Health 2.0 in 2015: Big steps forward

This week I attended Health 2.0’s Annual Fall Conference for the third year in a row.

I came away more impressed than I’ve been in previous years. Here’s why.

The Unmentionables Focuses on Aging, Caregiving, and Hospice

The Unmentionables session hosted by Alex Drane is always terrific, but this year was especially so, since it focused mainly on aging and caregiving.

If the video is ever made available I’ll post it here. In the meantime, you’ll have to make do with my Storify collection.

Particularly notable: [Read more…]

Aging, Health & Innovation as Geritech turns 3

Exciting times are afoot these days.  The end of this month will mark three years of the Geritech blog, so seems like a good time to step back and consider how things are progressing with aging, health, and innovation.

What is kind of neat is that the blog’s anniversary coincides with two major health and innovation conferences: Stanford’s Medicine X, and Health 2.0 (the flagship Annual Fall Silicon Valley conference).

The medical education part of Medicine X is underway as I write, with the main conference events scheduled for Sept 25-27. I’m sad to not be attending Medicine X this year  –have to be in New York for a family event — but I plan to attend Health 2.0 in early October. (I will also be attending — and speaking! — at the Louisville Innovation Summit in October, which will focus on aging.)

Both Medicine X and Health 2.0, which I attended in 2013 and 2014, are hugely influential, albeit in different ways. So it’s very interesting to review their programs (see here and here), and consider what they are presenting in terms of aging, the care of people with multiple chronic illnesses, and helping older people with functional limitations.

I’m happy to say that both conferences are featuring more programming specific to aging this year!

But first, my own gut impressions when thinking about what’s changed — and what hasn’t changed — over the past three years.

Then I’ll briefly share which upcoming sessions at Medicine X I’ll be especially sorry to miss. I can’t even watch the Medicine X livestream as I’ll be on planes or with family for the next three days. But you could watch! (And I’ll cover Health 2.0 in a future post.)

What’s changed in aging and health over three years

Honestly, at a high level and considering what counts the most — the experience of average older adults and their families — I would say not much, although good things do seem to be brewing. For instance:

The average healthcare experience of older adults and caregivers hasn’t changed much. This is my impression, based on what I hear patients and families complaining about and based on the stories I read in the mainstream press.

Now, many facilities and providers are innovating and trying to improve healthcare, and technlogy is playing a factor in that.

But the improvements seem to either be quite localized (I’m thinking of Mayo’s August 2013 study using Fitbits to improve recovery after surgery; this hasn’t become the post-op norm as far as I know) or of middling impact when it comes to people’s healthcare experience (e.g. more widespread patient portals, Blue Button downloads).

This isn’t to say that all the work on innovation and digital health has been useless, of course. It’s more to say that I don’t see major change. Yet. (Do you??)

Which means that either

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Case Study Part IV: What Joan Really Needs From Her Healthcare

senior health and medications

Today, I’m going to share the fourth and final part of my case study about Joan, a 79 year old woman struggling to manage her many chronic conditions.

I created this case study for my upcoming ebook, because over the years I’ve noticed that different people can have very different perspectives on a single person’s health challenges.

So in the book, I cover the perspective of Joan herself, the perspective of Joan’s worried family caregiver, and then the viewpoint of Joan’s primary care provider, Dr. Miller.

But of course, there’s one more perspective that’s essential to consider, if you are developing tools to help people with their health. That’s the external “expert” analysis and perspective, which I share below.

When it comes to healthcare — or anything important — we can’t assume that front-line users know just what is best, and what’s most likely to help them achieve their goals. That’s why truly useful tools must facilitate “best care,” or at least better care. Here’s what that could look like for Joan.

What Joan Really Needs From Her Healthcare

Dr. Miller’s not a bad doctor. But he’s busy, he’s under pressure to meet quality measures, and he hasn’t been trained to modify healthcare for older adults.

Like many doctors, he’s pretty focused on Joan’s documented health diagnoses. But what Joan really needs is for someone to help her with her health problems. I’d list these as follows: [Read more…]

Case Study Part III: The PCP’s View on Joan’s Health

Doctor at workPeople often wonder why doctors aren’t more interested in apps for their patients, or in trying something new to help patients. After all, we expect doctors to care about their patients’ health.

Plus, we know that doctors are now being held more accountable for outcomes, because we’re moving towards “pay-for-value.”

I do believe that most doctors care about their patient’s health. But it’s not easy being a PCP, and there are lots of reasons that the average PCP has difficulty optimizing the health of a medically complex senior.

Here is part III of the case study I created for my upcoming ebook: the point of view of Joan’s PCP, Dr. Miller. As you read, consider

  • What’s the doctor focusing on when it comes to Joan’s health? How does that align with what Joan herself is most concerned about, and what her daughter is concerned about?
  • What kinds of tools or services might help the PCP with what he’s trying to do for Joan’s health?

And for extra credit: what’s he overlooking that someone applying geriatrics — the art & science of modifying healthcare so it’s a better fit for older adults — probably would address? (Hint: it’s related to Joan’s vitals.)

Joan’s Health Story (According to Her Doctor)

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Case Study Part II: Joan’s Daughter’s View on Joan’s Health

In my upcoming ebook about better digital health tools for aging adults, I share a case study — an older woman named Joan — and I write about her struggle to manage her health from three perspectives: Joan herself, her concerned daughter, and her busy primary care provider.

Joan has more chronic conditions than most seniors — eight diagnoses, plus she’s had falls recently — but they are a fairly common combination in people who smoked and were overweight in middle age.

In this post, I share part II of the case study: the perspective of Joan’s daughter Susie, who is understandably worried about her mother’s health and wellbeing. (See Part I of the case study for Joan’s perspective, plus a list of her conditions and medications.)

As you read this, consider the following:

  • Do you know many people worried about the health of their older parents?
  • What kinds of technologies, tools, and services have you come across that might help Susie and Joan?

Joan’s Health Story (According to Her Family Caregiver)

Worried family caregiverSusie is worried about her mother almost all the time. [Read more…]

Case Study: The Story of Joan & Her Health

Did you know: in 2010, 46% of fee-for-service Medicare spending went to those 14% of beneficiaries who had six or more chronic conditions. (See Fig 3.2 of the 2012 Medicare Chronic Conditions Chartbook.)

You might think those are unusually sick seniors. But when I practiced primary care internal medicine, I saw people with 6+ conditions all the time. As you can imagine, they tend to see doctors a lot. (That data is in Figure 2.4 of the chartbook.)

It’s actually not that hard to end up with several chronic conditions by age 65: a history of smoking and being overweight in middle age will easily bring on 6+ chronic conditions later in life. And many of those seniors don’t look that sick or disabled.

But they struggle with their symptoms, and they especially can struggle with an overwhelming amount of “self-healthcare” to manage.

If there’s anyone who would benefit from digital health technology, it’s them. They need help with their health. Their primary care providers need help helping them. Their adult children are worrying. Oh and, we want to help them in order to minimize ED visits and hospitalizations, which are distressing for seniors and expensive for all of us.

Unfortunately, over the past three years I’ve found very little that seems usable and useful for these seniors with multiple chronic conditions.

So as part of my upcoming ebook about better digital health for seniors, I’ve written a little story. It illustrates the situation of Joan, an older woman struggling with multiple conditions. I’ve even included her medication list.

As you read this, consider the following:

  • If you’ve developed or are using a digital health app or service: do you think it will work for Joan?
  • More importantly: what do you think would be most beneficial to Joan right now, to help her with her health?

Joan’s Health Story (According to Joan)

Joan, aged 79, is more than a little tired of dealing with her health.

She didn’t always have health problems. She had a career and raised her kids and earned a good pension that supports her now that she’s retired. She lost her husband to a heart attack years ago, but she’d be doing fine on her own if she didn’t have to keep going to the doctor all the time.Maybe she hadn’t taken the best care of herself, but who knew the difference? Everyone smoked. And she quit five years ago anyway. She’s maybe a little overweight, all right, but you try having three kids and see if you stay slim.

She puts on a brave face but she feels a crippling guilt sometimes for not looking after her health. Maybe it’s her fault that she has hypertension now, and high cholesterol. She knows her diabetes and the osteoarthritis in her knees can probably be traced back to her weight, and her doctor’s told her that smoking caused the chronic obstructive pulmonary disease, and maybe the atrial fibrillation too.

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How the White House & Others are “Gauging Aging”

If you were to host a conference on aging, what would you put on the agenda?

And how would you talk about it?

I found myself mulling this over as I watched the first part of the White House Conference on Aging (WHCOA), which took place on July 13th.

What’s your frame on aging? Start with the Gauging Aging report

It’s especially interesting to consider the WHCOA in light of the recently published “Gauging Aging” report by the Frameworks Institute.

“Gauging Aging,” simply put, is a report about the differences in how aging experts and the public think about aging. It’s based on an in-depth analysis of how experts talk about aging and supporting an aging society, compared to how the public views the issues and the potential solutions.

By understanding the differences, experts can then get better as using communications that brings us to a shared understanding of the problems to be addressed,  in order to effect changes that are meaningful and beneficial. After all, narratives and ideas are important in framing how people perceive problems, and their options for addressing them.

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Fascinating Facts on Family Caregivers: Highlights from Caregiving in the US 2015

If you follow aging and caregiving, then you’ve probably already heard about the major new caregiving report that was released last month: “Caregiving in the US 2015,”a joint effort from the National Alliance for Caregiving and AARP. The study was funded by AARP, Archstone Foundation, Eli Lilly, Home Instead Senior Care, MetLife Foundation, Pfizer, UnitedHealthcare, and the Family Support Research and Training Center in conjunction with the University of Illinois at Chicago.

Strangely, this report seems to have been hardly covered by the major newspapers. I say this is strange because the findings are incredibly important and should be part of the national discourse, instead of only being covered by aging and caregiving wonks.

After all, everyone knows someone who’s struggling to help an aging spouse or parent. This nationally representative survey found that 18% of respondents were caregivers. Of those, most (79%) were helping an older person, as you can from this excerpt of the executive summary:


Caregiver prevalence & basic, from page 9 of the executive summary

The report also later notes that nearly half of caregivers provide care to someone age 75 years or older.

For this survey, caregiving for an adult was defined as providing “unpaid care to a relative or friend 18 years or older to help them take care of themselves.” (For child care recipients, the survey sought to identify people providing care due to “medical, behavioral, or other condition or disability.”)


Highlights from the executive summary

If you are involved in aging, caregiving, or even healthcare, I would strongly encourage you to review the report’s executive summary. It is chock full of fascinating data, which I’ll summarize below.You should also consider signing up for the related webinar, which will be on July 15th from 2-3p EST. Sign up here.

Older caregivers have a high care burden. The survey found that nearly 1 in 10 caregivers is aged 75 or older. They noted that such older caregivers — most of whom care for a spouse — tend to put in a lot of hours (34/wk on average), often are not enlisting paid help, and often have been providing care already for 5.6 years. This group reported being very involved in communicating with health professionals, and said they want more information about making end-of-life decisions.

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GeriTech’s Take on AARP’s 4th Health Innovation @50+ LivePitch

On Thursday May 14, 2015, AARP hosted its fourth Health Innovation@50+ LivePitch event, an event that “features the most exciting start-up companies in the “50 and over” health technology sector.”

In this post, I’ll list brief descriptions of the finalists, comment on how promising they seem to me — in terms of improving the healthcare of older adults — and tell you which products I’m most interested in. To see what I’ve thought of past LivePitch finalists, here’s my coverage of the first, second, and third cohorts. (Now what would be interesting is to see what’s happened to all those companies since, esp the winners. No time now to do it, but let me know in the comments if you have an update re a past LivePitch finalist.)

As usual, the start-ups were judged by venture capitalists and by a consumer audience. No judging or input from anyone whose primary work and expertise is to improve the health of people aged 50+.

See the FAQs for the eligibility criteria for this year. More interesting to me are the judging criteria and AARP’s categories (also listed in FAQs):

“The Judges will focus on these five critical elements:

  • Functionality – Is the company’s product easy to use, and does it get the job done?
  • Potential – What is the company’s business model and likely profitability, size of the market, likelihood of adoption, and growth potential?
  • Team / People – What experience does the team have, and can they make the product or service a success?
  • Creativity/Differentiation – Why would someone use this product and/or service over alternatives?
  • Scalability – Is this a small business not capable of scaling or is it a large business that has a lot of growth potential?

The AARP Consumer voting will focus on these four critical elements:

  • Need – Why should consumers want this product? Does the product/service address a significant unmet or under-met need? Is it unique?
  • Marketing – How easy is it to get the product?
  • Usage – Why is the product easy to use?
  • Value – Why does the value and cost of the product makes it a “must have”? What is the value proposition? Would someone use it and/or refer it to family and friends?”

AARP’s Categories for Health Innovation @50+:

  • Medication Management
  • Aging with Vitality, e.g. increase daytime energy, maintain muscle strength, manage arthritis, improve or aid in memory/cognition, brain fitness improve/aid hearing, improve/aid vision
  • Vital Sign Monitoring
  • Care Navigation
  • Emergency Detection & Response
  • Physical Fitness
  • Social Engagement
  • Diet & Nutrition
  • Behavioral & Emotional Health
  • Other
Compared to last year’s categories, AARP seems to have dropped the category of “aging in place.” They still don’t have a category about managing one’s chronic health problems, which I would argue is extremely important to maintaining the health and wellbeing of people aged 50+.

AARP’s list of this event’s ten national finalists is here. They also had an additional group of five Florida finalists, which I won’t have time to cover.

GeriTech’s quick take on the AARP LivePitch finalists

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Notes from the Institute on Aging’s Tech Conference


Last week I attended another one day aging & tech conference. But it was very different in feel compared to most events I go to, because this one was not hosted by an organization with an entrepreneurial background. Instead, the event was hosted by an aging services non-profit: the Institute on Aging (IOA). (Conference agenda is here.)

For those who aren’t familiar with the IOA,: it’s a terrific organization that has spearheaded a number of innovations related to better care of older adults over the past 30 years, including launching the first fellowships in geriatrics and creating the Friendship Line, the nation’s only crisis hotline to address isolation and suicide risk in seniors. (For more on the history of the IOA, see here.) The IOA has also often collaborated with the City and County of San Francisco on aging services.

This conference provided continuing education credits for nurses, social workers, therapists, attorneys, and residential facility providers. So the audience mainly seemed to be those individuals, rather than entrepreneurs and innovators.

This struck me as a bit of a pity, because the content of the talks seemed more focused on what aging people need — rather than how to make your entrepreneurial venture succeed — and I think the more entrepreneurs can hear about this, the better.

In truth, my overall impression was that this conference was “by the aging community, for the aging community” whereas most tech and innovation conferences are “by the innovation business community, for the innovation business community.”

Is there a way to merge these two groups more?? I don’t know the answer to that.

At the end of this post, I’ve embedded the Storify with all my tweets from the day, which hopefully will share a sense of the event, for those who weren’t able to attend.

A few particular talks that I really enjoyed

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