Aging Technology Watch

The Raisin System

2010-09-30T14:27:00.002-05:00

In the 9/26 issue of Bloomberg Businessweek, we learn of a company called Proteous Biomedical which is developing ingestible chips that can be embedded in pills, turning them into networked, digital drugs. The one-millimeter-square chip is activated by a patient's stomach fluids and sends a signal to a bandaid sized computer worn on the body. The computer uses Bluetooth technology to communicate with the patient's mobile phone, which alerts patients or their caregivers when they forget their medicine. The system has been tested in trials for drugs that treat heart failure, hypertension, and TB. Raisin-enabled drugs may hit the market as early as 2012. Additional information about Proteous Biomedical may be found at their website.

Smart Moneys' Take on Aging Technology

2010-09-10T15:04:00.002-05:00

Contributing editor Peter Keating, in the September 2010 issue of Smart Money, has made a useful contribution to the examination of aging technology. In his article, Peter argues that emerging aging services products fall into three categories. First, devices such as medication optimizers and telehealth systems, which keep you healthy. Second, there is technology, such as wearable devices that automatically detect falls and alert family members, which promote safety. The third kind of senior technology, such as cell phones with large buttons and bright screens, are designed to make modern gadgets easier to use.

Source: Smart Money, September 2010, pp. 38-39

GE Healthcare and Intel Form New Telehealth Company

2010-09-10T14:55:00.002-05:00

This announcement follows the formation of an alliance between the two companies in 2009, and makes good business sense, in my judgment. Many of the players in the aging technology arena are small and inadequately capitalized for the long run. Intel and GE have the deep pockets to stay the course and become THE dominant players.

The new venture will be based in Sacramento, and be owned equally by Intel and GE. Intel will contribute its assistive and remote health technologies, and GE Healthcare will contribute QuietCare, a remote monitoring system. The new company is expected to be operational by year-end.

Telemedicine Conference

2008-10-23T08:28:00.002-05:00

The Academy of Senior Professionals at Eckerd College recently sponsored a conference entitled "Communications Technology for Telehealth and Telemedicine." Conference speakers included telehealth experts from Intel, Verizon, Polycom, and the VA region encompassing Florida and Puerto Rico. The range and depth of the presentations were remarkable. Although telemedicine has been around for some time, the technology in support of remote access medical services continues to evolve. The sophistication of diagnostic tools was particularly noteworthy. And, the VA is clearly a role model for telehealth utilization.

Zume Life, San Jose, CA

2008-10-23T08:07:00.002-05:00

This firm's electronic minder system was recently featured in a New York Times article. The so-called Zume Life service includes two major technology components: an in-hand device, called a Zuri, and a web portal. The Zuri is a simple, small, handheld device that individuals use to get reminders and to record all health-related activities, events and status relevant to their own particular needs. The Zume Life web portal, for users and their caregivers, shows graphs, tables, and journals of the user’s health activities and status. The Zuri will cost about $200 when it is released in the spring. Users will also pay about $40 to $50 a month for Web services. A software version of the device that will run on an iPhone is also in the works.

HealthVault Data Uploading

2008-10-22T10:00:00.002-05:00

A recent New York Times article notes that Microsoft's new online health data storage system called HealthVault lets users upload data directly to their account from about 50 devices, including many blood pressure and heart rate monitors, and blood glucose meters and weight scales. Owners of the account can then share data with their case manager, who could be tracking their response to a new medication, for example. This is good news. HealthVaults' utility to the consumer will increase significantly with the addition of devices which can upload clinical information to the storage system.

The State of Technology in Aging Services

2008-04-07T11:27:00.002-05:00

In March of 2008, the Center for Aging Services Technologies released a useful report on the state of technology in aging services. Three groupings of technologies are cited: health and wellness technologies, safety technologies, and social connectedness technologies. We are reminded of the barriers to technology adoption, which include negative experiences and misconceptions, lack of financial incentives, lack of consensus on value, and inadequate infrastructure. The report concludes with several recommended actions, among which are supporting research on the value of aging technologies, involving older adults in product design, and designing new financial models which combine prospective payment and pay for performance.

Telehealth's Impact on Disease Management

2007-11-19T08:05:00.000-05:00

AdvaMed, an advocacy group of medical device manufacturers, diagnostic product firms, and healthcare information technology providers, recently released a report developed by the Center for Telehealth at the Medical College of Georgia. Key report findings follow.

The report, which is based on a review of published studies on telehomecare and remote monitoring, as well as several current case studies, focused primarily on how these technologies have impacted the care of patients with diabetes, congestive heart failure and chronic obstructive pulmonary disease. Among the findings in the report:

● A study of 281 congestive heart failure patients who received telehomecare found that they experienced a 60 percent reduction in hospital admissions, a 66 percent decline in emergency room visits and a 59 percent reduction in pharmacy utilization. In contrast, the control group experienced increases in all of these areas.

● When patients with severe respiratory illness requiring long-term oxygen therapy were remotely-monitored, hospital admissions decreased by 50 percent, acute clinical problems decreased 55 percent and hospitalization costs went down by 17 percent.

● A study of 400 diabetes patients found that those monitored by in-home glucose meters and video conferencing showed significantly greater improvement in reducing average blood sugar levels than those who did not receive such monitoring.

These are impressive results, to be sure. Additional studies of the use of telehealth with such at risk patients are clearly warranted, if the reimbursement case is to be made.

Free Microchips to Alzheimer's Patients

2007-11-19T07:37:00.000-05:00

The October 23-November 5 issue of the Florida Medical Business News featured a story about a joint venture between VeriChip and the Alzheimer's Community Care of West Palm Beach. VeriChip is offering free VeriMed radiofrequency implantable microchips to 200 patients with the disease. There are two goals for the undertaking. The first is to demonstrate that the product and the data base can raise care standards and improve the efficiency of care delivery. The second goal is to help persuade health insurance companies and CMS to provide reimbursement for the service. If one of the 200 patients is found wandering, law enforcement officials can take the patient to one of 12 hospitals with chip readers located in Palm Beach, Martin or St Lucie Counties. The chip contains a 16 digit number which enables medical personnel to access information stored by VeriChip. The patient database includes identification, next of kin contact information, allergies, medications, advance directives, and other pertinent material.

The Art Of Medicine

2007-11-16T16:53:00.000-05:00

In the 25th Anniversary issue of Health Affairs, we find a compelling article by Dr Jerald Winakur. He reminds us that the ability to listen is a fundamental aspect of the "art" of medicine, and in so doing, warns against against the sole use of technology to assess patient status.

"One of the great lessons I have learned as I worked at my profession over the years is that the "art" of medicine is the honed ability to listen. The practice of medicine—at least the day-to-day, year-in, year-out primary doctoring that I do—involves, in large measure, interpreting stories. Words, not data; nuance, not numbers are the commodities exchanged between my patients and me. I ask a few questions over and over. The answers come in an infinite variety.

By listening to our patients’ stories, doctors glean and process most of the information we need not only to treat ailing bodies, but also to care for our fellow humans as unique beings. It is my job to evaluate and formulate from a constellation of symptoms and concerns and worries, from a blizzard of outside data of often questionable validity. Add to this a mix of freighted family and past medical history, a tendency toward superstition and phobia and fears, and a conglomeration of tidbits and details picked up in the mass media or from well-meaning friends.

I have also learned that it is not necessarily what patients tell me but what they don’t tell me—what I observe from years of being alert to nonverbal cues—that is often even more important. Those aspiring diagnosticians who are unwilling or incapable of reading this invisible text, who study only a check-marked questionnaire scrawled by the patient while she sat in another room, or who stare remotely into a computer monitor at a robotic encounter, never understand—never begin to hear—the complete story."

Sensei for Weight Loss

2007-11-16T15:40:00.000-05:00

Check out this item from the 11/14/07 issue of Business First of Louisville. I hope the service is eventually made available from all cell phone carriers.

Sensei Inc., a joint venture between Humana Inc. and Card Guard AG, has introduced a new health and weight management program that uses cell phones as personal coaches. The program, called "Sensei for Weight Loss," currently is available to Sprint and AT&T customers.

Users go online to enter personal information such as desired weight, food preferences, meal times and exercise routines, and the program generates a customized nutrition and fitness plan. Throughout the day, the program delivers messages to the user's cell phone, such as weekly shopping lists, meal recommendations and motivational tips.

The program also records the user's eating choices and fitness activities and tracks progress toward goals. "Sensei for Weight Loss" is designed to help consumers make healthy choices throughout the day. For example, if someone plans a homemade lunch but then decides to eat out, the program can recommend an alternative meal that fits within the user's nutrition plan.

Boca Raton, Fla.-based Sensei was formed in 2005 by Louisville-based Humana, one of the nation's largest health benefits companies, and Card Guard AG, a Swiss health care technologies firm.

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Projected Growth in the Telehealth Market

2007-10-31T16:17:00.000-05:00

Datamonitor, an independent market research firm based in London, recently issued a report entitled "Telehealth's Increasing Role in Healthcare." They predict that the home telehealth market will grow at a five-year compound annual growth rate of 56 percent, compared to a 10 percent growth in the clinical market. The firm expects the overall global telehealth market will exceed $8 billion by 2012, driven by the needs of an aging population, a shortage of providers, and by extending the technology to a broader array of medical conditions. Growth inhibitors noted were, the lack of reimbursement, and the mismatch between available technologies and the day to day realities and preferences of end users.

Fewer Nursing Home Patients

2007-09-30T09:54:00.000-05:00

The USA Today recently reported that 7.4% of Americans aged 75 and older lived in nursing homes in 2006, compared with 8.1% in 2000 and 10.2% in 1990. The article further noted that the percentage of the oldest age group of seniors living in nursing homes has also been dropping. Less than 16% of the 85-plus population was in such facilities in 2006, according to the Census. In 1985, more than 21% in that age group lived in nursing homes. Few would deny that keeping seniors out of an institutional setting, for as long as possible, is good social policy. I'm taken by these observations, especially since they indicate a reduction in nursing home use, before the wide spread adoption of aging services technology.

Wii for Old and Young Alike

2007-09-30T09:40:00.000-05:00

A recent article in The State.com caught my eye. It depicted South Carolina nursing home residents in a virtual bowling match using the Wii video game. One respondent noted that the Wii is being used across the country in senior facilities, and continuing care retirement communities, as a way of keeping seniors active. The article notes that the Wii games require the user to stand and mimic the movements of swinging a golf club, serving a tennis ball, rolling a bowling ball, or swinging a baseball bat using a hand-held remote controller. So, there is both a physical and mental component to the game's use. Amazing! And to think that my Grandson wants a Wii for Christmas. Maybe I should think of getting a Wii for one of my senior colleagues as well.

Continua Version One Guidelines

2007-09-19T11:27:00.000-05:00

The Continua Health Alliance recently announced the unveiling of it's first guidelines, which will be promulgated early in 2008. The press release indicated that membership in Continua had grown six-fold, from 22 to 133 corporate members. According to the release,

"The comprehensive set of guidelines will help improve the quality of care by empowering consumers and their healthcare providers to more simply share information through common communication channels such as telephones, cell phones, PCs, TV set top boxes, as well as other dedicated health devices."

Continua's vision of readily connected health and medical devices to assist in chronic disease management is compelling.

"These interoperable devices include blood glucose tests, blood pressure monitors, pulse
oximeters and other basic vital sign monitors. Devices such as motion sensors, medication reminders and emergency response services ease the burden on family and professionals who provide care for the aging. These technologies proactively aid the secure, healthy independence of the aging in their own homes. Diet and fitness conscious individuals will also be able to seamlessly share their weight and exercise data with fitness consultants by using devices such as heart rate monitors, connected fitness equipment and activity monitors. Additionally, Continua-certified data transport hardware and software will further enhance broad based interoperability of these devices."

I was particularly taken by the announcement that Continua had decided to retain the services of Abt Associates Inc. to study telehealth reimbursement policy.

"Abt Associates will assist in cataloging, synthesizing and assessing all telehealth studies and
the peer-reviewed cost-effectiveness literature. This work will help Continua determine strategies for initiating increasing telehealth cost effectiveness, initiating quality improvement studies and for securing reimbursement for telehealth products and service."

VeriChips Linkage to Cancer?

2007-09-10T13:16:00.000-05:00

Today's Healthcare IT Strategist carried this summary of an Associated Press story, which was presented, in more complete form, in yesterday's New York Times, MSNBC News, and The Lakeland Ledger.

"FDA-approved microchips linked to cancer: study

When the U.S. Food and Drug Administration approved implanting microchips in humans, the manufacturer said it would save lives, letting doctors scan the tiny transponders to access patients' medical records almost instantly. The FDA found "reasonable assurance" the device was safe, and a subagency even called it one of 2005's top "innovative technologies."

But neither the company nor the regulators publicly mentioned this: A series of veterinary and toxicology studies, dating to the mid-1990s, stated that chip implants had "induced" malignant tumors in some laboratory mice and rats. "The transponders were the cause of the tumors," said Keith Johnson, a retired toxicologic pathologist, explaining the findings of a 1996 study he led.

Leading cancer specialists reviewed the research for the Associated Press and, while cautioning that animal test results do not necessarily apply to humans, said the findings troubled them. Some said they would not allow family members to receive implants, and all urged further research before the glass-encased transponders are widely implanted in people."

The Lakeland Ledger conducted a post article survey (n=109 respondents) which responded to the question "Would you allow yourself or a relative to be implanted with a microchip that gives medics access to a patient's medical records?" 64% of the respondents said no, and 36% said yes. People who answered negatively did so for religious reasons, for privacy concerns, or because they had medical reservations about the implant. Positive voices saw value in the implant in an emergency situation, and for use in identifying patients with a chronic disease.

The MSNBC News survey (n=3963 respondents) asked "Will you get microchipped now that it has been revealed that studies are linking tumors in lab animals to the implants?" 7% said yes, 83% said no, and 10% were uncertain.

I'm buying the MSNBC results because of the larger numbers, and because the results seem more aligned with my sense of the US population's "unease" with microchip implants for humans. (Note: Tens of thousands of pets have microchip implants, without adverse medical impact, at least to date.) Privacy, religious concerns, and medical reservations are pretty powerful barriers to customer acceptance. There doesn't appear to be much evidence that these chips will be much more than a niche product, on a going forward basis. Today, VeriChip's (CHIP) stock fell by 11% , and its' lead investor, Applied Digital Solutions (ADSX) stock, fell by 10%.

High Tech Hearing Aids

2007-08-31T06:56:00.000-05:00

On August 28th, the Wall Street Journal featured an article entitled "The Sleek, Chic, High-Tech....Hearing Aid." The featured device is Phonek's Audéo. The Phonak Group, headquartered in Stäfa, Switzerland, specializes in the design, development, production and global distribution of technologically advanced wireless and hearing systems. I suggest you check out the Audéo website not only to learn about the device, but to see how this vendor decided to market aging technology to an audience of upscale baby boomers. One of the "Audéo people" is featured to your right. He is described as an "Archeologist, Beach Volleyball Player, and Hopeless Romantic." The tag line for the site is "Your life, amplified." The site includes a sound demo, a self test, FAQ's, and a color guide featuring 15 color combinations with such labels as Green with Envy, Pinot Noir, and Flower Power. The devices cost $2500 to $3000 per ear. To me, the site is well done, but also borders a bit on parody. I should look so good!

Two other innovative hearing devices were mentioned in the Journal article. The first was Great Nordic Pulse and the second was Siemens' CIELO2 Active. Both devices are rechargeable, which is an improvement over the need to change batteries.

The article made several points which are worth noting.

a. By age 65, nearly a third of Americans have hearing loss, and 40-50% will develop such loss by 75.

b. Resistance to the use of hearing aids is high. Only one in 5 people who could benefit from the device wear it.

c. The cost of hearing aids is generally not covered by insurance.

d. The newer, smaller devices have driven overall sales of behind-the-ear devices from 44% last year to 50.2% of hearing-aid sales this year--exceeding sales of in-ear molds for the first time since 1982.

e. Digital hearing aids, in which incoming sound is processed with a computer chip before being fed into your ear, enables almost limitless massaging of the sound. For example, the Audéo automatically switches among four programs, one for music, one for quiet, one for speech alone, and one for speech and noise together.

The 2007 National Positive Aging Conference

2007-08-27T15:19:00.000-05:00

I'd like to draw your attention to this Conference, which will be held on December 6-8, 2007 at Eckerd College in St Petersburg, FL. The Conference site will tell you all you need to know about the event. According to the site, benefits for Conference attendees include:

Learn about current and future trends in services and programs for mature adults.
Take home new ideas to integrate into your programs.
Network with program implementers and thought leaders from around the world.
Hear and learn from program participants.
Have hands on opportunities with new and emerging technology and program tools.
Develop contacts and relationships for future program information and development activities.
Explore programming and partnering opportunities beyond your traditional boundaries-step outside the box!
Increase your commitment to a philosophy of “Positive Aging” through association with national and international thought leaders and program developers.

Early registration is recommended.

VeriChip Implants and Privacy Concerns

2007-08-23T15:40:00.000-05:00

Two articles dealing with human-implantable RFID chips in the St Pete Times and the Healthcare IT News are worth considering. The company producing the implantable RFID chips is VeriChip. The company is based in Delray Beach, Florida, and is publicly traded on NASDAQ (CHIP). The implantable chip was cleared for medical use by the FDA in October, 2004. The company's present focus is tagging "high risk" patients such as those with diabetes, heart conditions or Alzheimers Disease.

Some quick facts to consider:
a. The chips are inserted in the upper right arm with a a hypodermic-type needle. The cost of the procedure: $200.
b. VeriChip uses a patented process, called bio-bind, to secure the chip to muscle tissue and prevent migration.
c. Medical personnel wave a scanner within 12 inches of the chip. A 16-digit identification appears to identify the person.
d. VeriChip maintains the patient's records in its database. Customers pay an annual fee, from $20 to $80, to keep a medical file.

The American Medical Association Council on Ethical and Judicial Affairs recommended that radio frequency identification (RFID) devices can be used to help identify patients, improve patient care and secure access to patient clinical information. But the AMA cautioned that the "efficacy and security" of the devices has not been established. As precautions, the AMA said, physicians implanting such devices should:
a. Disclose the medical uncertainties of RFIDs to patients as part of the informed consent process.
b. Strive to protect patients' privacy by storing confidential information only on RFID devices with informational security similar to that required of medical records.
c. Support research into safe, effective and potential non-medical uses of RFID devices in people.

John Halamka, the Chief Information Officer of the Care Group Health System, wrote an article entitled "Straight From the Shoulder" in the July 28, 2005 issue of the New England Journal of Medicine. He has a VeriChip implanted in his body, and has claimed that there have been no harmful side effects. In a sense, he is serving as a poster child for the procedure.

Privacy advocates have yet to sign on, as far as I can tell. And, people who harbor religious concerns about such chips being a precursor to the "mark of the beast" will not be placated by the either the AMA or the FDA.

I sense that the use of implantable chips in humans will grow, albeit slowly. High risk patients would appear to be the major beneficiaries of the technology. Overcoming the public's unease, either on religious grounds or for privacy qualms, is a major constraint.

William Blair Health Care IT Index (WBHCIT)

2007-08-22T12:31:00.000-05:00

I'd like to draw your attention to this Index which was developed by William Blair and Company. The Index (WBHCIT) is an equal-weighted index of 31 health care IT stocks, originally constituted with a base value of 1,000 on December 31, 2000. The index objective is to capture the aggregate stock performance of the majority of companies that focus on providing software, systems, online content, or technology-oriented services to the health care sector. It is designed to serve as a useful tool for benchmarking both historical and future Health Care Information Technology (HCIT) stock performance. Some of the stocks in the current mix include Cerner, Allscripts Healthcare Solutions, and QuadraMed.

Index members must meet the following criteria:

Business Requirement: 50% of revenue must come from HCIT activities
Company Structure: Must be an operating company, not an investment trust
Market Capitalization Requirement: $50 million or higher
Exchange Requirement- Must be traded on the NASDAQ, NYSE, or AMEX

A student of mine calculated that if you had invested in the Blair Index as of January 1, 2001, you would have enjoyed a 47.7% annual return.

To the best of my knowledge, there are no aging services technology firms in the Index, as of today. Most of these firms are either privately held, have a market cap of less than $50 million, or are like ADT Security Services, a division of Tyco. Perhaps we'll see the inclusion of such a company in the future, or it may make sense to consider a separate Index for aging technology companies.

Med-eMonitor

2007-08-16T13:01:00.000-05:00

The September 2007 issue of Prevention Magazine featured a brief article entitled "Peace-of-Mind Pillbox." The article featured Med-eMonitor, an electronic device that hooks up to a standard phone jack. Medication times are announced with a musical tone, coupled with warnings about potential drug or food interactions. If you don't take your drug in 3 minutes, a family member is notified. The initial price of $119.90 includes the Med-eMonitor unit, a one-time set-up fee of $59.95 which includes telephone assistance and training, and the first month's lease charge of $59.95. Annual fees at the current monthly rate amount to $720. I was unable to determine whether the device is covered by current health insurance plans.

The device website offers information for professionals and investors, for consumers, and an on line store. The professional section ably describes the product, refers to product studies demonstrating medication compliance rates of better than 90%, and features a Demo which gives a general overview of the device in operation.

Med-eMonitor is sold by a Maryland based medical device company called InforMedix. Bruce Kehr, M.D. is Chair of the Board of Directors and CEO of the company, which is traded on the OTC BB market (Symbol IFMX). The stock is currently trading at .125 a share. Some key business partners include ADT Security Services, a unit of Tyco Fire & Security, and XLHealth, one of the nation's fastest growing disease management companies. The company is partnering with drug store chains as part of the consumer launch of Med-eMonitor. The most recent partner is Rodman's Discount Drug Stores in Washington, D.C.

Telehealth Ethical Issues

2007-08-13T15:22:00.000-05:00

The 2006 Archives for the International Conference on Aging, Disability and Independence includes an excellent paper by Janice M. Blanchard of the Society of Certified Senior Advisors. Ms. Blanchard argues that as telehealth products move from the research phase into the broader marketplace, economic and technological considerations take center stage, while ethical issues merit less attention. A moral and ethical framework for home-based telemedicine is warranted, in her view. Her framework would consider the following issues.

(1) Privacy of information. Who has access to data and how it will be used? Can it be bought and sold? How will privacy, confidentiality, and security of user information be assured?
(2) Privacy of person/place. Can user control monitoring system (e.g., turn it off and on, or establish a monitor-free zone)? How is the privacy of others in the home maintained?
(3) Informed consent. What constitutes informed consent, particularly with a technologically naïve or cognitively impaired person?
(4) Equity of access. How do we develop equal access when technology use presupposes some technological sophistication, skills, and basic comfort level? Who will pay for services? Will it develop into a two-tier system of medical service delivery?
(5) Autonomy versus dependence. Does home monitoring foster autonomy or dependence? What will be the consequences of perceived non-compliance?
(6) Paternalism. Does the desire to “keep a better watch" over aging parents actually reveal or underscore a paternalistic attitude on the part of service providers, adult children, and/or the medical establishment towards elders?
(7) Patient and provider relationship. What is the overall effect on quality of care? How are empathy, compassion and trust maintained via telecommunication?
(8) Medicalization of home. Will long term monitoring change the character of home? How do we maintain the separation of public and private sphere?

The answers to these important questions will come from research and from the experiences of telemedicine users and their family members. Blanchard's framework is a valuable contribution to any careful examination of aging technology products and services.

QuietCare Overview

2007-08-10T07:33:00.001-05:00

The Living Independently Group, a New York City based, privately held company was co-founded by John Lakian and George Boyajian, Ph.D. The CFO is Walter Bembenista and the COO is Robin McVey. It is a strong executive group with substantial expertise in investment banking, biotechnology, and home health security. Venture capital investors include Valence Capital, Loeb Partners and current investors. A 2006 financing of $10 million, led by Valence, will be used to enhance the product line, increase USA market penetration, and build market presence in the UK. In October of 2006, it was announced that Telemetry Systems, Inc. (TSI), a leading systems integrator and provider of home and business security solutions, would serve as a National Master Distributor for QuietCare.

QuietCare® is a 24/7 early detection and warning system that enables caregivers to monitor a senior or patient remotely, recognize potential health problems and intervene so as to avoid emergencies or more serious medical problems. There is no video or audio intrusion. The service was launched in 2002, and was the first commercially available solution of its kind. It was designed to meet the needs of approximately 35 million seniors who live alone in the US.

The QuietCare website is very user-friendly. Service benefits are clearly explained, there is a useful family assessment guide, and it's a simple matter to make contact with the company for further assistance. The home page notes that the service has received broad media exposure, including the New York Times, Wall Street Journal, and NBC Weekend Today.

A recent article on QuietCare in the Sarasota Herald Tribune merits our close attention. Key points from the article follow.
a. The service costs $400 for installation and activation, and $149.95 a month. The service also includes a two-way radio emergency alert system.
b. Typically, infrared motion sensors are installed in the refrigerator (Detect meal preparation), in the kitchen, inside and outside the bathroom, in the bedroom, and other activity areas. Most homes have six sensors, but some have as many as a dozen.
c. After installation, the off site computer measures daily living routines for 10 days, to establish a baseline activity pattern.
d. It works with people who live alone, so that any motion can be traced to a single occupant.
e. Privacy issues are minimized, since there are no camera's or microphones.
f. The family member, whether a mile or 500 miles away, can visit a password protected web site to get a quick status report. Deviations from normal behavior are flagged and communicated to the family member by cell phone and email alerts.
g. Four states have approved QuietCare for Medicaid reimbursement (Florida's Medicaid is not one of them).
h. It hasn't been proven that QuietCare, or other such technologies, actually delay institutionalization, one of the primary reasons for their development. However, such studies are likely, as more new products hit the market.

In sum, this product, and others like it, hold great promise for keeping loved ones at home for as long as possible. If the service can demonstrate real cost savings to the system, we'll see widespread insurance coverage , and significant product growth.

High Tech Tools for Older Folks

2007-08-05T08:16:00.000-05:00

Today, we look to Parade magazine to learn about some high tech offerings for the elderly. The eminently readable article follows. In the same edition, one finds the ubiquitous ad for the easy to use Jitterbug cell phone. It is encouraging to see aging technology references in "mainstream" publications.

"Many baby boomers find themselves worrying about aging parents or other relatives who are determined to remain in their own homes. The good news, says Marion Somers, a gerontology expert, is that elder care is going high-tech: “Technology is letting older people improve their quality of life and preserve their independence for longer than ever before while still getting the support and care they need.” A few of Somers’ suggestions:

• Cell phones with big buttons, bright screens and extra-loud sound. Easy to use in emergencies, with service as low as $10 a month. (Be sure 911 is on speed-dial.)

• Light sensors, to automatically illuminate the basement and paths around the house.

• Electronic envelope openers, for people with arthritis.

• A QuietCare system, to help seniors stay safe by monitoring their daily activity—including eating and taking medication—via wireless sensors positioned throughout the home. It even checks if their residence is too warm or cold. Caregivers can access reports through a secure personal Web site. For less than $3 a day, the system identifies emergencies such as falls and alerts caregivers or emergency services.

• Safe Return bracelets to help track Alzheimer’s patients if they wander off (available from the Alzheimer’s Association ).

• GPS navigation devices you implant in their shoes to track Alzheimer’s patients."

New York Times Article on "The Real Transformers"

2007-07-30T08:48:00.000-05:00

The New York Times Magazine featured an article on robots and robotics which I found compelling. Several highlights of the article are featured below, followed by my commentary.

"Bill Gates has said that personal robotics today is at the stage that personal computers were in the mid-1970s. Thirty years ago, few people guessed that the bulky, slow computers being used by a handful of businesses would by 2007 insinuate themselves into our lives via applications like Google, e-mail, YouTube, Skype and MySpace. In much the same way, the robots being built today, still unwieldy and temperamental even in the most capable hands, probably offer only hints of the way we might be using robots in another 30 years."

Comment: I cannot imagine work or personal life without my pc, and recall all too well my first Radio Shack word processor, and how primitive it was relative to todays' offerings. Today's robots are primitive in that sense, but will evolve until they become so embedded in our lives that they become "pc-like."

"Sociable robots come equipped with the very abilities that humans have evolved to ease our interactions with one another: eye contact, gaze direction, turn-taking, shared attention. They are programmed to learn the way humans learn, by starting with a core of basic drives and abilities and adding to them as their physical and social experiences accrue. People respond to the robots’ social cues almost without thinking, and as a result the robots give the impression of being somehow, improbably, alive."

Comment: I believe I'd respond to a robot's social cues without thinking. Pretty eerie, but we're "programmed" to respond to such cues. I am also taken by the observation that you can program robots to learn.

"To qualify as that kind of (sociable) robot, they say, a machine must have at least two characteristics. It must be situated, and it must be embodied. Being situated means being able to sense its environment and be responsive to it; being embodied means having a physical body through which to experience the world. A G.P.S. robot is situated but not embodied, while an assembly-line robot that repeats the same action over and over again is embodied but not situated. Sociable robots must be both, as well as exhibiting an understanding of social beings."

Comment: The definition of a sociable robot-being both situated and embodied- is very helpful. I need to move beyond the term "robot" to "sociable robot," in order to better evaluate the role of robotics in health care.

"Scientists believe that the more a robot looks like a person, the more favorably we tend to view it, but only up to a point. After that, our response slips into what the Japanese roboticist Masahiro Mori has called the “uncanny valley.” We start expecting too much of the robots because they so closely resemble real people, and when they fail to deliver, we recoil in something like disgust."

Comment: There are pretty significant implications for robotic design, flowing from this condition. I wonder how important "person likeness" would be to an acutely ill, short stay patient or to a chronically ill, long term stay patient. Would there be a difference, based on patient condition and stay? And, would we be less demanding of "person likeness" when we are in a passive, patient role?

"The robot (weight-loss) coach, a child-size head and torso holding a small touch screen, is called Autom. It is able, using basic artificial-voice software, to speak approximately 1,000 phrases, things like “It’s great that you’re doing well with your exercise” or “You should congratulate yourself on meeting your calorie goals today.” It is programmed to get a little more informal as time goes on: “Hello, I hope that we can work together” will eventually shift to “Hi, it’s good to see you again.” It is also programmed to refer to things that happened on other days, with statements like “It looks like you’ve had a little more to eat than usual recently.”

Comment: Autom may be useful for my weight loss regimen, but I think I'd shut it down, if it nagged me too much. It does seem to reinforce the assertion that weight loss is aided by peer pressure, even if the "peer" happens to be a robot. However, they are certainly more cost-effective ways to lose weight.

"A few of these uBots are now being developed for use in assisted-living centers in research designed to see how the robots interact with the frail elderly. Each uBot-5 is about three feet tall, with a big head, very long arms (long enough to touch the ground, should the arms be needed for balance) and two oversize wheels. It has big eyes, rubber balls at the ends of its arms and a video screen for a face."

Comment: I wonder how I'd feel if I visited my Mom in a nursing home, and found her being tended by a uBot-5. I wonder how she'd feel. The attitudes of the patient and the family would be critical. Variability in the number and competency of nursing home staff, is an issue, at least in my experience. Would the use of robots diminish such variability?

"At their core, robots are not so very different from living things. “It’s all mechanistic,” Brooks said. “Humans are made up of biomolecules that interact according to the laws of physics and chemistry. We like to think we’re in control, but we’re not.” We are all, human and humanoid alike, whether made of flesh or of metal, basically just sociable machines."

Comment: Perhaps it is true that we are all "sociable machines" and that the distinction between human and humanoid is less evident than we think. Intellectually, I can get my arms around this observation. Emotionally, I'm not there yet.