We keep talking about the future of aging--perhaps so much so that we forget to talk about what's currently available. Here is a partial list of recent technology advances currently being adopted on a wide scale. I offer it so you can see if you or your loved one might benefit from taking advantage of any or all of them.
According to this well thought out article, technology used to benefit seniors falls into three main categories:
"For the purpose of this report, aging-services technologies will be categorized into three broad categories based on the relationship these technologies address between the older adult and his or her environment (safety), oneself (both physical and mental health and wellness), and others (social connectedness)." Okay, although I would add a host of technologies aimed at the general population that have direct or indirect relevance to seniors, such as cellphones, etc.
Under safety, they further break down the category:
Fall detection and prevention technologies
For this class of technologies reliability is highly important. False negatives carry a higher weight than false positives. Reliability information is generally scarce. The effectiveness of these technologies depends on the setting, availability of caregivers and response protocols.
User activated push button on a pendant or wristband such as Philips Life Line (www.LifelineSystems.com), Life Alert (www.lifealert.com), and automatic, such as Tunstall’s wearable fall detector (www.tunstall.co.uk), which is accelerometer and tilt sensing based, and FallSaver (www.fallsaver.net) chair alarm, which is patch that integrates tilt angle measurement
Embedded in the environment (User’s compliance is not required.)
The University of Virginia’s floor vibrations-based fall detector (marc.med.virginia.edu/projects_gaitmonitoring.html), which showed promising reliability on crash-test and anthropometric dummies [19 Objective]; motion-based (Living Independently’s QuietCare, (www.quietcaresystems.com), HealthSense (www.healthsense.com), GrandCare (www.grandcare.com) and many research groups, including Virginia (marc.med.virginia.edu), used motion-based “possible fall” alerting functionality when lack of motion is detected)10; and imaging-based, including SIMBAD and the University of Missouri’s research effort (eldertech.missouri.edu/index.htm).
Mobility aids (User’s compliance is required.)
Mobility aids, traditionally used to enhance balance and/or help in weight support, are being adapted and enhanced to enable seniors to navigate safely in their environments. Examples include the iBot stair-climbing two-wheel balancing powered wheelchair (www.ibotnow.com), Guido the guiding walker (www.haptica.com/id2.htm), the University of Virginia’s robotic walker (marc.med.virginia.edu/projects_eldercarerob.html) and CMU’s and the University of Michigan’s guiding walker (www.ri.cmu.edu/centers/merit). (Readers of this weblog have seen more and more innovative solutions here.)
For health and 'wellness' technologies, they say:
Includes a base station with or without two-way video, usually with proprietary peripheral sensors, such as BP cuff, scale, spirometer, glucometer, pulse and temperature readers, wired or wireless connectivity (e.g., Viterion (www.viterion.com), Honeywell HomMed (www.hommed.com), Philips (www.medical.philips.com/main/products/telemonitoring), WebVMC (www.webvmc.com), Vitel Care (www.vitelnet.com), Health Buddy (www.healthhero.com), etc.). Some are interactive and incorporate condition-specific branching logic. Imetrikus (www.imetrikus.com/products.asp) has a universal connectivity hub, MetriLink, which allows connecting off the shelf low-cost health products (blood pressure monitors, gloucometers, etc.) to download the data to the Imetrikus Personal Health Record, MediCompass, to be shared with health care professionals.
Wearable
Value proposition may include better health outcome for the person, and reduced health care bills to payers. These technologies entail gross activity monitoring based on accelerometers as well as other sensors. Examples include simple pedometers, actigraphs (e.g. Minimitter’s Actiwatch), and HomeFree’s activity monitors to more sophisticated devices that incorporate physiological measurements, such as skin temperature and metabolic function (e.g. BodyMedia).
Environmental (passive)/non-wearable
These systems are based on embedding sensors in the environment to monitor daily life activities/behavior (such as QuietCare and others including, HealthSense and GrandCare), monitoring activities of daily living (University of Virginia (marc.med.virginia.edu/projects_smarthomemonitor.html)), and monitoring sleep quality (University of Virginia (marc.med.virginia.edu/projects_naps.html), Elite Care (www.elitecare.com)). Mainly targeted at professional and informal caregivers for coordinating care and early detection of decline in function or health issues; do not require user’s compliance. These systems work indoors only, mostly when a person is living alone. If the motion detectors are not pet immune, the presence of pets may affect the accuracy of the inferences and alerts generated by the system.
Hybrid
Hybrid wearable and environmental wellness monitoring systems require a wearable RFID reader and tagging objects in the environment with RFIDs, and they monitor ADLs; these are still in the research phase (e.g., Intel and University of Washington (www.intel.com/research/prohealth)). These technologies require the compliance of the user, and may not be scalable/practicable with existing technologies due to the low reliability and short battery life of the reader.
Telemedicine and Telehealth
Telemedicine technologies are targeted at health care professionals and are used primarily by home health providers, physicians and hospitals, mainly in chronic disease management and for short-term follow-up after hospital discharges, whereas telehealth technologies encompass using them, along with educational information, in self-management of one’s health.
Traditional telemedicine
Includes a base station with or without two-way video, usually with proprietary peripheral sensors, such as BP cuff, scale, spirometer, glucometer, pulse and temperature readers, wired or wireless connectivity (e.g., Viterion (www.viterion.com), Honeywell HomMed (www.hommed.com), Philips (www.medical.philips.com/main/products/telemonitoring), WebVMC (www.webvmc.com), Vitel Care (www.vitelnet.com), Health Buddy (www.healthhero.com), etc.). Some are interactive and incorporate condition-specific branching logic. Imetrikus (www.imetrikus.com/products.asp) has a universal connectivity hub, MetriLink, which allows connecting off the shelf low-cost health products (blood pressure monitors, gloucometers, etc.) to download the data to the Imetrikus Personal Health Record, MediCompass, to be shared with health care professionals.
Ambulatory and wearable monitors
Ambulatory and wearable monitors: Ambulatory and wearable monitors connect via wire—or wirelessly—to a recoding device that sends the data. These include ambulatory electrocardiography device (also known as Holter monitors). An example of these systems is LifeWatch’s (www.lifewatchinc.com/LWTpo_vsm.html) cardiac monitors that use a Bluetooth-enabled cell phone as a data recorder and connectivity gateway. These devices rely on the compliance of the users as well.
Purely interactive Q&A systems
These systems do not have dedicated peripheral measurement devices. An example of these technologies is ZumeLife (www.zumelife.com); these technologies are generally not reimbursable, except possibly under PACE and MA-SNPs.
Video phones and Two-way video stations
These devices are used to connect with a health care professional for telemedicine, televisits, and teleconsults; interventions with these technologies are generally reimbursable with limitations. An example of a simple system is KMEA’s videophone (www.kmea.net).
Passive/environmental/non-wearable
The University of Virginia’s bed monitor for vitals and clinical sleep assessment (under validation) and instrumented walker for gait and balance assessment are examples of this category of telemedicine/telehealth technologies that are under research; such technologies are generally not reimbursable, except possibly under PACE and MA-SNPs.
Medication compliance technologies
These technologies have monitoring, reminding, dispensing features and combinations thereof. Most of these technologies are stand-alone and are targeted at the seniors or the caregiver. Simple monitoring is offered by QuietCare. Intel and Oregon Health and Sciences University (OHSU) (www.orcatech.org/index.php) have prototypes of monitoring and reminding systems and Honeywell HomMed has a medication monitoring and reminding system as part of the telemedicine suite. The Med-eMonitor from Informedix (www.informedix.com) incorporates reminding and educational information/ instructions. The MD2 (www.md2.com) and CompuMed (www.compumed.com) products have the dispensing functionality but may require a professional caregiver to perform the loading and programming. Most products have usability/ user interface issues for elderly users. Many products can be found on the Internet (e.g. on www.epill.com).
These devices have the potential to improve health outcomes and reduce cost of care, and to provide peace of mind to informal caregivers, but are generally not reimbursable. There is some preliminary evidence of their effectiveness in improving medication compliance, but more objective evaluation studies, aiming to evaluate their impacts on health outcomes and the cost of care, are warranted.
Comments