Healthcare consumerism and the remote monitoring reality check

Deloitte has made an executive decision – ‘senior’ begins at 67.   Taking the first step onto a slippery slope, Deloitte, advisor to CIOs and other C-worthy executives, tries to get ahead of the age wave. To distinguish seniors from boomers (aging away as they are), their most recent report on healthcare consumerism has decided to pick its own cutoff for a generational split – despite Medicare (65), full Social Security eligibility (varies by birthday), and various senior discounters from AARP (55+) to AAA (65+). So we have a tantalizing question to ponder – does that mean that in 2013, senior-ness for Deloitte  begins at 68?  What about in five years – will it be age 72?  We are in a cycle of growing longevity that is surely underestimated by everyone, including consumers, but most significantly, then, will be Deloitte and the C-folk.   But they used a web-based questionnaire and didn’t provide age segment breakdowns of the 67+. As with most surveys, therefore, responders aged 67+ who indicated they would use remote monitoring to send information to their doctor (a hypothetical capability for sure), are NOT a representative sample of the older and still-viable decades (age 77+).

Is consumerism really a euphemism for tech curiosity and web-surfing?  In my Forrester days, surveys would often ask business responders whether they were using a technology now, and if not, would they use it in 2 years?  When it comes to emerging technologies, it was always a chuckle that many non-users reported year after year that they were not using XYZ tech now, but of course, they would in 2 years. Of course.  In 2009, Forrester predicted adoption of innovative technology for in-home health care – 12% of all seniors by 2015. Oh well, maybe not. Look closely at the responses in the Deloitte web-based survey and you can see the same disconnect – 50% are willing to use self-monitoring that sends information to the doctor (aka telehealth), one in five would use an app to download medical records, but oops, fewer than 10 percent are looking online for cost or quality info, and only 14% are even interested in tech that reminds them to take their medications.

Don’t pump up remote health monitoring capacity based on Deloitte.  Readers would be wise to take this optimistic new telehealth survey with the grain of salt that it merits. Last year's Linkage 2011 study of 1789 seniors age 65-100 revealed that a wistful 41% of seniors would like to learn about new tech from their doctor -- sadly, their doctor was not surveyed about tech willingness. And the Deloitte study is yet another repeat of a 2008 AARP Healthy @Home survey that indicated 57% of the 65+ were willing to have their health conditions monitored remotely by their physician (though few had the technology to do so). With all these variants of consumer optimism and industry potential (see 2009 Healthcare Without the Doctor or the 2008 VA Telehealth study), wishing and hoping that the doctor is going to be engaged in using technology to monitor chronic diseases is just that. The most advanced organization is the VA, which just made a move to drop the co-pay for remote visitations. But where, oh where, is the Medicare reimbursement for telehealth that would, of course, make its adoption for the 67+ population a rapid reality? Ah, too bad, telehealth is quite explicitly NOT reimbursed. Says CMS, go ahead and use it to make nurses and doctors 'more efficient.' Whatever that means.

Consumerism happens when retailers have telehealth devices jumping off shelves. So just this fall (uh, that would be 2012), Target will offer some 'quantified self' (aka telehealth) devices on the shelves – starting with the no-risk self-coaching meters. The irony: it looks like doctors will be in Wal-Mart before any of those telehealth devices on the shelf that could make their practices more 'efficient.' Until a transmitting weight scale and blood pressure cuff become mainstream retail inventory – and until Medicare reimbursement is in place -- the Deloitte survey is just another in the same-old (and increasingly old) survey storage – validating the wishing and hoping, but by no means validating likelihood of adoption.