Laurie Orlov's blog

Consider the Apple Watch fall detection age default.  Rant on. By now, and for most, no big deal, you may know that the Series 4 watch has fall detection. The setup includes your ‘emergency contacts’ acquired from your Medical ID, assuming you have Wrist Detection turned on.  Still with me? And perhaps you have also turned on the Health app (somewhere) and entered your birthdate. Still with me?  Assuming that Apple knows your date of birth AND it is 65+, the default setting turns the Fall Detection feature on – you then have to turn it off.  Which, since it is set to call Emergency Services unless you Cancel, might, as it has been with Apple Watch emergency calls, be a problem. 

When Apple speaks, a puzzled market listens. When Apple announces, industries crane their necks to hear. Last week they announced two features of a new watch, ECG monitoring and fall detection. In July, Tim Cook apparently did not want to get into the world of FDA regulation. Well, that was then – or he just wasn’t saying. In this new watch, both the ECG feature and fall detection have received FDA clearance within 30 days of applying, startling some observers who noted that closer to 150 days was more typical for a medical device.  Healthcare observers are concerned that false positives from ECG readings could propel people unnecessarily to already-overloaded Emergency Rooms. To date, the Apple Watch may have been of greatest interest to 40 year old males. Interestingly, 70% of cases of atrial fibrillation are among the 65+ population.  Does Apple really want the 65+ population to buy an Apple watch?

It's that awful time – the hurricane season.  The time when the national hurricane center forecasts, repeated ad nauseum, are destined to frighten everyone, no matter how far from affected regions. The same broadcast can dwell on cones and paths, and almost as an aside, remind those in beach areas that the evacuation instructions are meant for them.  Reversing highway direction and talking constantly about evacuation sounds like a plan – but some observe that the distance required to evacuate to safety could be as much as 250-300 miles. So residents who will 'shelter in place' stock up on supplies and watch the 24-hour source of all fear – cable news, looking for guidance from Jim Cantore, that icon among storm trackers.

Vacations and out of office messages – it must have been August.  Some have said that there is no point in attempting a business meeting, even online, for August. Perhaps you were one of the 5 million visitors to Cape Cod, roaming the hillside vineyards in California or attending an antique car auction on the coast of Maine.  Having managed to pull off two of those three in the same month, it’s not that crazy. But there were issues, disruptions and sizable opportunities worth noting in August, the biggest one was Best Buy's purchase of GreatCall, just six weeks after Amazon acquired PillPack, the latest big company acquisition -- part of a to-be-continued series important to families and providers of care to seniors. Here are the blog posts from the month:

Investors continue to salivate over health tech.  Rant on.   So the first half of 2018 saw $3.4 billion invested in Digital Health (which means whatever you want it to mean.) And even when investments or company roll-ups are specifically about the Medicare population – frothy writers cannot bring themselves to use clear wording. So Optum acquires DaVita Medical Group and Humana acquires Kindred Healthcare. Gee, what do they do? Yes that is vertical integration in the continuum of care – specifically for health services to elderly Medicare recipients.  And the $146 million that went into PointClickCare – that is software for long-term post-acute care (LTPAC), another euphemism for what it really is – care of the elderly, generally in nursing homes.

Reading the employee microchip article – does it make you shudder?  Observe the development and evolution of modifiers for the word technology.  Words like sustainable, appropriate, autonomous all come to mind. With the micro-chipping of employees – the convenience argument is ultra thin. But why would one think about a microchip for an ailing relative, aka an older adult? (Some say we will all get chipped eventually.)  Consider that these "chips will offer a convenient way to track people — especially those suffering from Alzheimer’s and dementia."  But who will opt in to being chipped and tracked in that example?  Employees could opt out – but can a person with dementia opt out?  How different is being micro-chipped from wearing a band with identifying address information? For whom is the 'convenience' of micro-chipping offered?  And because it is possible, should it be deployed?

​As summer winds down, innovators rev up.  August is winding down -- the calm before the autumn slew of activity.  Nonetheless, new milestones and partnerships were announced this month, including Embodied Labs becoming a finalist for the Top8 XR Education Prize sponsored by the Bill  Melinda Gates Foundation,  MedMinder reaching 1433 on the Inc5000, the acquisition of GreatCall by BestBuy, and MobileHelp announcing a partnership with LifePod.  And four companies released new offerings to help professional and family caregivers improve monitoring and well-being among older adults:

Many years ago, when the phone rang, we eagerly picked it up.  That was then. For good or ill, families want to text, message and chat. And the phone call has turned into a source of harassment and scams. Robocalling is a modern torment, sometimes multiple back-to-back dials from the same source, often spoofing our own cell phone numbers – where answering the phone puts us on a ‘sucker list’ sold to other scammers. Is it Rachel from Cardmember Services or the IRS Phone Scam,  a fake carpet cleaning offer or worse, the disabled veterans scam, or the grandparent 'this is your grandson' scam? 

First take – this links together multiple Best Buy initiatives, starting in 2011.   Look at the history of Best Buy. First a dabble with the now departed Wellcore in 2011 – clearly the time was not right – the oldest baby boomer turned 72 in 2018, but at 65 in 2010, consumers could not comprehend the utility of a wearable fall detector. But Best Buy executives saw the opportunity and decided to learn more.  More significant in 2011, Best Buy became a founding consortium member in a ‘living lab’ Charter House in Rochester, Minnesota (along with Mayo Clinic). "We believe technology has the potential to foster healthy, productive lives by enabling easier access to information and medical care," says Kurt Hulander, then senior director of health platforms at Best Buy.  

Voice First technology – triaging the healthcare opportunity.  This week’s Voice of Healthcare Summit in Boston offered up some intriguing attempts to create new Voice First interfaces that inform patients, streamline work, and demonstrate potential (like Answers by Cigna) in versions 2, 3 and beyond.  One of the most intriguing presentations – KidsMD – a Boston Children’s Hospital ‘accelerator’ initiative begun in 2016 and is winning over the staff.  The organization is clearly committed to using Voice First interfaces for patients, for internal questions (“Who is the Charge Nurse on 7 South?”), for hands-free operating room checklists, for post-discharge guidance and for home health (100,000 interactions to date).  They’ve added a skill called AskICU that highlights the potential for ‘hands free, eyes free’ questions that have easy (but difficult to find) answers, like available beds on a floor, or detailed answers like “Medication dosage details from the Code Cart”.   The other hospitals in Boston are well aware of the innovation at Children’s, but other than experiments (like one at Beth Israel Deaconess), nothing of the scope of KidsMD has materialized.  In other blog posts from July: