Tag Archive for: Residential Systems

Finding Opportunities for Health Care Technology Integration – Residential Systems Reports

Lee from Residential Systems does a nice job of discussing the opportunities in Digital Home Health. GrandCare’s VP of Marketing, Laura Mitchell & CEDIA’s Dave Pedigo weigh in on the dealer/integrator opportunities in home health technology and why the in-home health care providers should be listening…  NOTE: the technology called Health Fronts, should be HealthSense

RX Integration
By Lee Distad, September 6, 2011

Full story: http://residentialsystems.com/article/63422.aspx

inding Opportunities for Health Care Technology Integration

Technology is getting to the point where in-home technology can do things that help medical professionals monitor their patients remotely, long term.

In the AV and automation channels there are categories that are widely adopted, such as AV distribution, as well as ones that are less so, such as energy management. At least at present, home health care is a category that is in the latter group. But a partnership between CEDIA and manufacturers of these technologies is seeking to make it both better known and a successful profit center for integrators.

CEDIA’s director of technology, Dave Pedigo, has been personally embedded in home health care research for the past year. As he puts it, “The elevator to get on and understand the category would be to take away the technology for a second and look at sheer numbers: there are 100 million in the U.S. alone who are reaching retirement age. At the same time there’s a serious shortage of doctors: as many as 150,000 fewer than needed according to the Wall Street Journal.”

With the growth of an elderly population and decreasing number of medical professionals, the question becomes how that disparity is going to be handled. Pedigo explained that, “Technology is getting to the point where we can do things that help the medical professionals.” By which he means the ability to remotely monitor patients, long term.

The home health care market is very much in its infancy, according to Laura Mitchell, VP of marketing for GrandCare Systems. Although she warns that it’s not as undeveloped as some people might believe. “Maybe it’s better to say that it’s an adolescent with braces,” she joked, going on to assert that the category has been around for some while now and is seeing more vendors and more advanced technology.

Mitchell explained that when GrandCare was being developed in 2005 there were only three major players: GrandCare, QuietCare, which is now a part of GE, and Health Fronts. While educating the market is still ongoing, Mitchell said that it was more of an uphill back then, requiring her to get out in the field, telling people that the technology exists, and getting health-care professionals to accept it. “I went from place to place,” she said, “including long-term and in-home care providers, many of whom saw us as competition.”

Mitchell said that her mission was to teach health-care professionals that home health-care technologies are supplemental to the health-care workers, and not a replacement for the human touch. “A baby monitor is not a replacement for a mother,” Mitchell said, noting, “Our products enable a better standard of care and a bigger picture of wellness.” For example, a computer algorithm can see patterns of behavior and vital signs that a family member or in-home care provider might miss. That said, the system is simply reporting information. “The smartest part of the system is the caregiver who’s making assessments based on that information.” She concludes.

GrandCare Systems’ Laura Mitchell said that her mission has been to teach health-care professionals that home health-care technologies are supplemental to the health-care workers, and not a replacement for the human touch.

What it Means to Integrators

So why should integrators consider home health care? According to Mitchell, with an aging boom under way in the USA “This is something that has to happen, and must happen to assist Americans coping with the aging boom.”

According to Mitchell, there is a lot of education that needs to be done. As far as people outside the industry are concerned, home health care is synonymous with PERS, the Personal Injury Service, and better known by the iconic commercial tagline, “I’ve fallen, and I can’t get up!” Mitchell said. “One of the biggest hurdles is explaining that this category is more than that. With crisis management, you push a button and something happens. But that’s a reactive technology. Other solutions, such as what GrandCare focuses on are proactive, preventative solutions.”

It’s Mitchell’s assertion that prospective clients should not wait until an emergency to get a home health-care system in place. Rather, that they should be looked at in the context of ongoing wellness; using the feedback and data from the system for preventative care. “Think of these systems as being in place as ‘no news is good news’ systems,” she explained.

Technology continues to progress, with recent innovations including medication management and GPS-enabled reporting, for tracking when a subject has gone beyond their normal parameters.

“Some of the medication technology can dispense medication at the right time and provide health and dose advice,” Mitchell explained.”

Although she points out that without a throat camera, there is no verification that the meds have been swallowed. Even then, technology is being developed with tablets that can alert the system that they’ve been dissolved. While that remains a future technology, monitors that track blood pressure, bodyweight, movement around the house, including frequency of bathroom breaks, and sleep patterns exist now, and these provide care givers with a more complete picture of a subject’s well-being.

Pedigo suggested that there are dual issues in play that make home health care ideal for integrators. The first is that there is a large potential client base, which translates to lucrative recurring revenue opportunities. The other is the nature of the technology itself.

“I don’t think it can be cookie cutter, which makes it ideal for integrators; we’re used to installing motions and dry contacts, and we’re already installing other systems,” Pedigo noted.

CEDIA’s Role

So what’s CEDIA doing to help raise awareness of home health care with integrators? “Well, we’re doing a couple of things,” Pedigo replied. “We’ve formed the Home Health Advisory Group, which comprises manufacturers that are advising us on what we should be doing for the industry, and helping CEDIA develop training materials.”

GrandCare Systems Laura Mitchell says that one of the biggest hurdles to selling home health-care category, is explaining that it’s more than just, “I’ve fallen, and I can’t get up!” technology synonymous with with PERS, the Personal Injury Service.

A big part of CEDIA’s outreach is clarifying what home health care really means. “We’re taking this nebulous concept and honing it so that our members can sell it,” Pedigo explained.

At the moment, the home health-care field is wide open, yet with risks and unknowns that integrators will need to sort out.

“I think that at the moment there are few specific certifications involved, but I can foresee that changing,” Mitchell said. However, she pointed out that if integrators get involved with offering any healthcare devices, like blood pressure monitors, they have to be HIPAA (Health Insurance Portability and Accountability Act) compliant.

“GrandCare has a HIPAA compliance officer, and we are teaching a course on this on September 7, 2011, before CEDIA EXPO begins,” Mitchell noted. This introductory course is an eight-hour session that covers everything integrators need to do to receive HIPAA certification. HIPAA compliance means that vendors are unable to sell to a dealer unless that dealer has achieved certification.

Mitchell also noted that integrators need to address the category with their commercial insurance provider, and be prepared to educate them. “From an insurance point of view there really are no rules yet,” she said. “The insurance companies still view it as a crisis system, like fire alarms, even though it isn’t that at all.”

Integrators may need to explain to their insurance carriers that they aren’t selling lifesaving devices; they are selling wellness devices.

And the business model itself may be more “industrial” than retail. Rather than being a quickbuck business, it requires cultivating connections in the health-care field and a potentially large list of decision makers who need to agree to the installation, including health care professionals and family members.

“Our dealers have an average of three meetings with the principal decision makers before a sale is made,” Mitchell said. “It’s not a quick cold call.”

As a result, she strongly recommends partnering with a care provider that specializes in aging, whether in a long-term care or a home-care capacity. Those partners understand how to have this conversation with prospective clients without sounding like a door-to-door salesman. “Dealers should stick to what they’re best at, which is the installation” Mitchell said. “A person who is used to dealing with the elderly has the patience and empathy that will help build your credibility.”

Lee Distad (www.leedistad.com) is an Edmonton, Alberta-based writer.


The ‘Aging-in-Place’ Opportunity featuring aging technologies like GrandCare Systems

The ‘Aging-in-Place’ Opportunity
By Dan Daley, February 1, 2011

Aging Technologies
Presto’s products convert electronic communications from family into printed multimedia letters for seniors.
Why Digital Home Health Care Technology May Be Good for Your Business
We’re getting older, and that’s good. That was the message from the dais at the Digital Home Health Panel that took place during CEDIA EXPO in Atlanta this past September. More specifically, referencing data that shows 70 million Americans reaching senior status by 2030, Ken Kerr, president and CEO at Home Controls, which distributes Grandcare, Presto, and ClearSound elderly care and connectivity devices, put it bluntly: “New needs in huge numbers in an aging population equals new opportunities.”

That was the point that a half dozen or so technology companies that are targeting the home health care industry wanted to get across. All market sectors start off small, and if home health care does develop into a major source of revenue for residential systems integrators, the approximately 50 systems specialists who comprised the panel’s audience might be looked back on as the beginnings of the small army that the product manufacturers and distributors believe will grow into in the coming two decades.

In contrast to the acrimonious health care insurance debate that took place a year earlier, proponents of home health care technology got down to the economic brass tacks early on. Kerr compared the cost of assisted living or nursing home stays–he cited the approximately $75,000 it costs to maintain one person annually in a nursing home environment–with the cost of outfitting a home with sensors that monitor, record, and transmit information about location, medications, and other key daily necessities and said it would be a fraction of the ongoing costs of living outside the home.

“That’s the value proposition to the customer,” Kerr explained. But the numbers are equally good for the integrators that will sell and install those technology products. “Digital home health products are not yet commoditized, so the margins are very, very good right now, like the home theater business when it started out,” Kerr pointed out.

What Integrators Will Need To Know
Aging-in-place as a systems proposition is most analogous to security integration; in addition to the sale and installation of technology products, there is also a recurring revenue stream derived from monitoring data recorded and transmitted by system sensors. These system/monitoring combinations, from companies like Grandcare and Halo Monitoring’s MyHalo fall-detection system, will be worth $20 billion in North America by 2020, according to Laurie Orlov, founder of the Aging in Place Technology watch blog. Grandcare’s system is an example of the active system/monitoring approach that will take the place of, “I’ve fallen and I can’t get up!” passive alert transmitters.

Motion sensors–wireless X10 and Z-wave modules work on the Grandcare system–placed around an elderly parent’s home will send to the caregiver’s laptop or PC information about the occupant’s movements, or lack thereof. That information is important, said Charles Hillman, CEO at Grandcare.
“If someone gets up to use that bathroom in the middle of the night, you expect them to be back in bed within a few minutes,” Hillman said. “If they’re not back in certain amount of time, an alert is sent to the person who monitors them.” The same type of information is also recorded and sent by active pillboxes that show the occupant what to take and when to take it, as well as indicate to the caregiver that the medication has been dispensed.
Programming is typically of the “if this, then that…” type: door sensors can be programmed so that if a particular door is opened between 2 a.m. and 6 a.m., an e-mail or text notification is sent to the caregiver. Blood pressure and weight information are also sent via Bluetooth to Grandcare’s main processor, which includes a display large enough to be read by aging eyes, and then on to the caregiver. However, they will have to learn what to watch for and which bits of information are significant. For instance, Hillman points out that a gain of eight pounds in three days could be an indication of impending congestive heart failure. Thus, user education will play an important role in the successful application of these systems.

The cost of these systems is within reach of many if not most families; a typical Grandcare system will cost between $3,000 and $8,000, plus a $49 charge per month for monitoring services. However, that cost may still be out of the reach of a substantial number of seniors and their families. That’s where Medicaid and Medicare, the federal health systems, come into play, or not… Home healthcare technology is still so novel that it hasn’t been approved by federal administrators. “[Medicare approval] is going to be a state-by-state situation,” Hillman told the CEDIA audience, noting that the federal programs are administered by the states.
Another pitfall that systems integrators will have to reckon with will be liability issues, including system performance and access to a customer’s medical records, which could potentially run afoul of the Health Insurance Portability & Accountability Act (HIPAA) regulation (see sidebar).

Health insurance coverage of aging-in-place technology may fall in line with whatever federal overseers decide on the subject, so that outcome will take some time to manifest itself. However, longterm care insurance may become a factor sooner. “Long-term care insurance companies have been collecting premiums for years now, and it’s going to come time soon for them to start paying out,” Hillman said. “Covering aging-in-place technology will result in lower overall payouts in the long run.”

And that was an underlying theme throughout the presentations: the fact that, as America’s population ages, the existing healthcare proposition will no longer be able to viably support it.

GC HomeBase
Motion sensors–wireless X10 and Z-wave modules work on the Grandcare system–placed around an elderly parent’s home will send to the caregiver’s laptop or PC information about the occupant’s movements, or lack thereof.

The Psychology of the Sale
While much of home health care’s technologies are based on systems similar to those currently used in home automation, there are significant differences in the culture of that technology. For instance, where home technologies are viewed as a mostly male domain but subject to the industry’s quaint but nonetheless very real “wife acceptance factor,” decisions made about agingin- place technologies will be heavily weighted toward female family members, because women tend to take on the caregiver role. The target demographic for these types of systems will be 45 to 65 years old, says Peter Radsliff, president and CEO of Presto, whose product converts electronic communications from family into printed multimedia letters for seniors.

“The family caregiver is usually the oldest daughter, and she’s the quarterback when it comes to choosing healthcare systems,” he said. “But it’s always going to be a multigenerational sale.”
The psychology of the systems sale is similarly affected; the buyer isn’t generally the person being monitored but the person or persons doing the monitoring. Technology can be used not only to assure a senior’s safety but also to assuage the guilt that family members who now live in other parts of the country can feel about not being nearby anymore.

“The family may feel guilty about lessening the connection between themselves and the senior members of the family,” Kerr said. “Technology can help bridge that gap.”
That brings up an interesting element of aging-in-place as an integration sector. Several products integrate social networking features. Grandcare’s GC Trillium processor lets family members and seniors send and receive pictures, voicemails, letters, videos, and music, as well as brain fitness games in what Grandcare’s director of business relations Laura Mitchell says is a “nonintimidating technology solution.”

Jack York, president of It’s Never 2 Late, a Colorado-based company that creates customized computer systems with therapeutic and entertainment content for use in nursing homes, assisted-living communities and adult-day programs, says companies that have tried to develop the aging-in-place market and failed had focused too much on the technology.
“We’ve seen many of them come and go because they think it’s the technology that will sell the idea,” the former Silicon Valley entrepreneur said as part of a presentation titled, “Connecting The Greatest Generation.” “The reality is, you need to connect on the personal level. You need engagement software that can connect people as well as offer person-centered therapy to help stabilize cognitive decline.”

Hillman agreed, stating, “Socialization is the Trojan Horse; it gets the senior past the technology aversion. It’s the connectivity that will sell to the senior.”

All of the companies that made up the home health care pavilion at the CEDIA Show are small, independent firms. Some are also obvious candidates to become the entry point into home health care technology for larger companies by way of mergers and acquisitions. Larger entities, however, are also beginning to target this emerging sector. In August, technology giants Intel and GE announced a 50/50 joint venture to develop and market products, services, and technologies that promote healthy, independent living at home and in assisted living communities, though these are commercial propositions aimed at connecting seniors at home with institutional caregivers. There’s also interest stirring in technological academic circles: at CEDIA, Georgia Tech showed a prototype of a bathroom mirror that can monitor and analyze skin tone using IR scanning, which can alert users to potential skin cancers and other diseases.

Ken Kerr
Ken Kerr, president and CEO at Home Controls, which distributes Grandcare, Presto, and ClearSound elderly care and connectivity devices, puts it bluntly: “New needs in huge numbers in an aging population equals new opportunities.”

The residential systems industry is beginning to take notice. In September, the CEA added an awards category for Home Health Products to its Mark of Excellence Awards. The upper tier of residential systems manufacturers is aware of the potential for an aging-in-place market, and there’s been some proactivity in that regard, such as ELAN’s contribution of automation components for the Eskaton National Demonstration Home in Sacramento, California. But they likely will not be market makers.

“The bigger you are, the longer you wait for new markets to emerge,” Joe Lautner, manager of business development and product management at ELAN, said candidly. But Lautner says the agingin- place market is one that is high on his agenda to monitor, which he’s doing by talking with insurance companies and the CEA. “We’re trying to test the market, to get stuff in front of seniors and see what we can learn from it and what dealers can make money on,” he said. “We have to build a business case first.”

Thus, the group of independent companies that gathered at CEDIA is the point of the residential home-care technology spear, collectively focused on using technology to keep seniors safely in their homes longer and connected to family. They have a reason to be bullish on that opportunity. As Peter Radsliff of Presto put it, “This is market that’s not going to start contracting anytime soon.”

What You Need to Know About Privacy Rules
When integrating an aging in place system, ES Cs will have to consider liability issues, including system performance and access to a customer’s medical records, which could potentially run afoul of the Health Insurance Portability & Accountability Act (HIPAA ) regulation. This rule sets national standards for the security of electronic protected health information, and the confidentiality provisions of the Patient Safety Rule protect identifiable information being used to analyze patient safety events and improve patient safety. Grandcare CEO Charles Hillman suggests that integrators anticipate these issues and have waivers for clients to sign ready as part of project documentation. “I’d also suggest involving the family as much as possible in this,” he added, noting that they can open doors to government and healthcare agencies, thus cutting through some of the bureaucracy.

A Few Questions To Ask Yourself
Peter Radsliff

Peter Radsliff, CEO of senior connectivity device maker Presto and nominal head of the home healthcare technology trade group AGETEK, says these are the issues that integrators need to address as they consider the agingin- place market.
■ Do you need new skills, and if so, how to acquire them? Will it be via new training or by adding new personnel?
■ Will you need a new brand or division to enter the market? “You may want to differentiate your home theater or automation business from this,” he said. “A separate brand may make you more credible in the senior market.” It may also help you leverage an existing client base.
■ Who will do the selling? “In many cases it might be better to bring in someone who has healthcare sales experience,” he suggested.
■ Will you sell into residential or commercial markets, or both? Unlike other systems sectors, home healthcare technology’s lines are blurred as more seniors move into assisted living homes and independent living facilities, where homes are part of larger communities.

CEDIA Sees Huge Opportunity in Home Health Care
Noting that many ES Cs are of an age when family members begin to require extra health attention and referencing a family member of his own in that situation, Dave Pedigo, senior director of technology for CEDIA , says that home health care and aging-in-place technology represents “a huge opportunity for systems integrators.”

Pedigo says the first-ever health care technology pavilion indicates CEDIA ’s belief in the potential for the sector, and he confirmed that the organization is working in tandem with home health care manufacturers’ trade group AGETE K to develop the market. However, he cautioned, significant legislative and regulatory issues remain to be addressed, such as insurance and Medicare coverage of technology products and installation, and complex liability issues for ES Cs. But, Pedigo concluded, “I think we’ll look back a few years from now at this year’s CEDIA show and realize this was the beginning of a potentially very big new market, one in which ES Cs can do well with by doing good.”

Dan Daley is a freelance writer in Nashville, Tennessee.