Saturday, February 16, 2019

Care Robot Classification Scheme and Examples

Disclaimer: I own Pillo, Anki Vector and two Hasbro Joy For All pet robots (Orange Tabby cat and Golden Pup), and have had a year-long access to MABU and owned Jibo for a short time. Before year-end, I expect to own ElliQ and Temi, the telepresence robot.

In the course of my study of care robots, I developed the following classification system which is composed of three categories: Humanoid Design, Care Companions/Care Managers, and Pet Robots. Let's go through each category and identify robots which "fit" within that category. To enable further study, hyperlinks have been provided for each robot.

Humanoid Design


Robear




Moxi by Diligent Robotics




















Care Companions/Care Managers





















Pet-Like Devices











I


Launched in 2017 and Closed in 2018 (Companion Robots)








In summation, Here is a listing of Robots supporting Aging In Place

Remote Patient Monotoring (RPM):  ElliQ, Temi Telepresence Robot

Care Companions: Anki Vector, Pepper

Chronic Care Managers: MABU, Pillo

Digital Nursing Assistants: Moxi, Robear

Safety Monitoring and Care Alerts: iPal, Buddy






















Reflections on Digital Health Technologies supporting Aging In Place

Enduring Conclusions
  • Keeping the aging in their homes for as long as possible enhances the quality of life and preserves scarce resources
  • Consumers for these technologies need a framework of analysis, a sense of the evolving market, and a discerning eye for compatibility and value
  • Don't turn your back on low tech assistive devices such as a magnifying glass or an amplified telephone
  • Biggest concern of seniors at home? Falls! Need to fall-proof your home or apartment
Near Term Projections

 2019>>>>>>>>2021
•Immature sector >>Sector maintstreaming                                   
•Unbundled services>>Bundled services (Amazon model)
•Voice emerging>>Voice becoming pervasive
•Diffuse market leadership>>Big 5 owns the aging tech space
•Care Robots pilots>>Care robots in home and post acute care
•Privacy & security concerns>>Ongoing, but Blockchain helps   
•HIPAA concerns>>Amazon & Google drive compliance by others
•Technologies not well supported/intuitive>>Frictionless technologies
•Predictive analytics gaining favor>>Predictive analytics commonplace
•VR & AR pilots>>VR & AR clinical applications used widely
•Accreditation/Certification?>>Telehealth, robots and IoHT certified
Few smart homes and senior living units>>Smart living options abound
Digital tech is out of pocket>>Provided free by health systems/plans*


* Freely provided by systems/plans to prevent re-admissions and to manage chronic care


Comparing Amazon Echo Show and Lenovo Smart Display with Google Assistant

Have owned both voice activated screen devices for several months, and use them on a daily basis. Although the percentage of current screen owners is small, I prefer the option for several reasons. Screens nicely compliment voice experiences by reinforcing the main message of the dialog, presenting options, and providing videos and images as well.

Advantage Google Assistant?
  • More touch screen options
  • Access to YouTube
  • Visual prompts for follow-up questions
  • True search engine*
  • Baked in skills-no need to use smart phone to enable skills
  • More users world-wide and more language options
  • The ability to do some chores for you—things like screen your calls on an Android phone, or (in a feature called Duplex, which rolled out this fall) hold telephone conversations with an actual human to book a table at a restaurant or an appointment at the salon 
Advantage Amazon Echo Show?
  • Access to Amazon Marketplace for order, reorder, and shipping updates
  • More skills than Google, and the gap shows no sign of narrowing
  • Dominant market share in the United States
  • The Amazon Alexa is found in Anki Vector, LifePod, and behind the Facebook Portal
  • Acquisition of Ring and Eero indicates a major bundling initiative-one stop shopping for connected internet of things
  • More than 10 thousand employees working on Amazon voice
  • Better member support. Both send weekly e-mails touting new uses, but Amazon's is more comprehensive and more helpful
*Query: Ask both devices this question: Who is the Chief Executive Officer of Leading Age Florida? Google's answer is accurate while Alexa will tell you about the Chief Executive of Florida. The Amazon features what has been described as an action engine, telling the person what it thinks they want to hear.

Screen size, options for other voice devices, sound quality, and pricing are comparable. Both devices are constantly updated in the cloud and both have improved services over time.

My vote? Slight edge to Amazon Show.




Takeaways from the 2019 Alexa Conference, Chattanooga, TN January 15-17



Most older adults need help and support in setting up Alexa and managing skills-an observation borne out in my aging tech classes here in Tampa Bay.

Alexa may have 20,000 skills, but we have yet to see a "killer app." And, most people abandon their skills after a very short time.

Voice biomarkers will likely be used to detect dementia or stroke -  probing information buried in human voice.  Check out Sonde Health's focus on biomarkers.

HIPAA Discussions: Law passed in 1996 and no updates since then. Amazon's Alexa was launched in 2014 and Google Assistant in 2016. No adoption to emerging technologies. Few, if any players are willing to defy HIPAA. Projections that Amazon and Google will be HIPAA compliant by the end of 2019.

Voice wars among the Big 5 (Apple, Microsoft, Google, Facebook and Amazon). Prediction that no start-up will come to dominate the market.

Front Porch has made major research contributions to the post acute care community. They have done studies of voice, telehealth, hearing loss and video games.

How about a voice activated smart car that would monitor your vital signs and direct you to the nearest hospital in the event of a significantly abnormal finding?

Orbita, the Boston based voice platform, likens itself to a "word press" for healthcare - software used to create website, blog, or app/skill.

Vision offered by Teri Fisher? Sick bay in the home. No MD intervention. Voice first serving as a triage nurse. Daily reminders for aging in place. Ordering scripts via Alexa, and delivery to the home by drone.

Melissa Campbell talk on "Why Parents Should be Wary of Echo Dot Kids" was a remarkable counterpoint to general upbeat nature of the conference. Here  are some of her comments. Anyway you slice it it, Alexa is a market device. Great for data collection and revenues, but not for kids. Not made for kids, but made to appeal to kids. It's all for Amazon. (See New York Times' article on Co-Parenting with Alexa)

Keynote address by Kesha Willaims, Software Engineering Manager, Chick-fil-A Corporate, was awesome-one of the best speeches I have ever heard!



With voice, the user controls the technology. Before, had to access technology by typing, touch, or coding. First time tech is adjusting to us!! (Brad Metrock, Conference Organizer)


Health Care entities will be the biggest users of Voice. 

Will take 5 years for Voice to mainstream, then Voice will be everywhere/pervasive

Geico and Progressive (Flo) should have synthetic voices specific to their brand-they don’t now

All in all, a remarkable experience! I am already booked for Alexa 2020!

Friday, February 15, 2019

Digital Health Technology Series

After two years of testing this material with attendees at local Osher Lifelong Learning Institutes, I have prepared this 6 part series on Digital Health Technologies supporting Aging In Place. Your reviews and comments will be welcomed. Thank you.



Digital Health Technologies Supporting Aging In Place



1. An Overview of Digital Health Technologies

Digital health technologies have the potential to transform health and wellness for aging clients, and to provide assurances for their family members. Broadly speaking, consumers of these emerging technologies need context, a framework of analysis, and a sense of the dynamic marketplace for such services. Learn what the promoters and the critics of these technologies have to offer. Key ethical issues will be discussed, and you will discover a device certification program, and its distinctive logo. The overall goal of the presentation is to help you make informed decisions on the cost, utility and quality of digital health technologies


2. Care Robots: Managing Care and Providing Companionship 



Care robots have the potential to increase the productivity of caregivers, provide emotional support and companionship, and to serve as effective accountability partners in such matters as medication adherence and physical exercise. Experiments with robotic pets in senior settings such as memory care units are increasing. In this class, you will learn to identify the types of robots currently available and to understand what the promoters and the critics have to say about these devices. You will have hands-on experience with robot pets and a robot companion called Vector. The overall objective is to ensure that you have the tools and insights to be an informed consumer of care robots.



3. Virtual and Augmented Reality's Potential for Health and Wellness 



The immersive experience of virtual reality (VR) is being used both for diversion therapy as well as a growing number of clinical applications, like pain management. Augmented Reality (AR) allows users to view digital information and images as an overlay to the real world. Increasingly, AR is being used to provide surgeons with an array of clinical information while operating, and it is playing an important role in medical education. We will examine use cases for both VR and AR and identify leading VR and AR vendors and their respective products. Attendees will experiment with VR viewers, including the Oculus Go by Facebook



4. Voice-activated Devices: Improving Care Coordination and Patient Engagement



Voice assistants have achieved popular adoption with over 50 million consumers in the U.S and an estimated 100 million users worldwide by the end of 2018. The devices are expected to play a major role in care coordination and patient education. Like any new device, they have strengths and limitations, which we'll explore. While Amazon and Google are current market leaders, we'll identify other tech companies coming into the market, especially with smart display devices. Use cases for voice in clinical trials and in senior settings will be identified. The Amazon Echo Show and the Lenovo Smart Display (With Google Assistant) will be available for student inspection and interaction.

5. Smart Homes and the Internet of Health Things




Smart homes, featuring wireless security, safety and utility devices, are entering the mainstream, after years of experimentation at leading academic institutions. For example, Lennar, a major home builder, is now marketing a Wi-Fi Certified™ Smart Home featuring Amazon Alexa. Internet of Health Things are devices/wearables which track vitals, monitor medication use, and issue fall warnings. Apple’s Smart Watch (Series 4) is a prominent example of such devices. Discover the strengths and weaknesses of both technologies, the interplay between each, and future projections. 

6. Telehealth/Virtual Care

Telehealth has potential to make care available to underserved areas, extend the reach of specialty medical and psychiatric care, and to reduce care and transportation costs. Nearly all US health systems are planning to offer telehealth options to their constituents. We will discuss factors which will promote telehealth growth as well as factors impeding such expansion. Special attention will be paid to virtual physician visits, which are becoming more available to healthcare consumers. Case studies of telehealth market leaders like the Veterans Administration and Avera Health E-Care will be considered. We’ll examine what the skeptics of telemedicine have to say as well. Lastly, we will showcase the new ClearHealth Quality Institute Telemedicine Accreditation Program sponsored by the American Telemedicine Association.

February 2019






Friday, September 10, 2010

Smart Moneys' Take on Aging Technology

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

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.