Aging in place and tech-enabled healthcare are not in synch

Seniors do their best to live and stay well. If you live in Florida and go to a concert at 4:00 pm on a Friday, it's not surprising to be surrounded by seniors in their 80's and beyond, dressed up and slowly climbing the steep stairs up to the balcony. These concertgoers likely live in their own homes, drive their own cars, and enjoy concerts and perhaps a nice meal in a restaurant afterward.

But how motivated is the healthcare system to keep them that way? According to Deloitte's 2008 Surey of Health Care Consumers, 75% of consumers, especially female baby boomers and seniors, are interested in the expanded use of in-home self-monitoring devices and Internet-based methods that would reduce trips to the doctor's office and even lower their own costs.

Government payment methods are not focused on the home. But as Deloitte researchers point out in an analysis of Technology-enabled Connected Care, the 'healthcare' system is designed today to reimburse based on performing procedures and providers visits. The report notes that less than 1 percent of Medicare's $400 billion budget is spent on pilot programs for testing in-home technologies (how much less was left to the imagination).

Reform and advocacy efforts target health records, not wellness. In fact, technology use for in-home monitoring that could help keep seniors well has yet to make it into the mainstream advocacy of healthcare reform efforts, which seem largely concerned with electronic medical records and personal health records, as though these will keep healthcare costs down in the never-exactly-stated near term. I am not convinced. If your doctor and my doctor both have EMR systems and you and I have PHRs that we keep up to date, by the time these are all standardized and in easy-to-communicate formats, what will have been done to monitor our blood pressure at home, check if we've taken our medications, or helped prevent us from falling down those steep stairs?

Aging in place success will be outside the standard healthcare system. I would argue that instead, we should learn more about aging in place technologies -- those tools and services that can directly help us age well and with satisfying lives, technologies that we will want to pay for ourselves, independent of whether our doctor is tech-enabled, or whether one EMR talks to another. The market for these technologies doesn't depend on a payment system or government reform. But this early market must grow and become more sophisticated, offering a menu of services, to really be of benefit to boomers.

Role- and need-based service hubs will emerge and grow.  Aging in place technologies are beginning to gravitate towards hub-and-spoke portals, so dominant in eCommerce evolution, that provide a lens into how roles (like caregiver, senior, and provider) relate to needs (like home monitoring, and medication reminders). As hub-and-spoke portals mature, they will offer concierge service for consumers to view and share information, as well as purchase targeted products and solutions. Consider role-based hubs like Grandparents.com, Caring.com and GilbertGuide), and need-based hubs like AARP.org and WebMD. Their partner spoke vendors (like Intel, Jitterbug, or HealthHero) may advertise or even connect directly to these sites. In the future, some platform vendors may become even become important as hubs, like Philips, for example, in healthcare, or perhaps Facebook, building on a growing social network of seniors.