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No Impact for Seniors: Paper books, Health IT, FCC and other GOALs
Mon, 04/26/2010 - 16:18 - Laurie Orlov
Excuses everywhere as to why not this and can't do that. If you're trying to make sense out of lack of progress in terms of Internet adoption and seniors, look no further than Friday's Senate hearing, with its overreaching title: "Aging in Place: The National Broadband Plan and Bringing Health Care Technology Home." Read and absorb a veritable laundry list of reasons why we need to buckle down and get a plan in place to get health technologies into the home -- maybe by 2020.
Is lack of broadband access the real problem? Never have so many heard so much about insurmountable barriers to stem rising healthcare costs of an aging population. Let's skip most of the barriers -- they are for others to debate -- and just focus on one noted by Mohit Kaushal, digital healthcare director, Federal Communications Commission, about connectivity: "Broadband is either missing or too expensive."
Never mind that this ground has been covered. So we know that the Veterans Administration and many others have already studied savings from telehealth (see blog comment "Don't expect turkeys to vote for Christmas" - my all time favorite.) Never mind that there is absolutely nothing preventing the telecom vendors right now from offering seniors low-priced broadband along with a useful application (like this pilot in Chicago). Oops - that requires a computer. Never mind that computer prices are amazingly low (the little Acer netbook with the great backlighting I am typing on right now cost $299 at OfficeMax.)
Let's just say a miracle happened -- and all was available. Let's imagine that instead of spending billions of federal dollars hyping broadband, instead of conducting more studies, and starting up vendor-sponsored Project GOALs to educate seniors about the advantages of broadband, what about this vision? Let's just imagine a world in which a really cheap Internet access plan (< $20/month) was bundled with a cheap brightly lit computer that weighs less than 3 pounds (< $300), with pre-loaded apps that were paid for by the carriers and computer vendors.
Marketing was plentiful. In this imaginary world, the vendors get together and buy large ads in local (hardcopy) newspapers around the US. Now let's imagine that every NCOA sentor center and SeniorNet learning center in the US has an easy-order process, that AARP offers a sizable discount on the computer as well as the broadband access. And with income verification in conjunction with other senior programs in this new world, it is even feasible to qualify for a free computer and better discounts on service.
Keep imagining beyond paper-based instructions. But how are folks going to learn how to use what they have? Well, maybe they could buy a charming, but soon to be out-of-date paperback book (see review). Instead, how about this? Now that they have their new little computer, their discounted broadband access is enabled by providing a coupon code over the telephone. But unfortunately, the computer comes with apps that may or may not be described in the book and also has startup instructions that most likely will not be described in the book.
Training is available through multiple mediums. What if the machine came with a training DVD? Or it was labeled with an 800 number where newcomers could listen to step-by-step instructions about setup that were provided by one of the vendors involved? On that call, they learn that they could call another 800 number and listen to telephone-based training in the use of the pre-loaded applications provided by the vendors.
Bingo! Then amazed, our newly outfitted senior, just like 105-year-old Will Clark, gives a big chuckle at what they can now see via the apps and find on the web, including those online Facebook family members and old friends. And on their training call, regardless of where they live, they learn that they can sign up online with pre-vetted services for transportation, meal delivery, and even online health consultation from their doctor (who mentions home health monitoring services that are now covered under Medicare). Maybe the computer label also has a phone number to call 24x7 to troubleshoot both the broadband service and... the computer itself.
Crazy? Aside from the fact that we all need these features, ask yourself this -- do we really need national broadband plans, GOALs, FCC initiatives, and every other objective that sets targets 10 years from now? Isn't this feasible with just a little bit of vendor willpower and cooperation -- and a desire to make more money by expanding their reach into a 65-plus market that is only 26% penetrated?
Your thoughts are welcome.
Comments
Hear! Hear! Well Said.
Broadband access is the least of the problems of the senior market, especially to the folks that have had little or no experience with technology besides the flashing time on their VCR or the impossible situation with media remote controls. The main problem to-date is the fact that technology solutions have been inaccessible to many because they required people to 1) learn how to type, 2) learn the basic fundamentals of computers and 3) learn about the Internet. It's like trying to drive a car while blindfolded. Too much to learn without the proper underlying motivational reasons.
But, technology has reached a point where machines talk to machines and in-home technology *should* act as an invisible servant. We are not quite there yet in the senior tech world, but it's coming. And, with the advent of simple-to-use touch systems like the iPad where you can forget your password after it's stored in the "app", we will most likely see far more adoption of the devices that make one want to get broadband (or buy the built-in cellular broadband.)
The FCC's national broadband plan is so complicated it seems to forget the basics of what we are trying to achieve in this country - ubiquitous, instant-gratification broadband (where instant-gratification means you-get-what-you-want-when-you-want-it inside the 300 ms human-tolerance for delay.)
Our company has decided to quit talking and start doing and is revving up to work with local constituencies in San Diego County to adopt the technologies that will help keep seniors in their homes. The major hurtles are twofold. First, most don't have a clue about the types of technologies available. We know we have a huge education effort in front of us. Second, most of these technologies seem to be created with the idea that they are the only one in the home. If more than one is deployed to meet the needs of the caregiver and patient, it starts to become a management headache for the caregiver. We know we have to find a simpler way to manage multiple systems.
That said, it is time to start walking-the-walk instead of whining about how it's going to take 10 years to get to the types of systems that are in use worldwide today. Instead of the "let's beg for a 100 megs" that the national broadband plan pitches, we can closely watch efforts like those in Ohio's One Community and Google Fiber Pilots to see how we can use technologies most effectively.
Eric Dishman's testimony on Friday pointed out a simple immediate solution to moving the ball forward - a national pilot project in 10,000 homes that documents the successful use of technology and broadband. Let's hope someone in the Beltway was listening.
From Joseph Coughlin, MIT AgeLab
This has been the fate of telemedicine and related technologies for over 40 years. At least there is public agenda status in the form of hearings. That is progress. However, there remains a vacuum of a committed, organized and focused lobby to move this from symbolic politics to policy. Because the service providers are and will be fragmented, the power is fragmented, consequently, there is little incentive to build a coalition on the Hill. Moreover, the oxygen is out of the system on healthcare. I suggest redefining this as an economic growth opportunity that translates into national competitiveness, jobs and translating demographic transition into impetus for innovation. The US ICT industry has the opportunity to lead the world in technology and services innovation to respond to the aging markets throughout the world, e.g., 165M older folks in China and millions in Europe. The 'good' reasons of care, compassion and cost reduction have not been effective. It is time to realign and expand the debate to include a larger set of companies nationwide.
And, besides, at this rate, there won't be services in place for all of us!
Is broadband the real road block?
Once again you have identified the enemy and it is us. Why is it so easy to understand that a child must walk before they can run yet we expect adults to have a mysterious sixth sence about technology. I have spent 40 years in the telecom and data field. Trust me, we have come a long way from smoke signals and pigeons. Still, the basic concept is communications. I don't care if seniors start with a mastery of the TV remote, or they prefer to study the complexities of the new Intel dual processor. START SOMEWHERE! LIke most things in life, it is up to the individual to put effort and time into improving themselves. Seniors, if the vendors won't step up. let's do it ourselves. Start with a product like Presto Mail that sends e-mail and pictures in "FAX mode". The only thing you need to know is how to add paper and take the printed copy out of the machine. You don't even need "broadband", just a telephone line. Try Pointerware. Just click one of the large boxes and see what happens. You may be surprised and delighted. Welcome to the wonderful world of technology. Be the first senior on the block to host computer classes for underpriveleged school kids. Laugh at your mistakes and delight in your successes. This is something that is ageless. Don't miss out.
Aging tech/eHealth NOT dependent on broadband!
Earth to Congress: you don't need broadband to connect seniors to technology that can assist them in their everyday lives. We don't have to wait 10 years for solutions because they are around right now.
Point One
There are plenty of here-and-now systems that work just fine with normal telephones (even dialup), operate on cellular/M2M connectivity or even POTS. No laptops needed (another one of their insurmountable barriers). But if you want to connect older people to the internet, why not connect them wirelessly or via satellite? The wireless and dish companies can discount or subsidize senior programs. (Hey, this is one place where that Federal broadband $ can go, more effectively and less expensively, AARP can work some deals--and Bill Gates could take a chunk of his foundation money and extend Microsoft's efforts in this area.) A lot of this great United States has areas where broadband is not economic and won't be delivered anytime soon. (Note that Verizon FIoS is at a dead halt geographically) POTS, wireless and satellite are here and now.
Point Two
The real game here is Congress and Washington bureaucrats getting their piece not only of broadband, but healthcare technology. With broadband, this has been a back and forth fight since Al Gore and Clinton with the Feds being more a expensive, money-burning roadblock than a facilitator. There is a different agenda here, and it has little to do with providing seniors with helpful and independence-supporting systems NOW. Laurie, kudos to your ideas about working with NCOA, SeniorNet and AARP to create a system of solutions, perhaps advertised in newspapers or via senior centers and (I'd add) radio. If multiple technologies can be packaged together, made easy to install and affordable--that works.
Eric Dishman's Senate testimony -- from his blog post
https://blogs.intel.com/policy/2010/04/testimony_to_senate_aging_committee_national_e-care_plan_needed_now.php
Roundup on Senate hearing on Telecare Aware
Steve and I posted a 'roundup' on the Senate hearing including the Dishman blog post, the full 2 hour hearing video and a link to your comments above Laurie, and this active thread. http://telecareaware.com/telecare-telehealth-ecare-broadband-laurie-orlov/
Boomers and Older Adults in the World of Broadband
I would love to live in the world Laurie described. I daily encounter older adults who lack sufficient computer skills. And more often than not, they are unaware of their lack of knowledge I began my business to teach Boomers and Older Adults more about Social Media: Facebook specifically, so that they might communicate cross generationally with grandchildren and great-grandchildren. I firmly believe that as age increases and health decreases that an individual's social circle also diminishes, and as the social circle shrinks, the quality of life starts a rapid decline.
As I enter my community, armed to teach in a variety of settings, I repeatedly find a lack of basic computer skills. This lack of skills has required that I modify my business plan and have begun meeting one-on-one to provide step-by-step instructions in the client home, using their computer, experiencing what they experience. It may be a bit more time consuming, but I truly feel that the technology playground should be open to all.
My own father, a 75-year-old retired computer programmer had skills that had not been updated since the early 90s. So in the Fall of 2009, I spent a week of intense training, moving him from an out-dated Windows machine to the new iMac. Now, even though we live 2500 miles apart, I am able to show him new tricks with his computer daily. He also has Apple Customer Support which is incredible. Support via phone, utilizing Skype and Quicktime movies to "show how to do something" and even having the ability to "take over his machine" to check on settings has opened a new world.
But not every 75 year old has a geeky daughter who has the time and inclination to help bridge the technology gap. :-)
If Boomers and Older Adults are to embrace new technology, it is truly up to the service providers and those wishing to sell to this generation, to step up and make the products easier to use AND provide training. When my clients get frustrated and state "I should know this", I merely smile and say "you were too busy out living life, changing the world, when this technology came on the scene." But it is never too late to teach an old dog new tricks, all it takes is common sense and a bit of patience.
And while they make excuses...
...villagers in Nepal are getting health care via their mobile phones. See 'mHealth: the developing world really needs it'. What a contrast!
Age wave or meteorite?
Helloooo! The age wave is crashing down on societies around the world while local governments and unimaginative aging in place technology companies pursue inept marketing strategies. Unbelievable!
Let's break the problem down: First, build a model home incorporating Universal Design, Smart Home, Green Home and a suite of Aging in Place Technologies...Second, expand from the model home into a Lifespan Community encompassing all of excellent ideas to be derived from "No Impact for Seniors: Paper books, Health IT, FCC and other GOALs" and the excellent replies it evoked. Third, Showcase this demonstration project to local seniors as well as Federal, State, local officials and home builders-and myoptic AIPT companies.
The time and need for innovative approaches to dealing with the enormous burden ( and opportunites ) of the age wave is now.
I'm moving to St George, Utah in June to find a suitable parcel of land for a model home.
I'll be forming an advisory board to help me refine this vision and implement it in the real world.
Thanks to you, Laurie, for consistently shining a light on the path ahead for aging in place technology!!
From Jitterbug founder -- Arlene Harris
Re your imaginary future, reliance on government is dubious – my business instincts are too strong – Jitterbug was instructive. Like Gary and Joe, I’ve a pragmatic market view perhaps additive, that is: Smart application of technologies delivering compelling consumer offerings based on creative, collaborative and holistic business models where value is clear and costs are shared should provide the self interest needed by each in the ecosystems around aging to drive adoption forward faster. It seems we’re now entering another period of warp speed in the application of technology to solve human problems. Innovation is essential to staking our place in a global community; addressing “aging economics” and the “technology of aging” could also be a leadership spot for us as a nation. Underpinning this view is my notion that those of us who were part of the technical revolution have high expectations, are intolerant of being ignored and are willing to spend (and hopefully invest) in applying more appropriately what the youngsters enjoy to our independent living prospects.