- A recent survey of vendor preferences among senior living providers finds that they aren’t using telehealth all that much – but they are taking a liking to mHealth.
The survey by Ziegler indicates less than 10 percent of the 143 chief financial officers of single and multi-site senior living facilities are using a telehealth platform to connect staff and patients to outside healthcare services for video visits or consults. About a quarter of those are partnering with local health systems, while the rest are using a commercial vendor like Honeywell Life Care Solutions, Teladoc or MDLive.
Nearly a quarter of the respondents, however, are using remote monitoring technologies like wearables and sensors to track patients and patient movement.
The potential is there for growth. The Ziegler survey finds that almost 94 percent contract with outside physicians, while 83 percent outsource for rehabilitation or therapy services.
While telehealth and mHealth solutions are often associated with helping seniors remain in their homes longer and out of hospitals and senior living facilities, a growing number of those facilities are using that technology to improve their operation and the clinical outcomes of their residents.
This might include a telehealth link to a local health system for primary care and off-hours services, mHealth solutions that track patient movements (especially those with cognitive issues like Alzheimer’s) or tablets, kiosks and even robots that give residents and staff easy access to healthcare information.
At the University of Alabama Huntsville, researchers are collaborating with Huntsville’s Center for Aging and the UAH’s College of Nursing to test remote monitoring solutions that can help facility nurses keep tabs on their most fragile patients.
"In the case of strokes, you have changes in both speed and stability," said Dr. Emil Jovanov, director of UAH’s Real-Time Physiological Monitoring Lab, which is testing mHealth apps that can help caregivers track minute changes in patients that may be indicative of a stroke. "Very often, a sequence of small strokes signals that a big stroke is coming. If you detect early the effects of the smaller strokes, then the physician may be able to prevent the big stroke."
At the University of Missouri, meanwhile, researchers are testing new technology in Tiger Place, the university’s own independent living community. The goal is not only to find solutions that allow seniors to stay in their own homes, but to improve remote monitoring programs in assisted and independent living facilities.
“In-home sensors have the ability to capture early signs of health changes before older adults recognize problems themselves,” Marjorie Skubic, a professor of electrical and computer engineering in the MU College of Engineering and director of MU’s Center for Eldercare and Rehabilitation Technology, said in a 2016 press release announcing MU’s participation in two National Science Foundation-funded mHealth projects involving radar-embedded sensors. “The radar enhances our ability to monitor walking speed and determine if a senior has a fall risk; the bed sensors provide data on heart rate, respiration rate, and overall cardiac activity when a senior is sleeping. Both sensors are non-invasive and don’t require seniors to wear monitoring devices.”
California-based OhmniLabs, meanwhile, is putting its zero-touch robots into senior living facilities and even private homes through partnerships with Home Care Assistance of North America (HCA), a national health and homecare provider, and California senior care facilities like The Heritage Pointe in Walnut Creek and Avenidas in Palo Alto.
“We started with the idea of creating an affordable robot for the home environment,” company co-founder and CEO Thuc Vu said. “What we saw in (elder care) was that there were no other products like ours.”
One obstacle facing senior living facilities is that payers generally don’t reimburse for remote monitoring, leaving facility managers to come up with their own ROI on the technology – either through a business arrangement with the telehealth or mHealth vendor or after studying how the technology cuts healthcare costs.
The Centers for Medicare & Medicaid Services is also getting in on the act. Recognizing that post-acute care services in skilled nursing facilities account for more than $1 billion in healthcare expenses each year, CMS recently announced a project in Florida to test how a telehealth platform could reduce those costs in three such SNFs.
“Studies show that approximately 60 [percent to] 70 percent of all nursing home transfers to the hospital are unnecessary,” said John Whitman, executive director at Pennsylvania-based TRECS Institute, which is coordinating the study. “Sending a vulnerable senior to the hospital only increases their exposure to a wide range of other proven, adverse effects.”