captured in the LeadingAge report, "Preparing for the Future: Developing Technology-Enabled Long-Term Services and Supports for a New Population of Older Adults."
The report grouped common technologies into one of the following categories: infrastructure, safety, health and wellness, documentation and social networking. By focusing solely on both the safety and the health and wellness categories, many of the salient points of the report become apparent.
The application of safety technologies such as electronic call systems, personal emergency response systems (e.g. Phillips Lifeline) and fall detectors were ubiquitous among the AST applications. Commercially popular vendors such as QuietCare and BeClose at Home were commonly introduced into CCRC and independent housing settings. Passive monitoring can be invaluable in increasing client safety and in the early detection of physical and cognitive decline. One challenge for the LTSS provider is that data from these systems is often not easily shared with one another, or with their EMR systems thus reducing possible efficiencies and improvements in care delivery.
Health and wellness technologies including, tele-health devices for the home, point-of-care kiosks in common areas, medication dispensers (e.g. HomMed) and remote monitoring sensor technologies (e.g. WellAWARE) were introduced by many vendors. Interestingly, the introduction of tele-coaching and telemedicine for rural LTSS providers closely mirrors the application of those technologies for similarly situated acute care providers (e.g. Billings Clinic). Healthcare reform and the current drive to reduce readmissions to hospitals was a key driver in implementing many of these AST initiatives and many of the case studies validated the critical role ASTs can play in this arena.
ASTs like other information technology investments are significant capital expenses. The ROI (both tangible and intangible) varies depending on the technology and the setting where it is employed. In some instances the ROI relating to an AST deployment was significant and in other instances it is difficult to gage. Interestingly, many AST deployments relied on government and private foundation grants. Additionally, the private pay market currently seems indifferent to these technologies. Market penetration of many ASTs remains small and providers must still educate their clients regarding the benefits of the AST to generate interest. Moreover, even once the client becomes interested in the technology, they still remain unwilling to pay for the associated cost. When creating a business model, it remains a challenge for all the providers to provide technology-enabled services in an affordable manner for all clients. Additionally, successful technology deployment requires staff involvement, commitment from organization leaders and well defined goals and focus.
I recommend that anyone interested in this topic read the report. The case studies of these early implementers of ASTs provides an interesting glimpse to the future of long term services and supports for older adults. What do you think?
Learn more on Twitter @aginginchicago