December 2011 Newsletter -- 2011 wrap and 2012 trends to watch

The basic technologies that have changed the user experience for everyone are well-known in the consumer electronics world. They are GPS/cellular tracking, touch screens, voice activation, battery technology, cameras, accelerometers, and sensors. But these are migrating slowly if at all into the market of offerings to enable older adults to live well for longer, aging at home if they wish. This could be because of a soft economy, a risk-averse senior housing community, a tech-averse home care industry, or other factors. But it is a truism of vendor-hood that switching to new technologies involves a cannibalization of existing markets – one must pick the right time. Looking through the aging-in-place technology lens into 2012, there many points of light that will shape the year:

PERS – the little button morphs into mobile.  At the most recent mHealth Summit, it was interesting to see a Verizon (yup!) staffer wearing a mobile PERS watch – meanwhile the much-thrashing Lifecomm device still can’t be bought for love or money. Adding some confusion, AMAC, one of the Lifecomm partners, was acquired by Tunstall.  Philips Lifeline is sticking to its guns, gloomy ads, and consistent product line. Why change with a ready market of 82-year-old women living alone? Well, one reason is competition, from traditional companies like LifeStation and VRI. And on the out-and-about front, MobileHelp already has had a viable offering in 2011, GreatCall (the Jitterbug founder) introduced the 5Star Responder, a GPS-enabled pendant -- a step forward in making mobility matter. It can be purchased online, and at $14.99, talks to a professional call center – no doubt pressuring lower-end PERS ($29-ish) market pricing. And those PERS apps on smart phones like Guardly ($12.99 now) or vSOS (free on Android) are waiting for younger seniors to adopt smart phones – look around the store at the folks in their late 60’s and 70’s and wait for the next Pew Research survey.

PREDICTION – PERS GETS OUT OF THE HOUSE:  The aged 85+ and up and (anyone who is confined to a limited space) becomes the target user of traditional home-bound PERS, the button is an instance of an interaction model that will overlap with other interaction models – 2012 should see vendors who have the PERS buttons socializing with vendors who have sensors and accelerometers – both of them adding social connectivity – reversing the PERS isolated woman’s test call inbound to a smarter call outbound: we haven’t heard from you, how’re you doing, along the lines of Great Call’s Check-In service.

REMOTE MONITORING – health is expected, telehealth is now passé. The distinction between remote health monitoring (aka telehealth) and passive activity monitoring did actually blur as predicted last year  – so much so that it seems silly that I harp on this label distinction when talking to the press. Vendors link in a few devices for vital signs, obtain FDA approval, make sure to be HIPAA-compliant, and voilà – remote monitoring for fill-in-blank. And just in time, because remote monitoring is so yesterday, now that lowering health costs is a priority and mHealth is, mmm, here. In 2012, it may be best to categorize offerings as mHealth in a year in which doctors all have tablets and smart phones, more or less for patient benefit, so really, form factor has been decided.

PREDICTION – mHEALTH REVIVES MONITORING:  The stationary nature of in-home activity and telehealth monitoring will give way to a disconnect-and-go tablet world that can be docked at home and plays nicely with a cell/smart cellular model. For those walking the floors at CES, you will see tablet apps of every type flowering hither and yon – perhaps you'll see them tethered to a phone. RIM, the anti-marketer, produced an early version of this with the Playbook-BlackBerry tethering. Why not a few tablet apps for seniors (in addition to health and activity monitoring) that sync up with a phone-like device? It may be like trying to cram a large box into a flat rectangle, to start at the hardware end -- look at Care Innovations Guide, for example. Why not a partnership between a fitness device vendor (like Fitbit or Philips DirectLife) and a remote monitoring vendor like BeClose or Aframe Digital?  And software-only products like Independa and GrandCare may well benefit from both platform flexibility and a new interest in combining activity sensors and health monitoring.

HOME CARE -- gets the attention, not yet the tech deployment, it deserves.  May you live in interesting times – this past year saw the boom of jobs in home health and home companion care -- to the point where they comprise the fastest growing so-called job opportunities in the US. But given their low wages and mostly missing benefits, federal efforts are underway to apply wage and overtime protection to these 2 million or more workers -- 40% of them on Medicaid and/or food stamps. Beyond the controversy over who works, who pays and how much, there is still no talk of requiring any type of monitoring technology in the job – and in one survey from Magnolia Prime recently, at least 50% of the home care agencies surveyed reported that they had "no plans to purchase, replace, or upgrade their technology in any way." So they say.

PREDICTION – PLANS WILL BE MADE: Not so fast, folks – 2012 is the year in which the health care industry becomes obsessed with avoiding hospital readmissions – translated as the need to stay at home once discharged. So first workers become part of the Fair Labor Standards Act, then cuts to Medicare/Medicaid will be on the Congressional lunch table, and when costs and reimbursements are cut, someone, somewhere will wake up and sees a tech that could potentially lower a cost and prevent layoffs. As one executive of a home health agency noted recently: “If I had a way to verify that our clients were actually doing their prescribed physical therapy, it could save three visits per week.” And what’s it mean that SeniorBridge was acquired recently by Humana? Humana and other insurers realize that they are in the ‘senior’ business with numerous possibilities for applying more tech to lower cost and engage families in sharing the care, or at least the communication. Finally, who would have seriously thought that California would launch a 'Medication Dispensing Machine' pilot?

A microphone is ubiquitous  – but will vendors follow? Siri, the talking iPhone pseudo-psychologist, created a new nightmare in airports – people conversing with their phones ("I said I was looking for the restroom, not a guest room! Sorry, Dave, I can’t find one here.”) Siri reminds us that if voice recognition and speech technology exist, they become must-haves, along with Microsoft’s Windows Phone, Google’s Android phones, and Dragon software (which now powers so many different types of interactions). But most vendors in the age-related technology categories are still iterating their current products trying to build up share before an inevitable consolidation.

PREDICTION – NO SPEAKING IN 2012: Despite the presence of voice interfaces on consumer devices, in a struggling economy and a niche market category, products geared for seniors will not make much effort to incorporate voice interactions (unless they are emergency response related) in 2012 – however, it may be required by 2013.

Touch screens are now the primary ‘command’ interface.  What you touch is what you get to do. Typing a command after mousing your way around – is so over, probably for the best. The Telikin Senior Computer (Linux-based) launched this past year, and is selling very well, according to the company. It does a whole lot more than your average tablet, despite their many charms. If one thinks about tablets as great portable media consumption devices, a computer in the home can still do more with more connection and storage possibilities. And every once and a while, one wants that keyboard (ah, the keyboard!) to enable communication of that long and punctuated thought. 

PREDICTION – DEVICE PRICES WILL INTERSECT:  A tidal wave of price-competing tablets at CES will be side-by-side with ultra- and other skinny-books. Why waste some good operating system evolution, since Windows 8 will soon support Kinect gestures, opening up a world beyond Xbox games!  For road warrior seniors (yup, you heard me, they’re on my West Palm Beach flights), several of these sorted into sleeves in their carry-ons may seem smart.  For those that only want their online fun and diversion inside the home, the Telikin or one of the all-in-one computers may be appropriate.

Games as a UI for apps – the promise but not yet the reality. So speaking of Microsoft and Kinect, 200 companies are ‘exploring’ the commercial possibilities, but there's still no commercial software development kit – which means a waiting game for really applying Kinect’s ‘see you, hear you, interact with you’ gesture-based model. No doubt Microsoft now seems an opportunity to wait until its Windows and Kinect fortunes can be upgraded together, so to speak. The company wants to see more apps developed and in November, they offered money to make it happen.

PREDICTION – NO APPS UNTIL THE WINDOWS OPEN:  If it takes this long to get a commercial development kit out there, vendors will play around a bit, but nothing much in the way of apps will emerge for older adults until the stars are aligned for Microsoft, who may tell developers to upgrade to Windows 8 to ship a commercial Kinect application.  Over at Wii-land, the device is as popular in senior centers and senior housing as ever. Kinect will not change that, but it may skip past into group therapy with avatars.

Caregiving apps – should be plenty, not there yet.  For all the growth in home care and home healthcare, go to the iTunes store and search for caregiving – podcasts, books, videos, but no apps – despite 7 million links to the phrase on Google.  It should remind us that caregiving is a major pre-occupation -- see Caring.com -- and caregivers want technology.  But front-office apps (connecting service providers, family member end users, seniors) and care coordination software suites that caregivers say they want have not yet emerged into well-populated software market.

PREDICTION: Just as the tablets, computers, and smart phones have yet to really find their common ground, caregiving has yet to be on the radar of investors -- which means app developers are scarce. Maybe that's because most caregivers in the midst of caregiving don’t see themselves with that moniker. So their service providers who cover the last mile with care recipients will have to help raise awareness of their needs -- these transcend the time, attendance, billing and payroll apps typical of professional home care. Perhaps the coming readmission penalties, rather than resulting in more phone calls and home visits, will spawn interest in care coordination software – for real.

Finally, a hope.  Televisions are becoming cheaper – and a fight is underway to make them interactive. With apps, better remotes (hopefully a lot better!), even though TVs seem to be both less profitable for manufacturers, they are owned by everyone (2.8 per home in the US!)  Maybe 2012 will be the year that apps for seniors and caregivers will be deployed through one of the battling television variants.  From this blog to their ears.

Thanks for listening and your comments and corrections are welcome!  If you are receiving this through a subscription to the monthly e-mailed newsletter, please sign up on the website, upper left side home page of Aging in Place Technology Watch.

I look forward to seeing many of you in my travels online and off in 2012!

Have a great New Year!