Thursday, November 1, 2012

3 key points learned in a month of GeriTech

It's now been a month since I started documenting my search for technology to improve geriatric care on GeriTech. During these past several weeks, I've watched some keynotes from recent big health tech conferences, started following clinicians and health techies on Twitter, met some like-minded clinicians in person and online, connected with some entrepreneurs in the health tech space, and reviewed some of the relevant peer-reviewed literature.

Here's are three key things I've learned so far:

1. Healthcare tech is a hoppin' space!

Lots of energy, lots of people, and a fair amount of money and entrepreneurial energy seem to be in healthcare tech. Recent big conferences included Health 2.0, the New York eHealth Digital Health Conference, the Wired Health Conference, the Strata Rx conference (that one is data-focused), and the Wireless Health Conference. They all seem to be combining technology, business, and a hefty dose of consumer-driver healthcare, with a variable amount of policy. Insurance companies are often partners, and sometimes their CEOs are featured as keynotes, which makes sense I suppose since big payers are big players in this arena. Some foundation support is present, especially RWJF.

On another front, the Digital Health group on LinkedIn has 13,348 members (now including yours truly), with multiple ongoing discussions and polls. A little over 1,100 appear to be physicians, although it's hard to tell how many of them are practicing docs or academics, as opposed to physicians in industry and business.

2. There is interest in the aging space, but it's probably not the focus of most healthcare tech innovation.

Boomers are a "large market", and I've seen AARP involved in several events (including their own health tech innovation event, which I commented on here). I've also come across countless companies and products for aging-in-place, and connected with Aging 2.0, a group dedicated to fostering innovation for the 50+ market.

That being said, my impression so far is that most of the innovative energy is directed towards products for a younger, medically less complex population, and here's why:
  • Private insurers are interested in saving money, and possibly also in looking hip. Boomers will be increasingly covered by Medicare, which is much less nimble when it comes to adopting new tech, decidedly less interested in seeming hip, and perennially bedeviled when it comes to saving money.
  • Healthcare tech innovators are understandably thinking of the business case when they design products. In general, seems a business case is easier to make when targeting a younger population who presumably will pay out-of-pocket, or use HSA money, or have their employers pay, or perhaps have their hip insurance companies pay.
  • For obvious reasons, it is WAY easier to design a product for younger less medically complex people. My own patients not only are medically complex, but also ideally would be offered products that accomodate vision problems, less flexible fingers, less flexible minds, the involvement of caregivers, etc. All this means that healthcare tech innovations for the elderly are a much tougher design proposition.

3. There seems to be an information and culture gap between academic experts in geriatrics, and the world of healthcare tech innovation.

Last May when I went to the American Geriatrics Society meeting, there was a talk on new innovations in technology. It was given by a non-clinician industry insider. Nothing wrong with this per se, but I do think this illustrates our relative uninvolvement in this big booming world of healthcare tech. Most likely this is because academics live on the grants-and-publication schedule, which every year is falling further behind the pace of healthcare change in the real world.

Meanwhile, here are a few telling statements I've heard since starting GeriTech:
"I don't know what [integrated patient portals] are. Are they portals that give patients access to the EHR as in Open Notes?" -- Academic physician & Ivy league professor, currently involved in a project of improving health care for seniors
" I am a bit of a professional techno skeptic but I am sure that eventually it will become really and truely helpful." -- A program director at a prominent foundation dedicated to improving the health of older Americans.
"More care, less technology." -- Goal #3 of the Hasting Center's Over 65 project.

Onwards and thank yous

I have a fair streak of techno-skepticism myself, but as I continue to believe that the right use of technology is critical to effectively and sustainably meeting the healthcare needs of America's elders, I'll be continuing to explore this space for the foreseeable future.

Clinicians, you've generally been pretty quiet so far, but I hope eventually to persuade some of you to contribute. Please consider:
  • explaining a clinical problem that might benefit from a tech solution
  • sharing a useful tech solution that you've found
  • commenting on anything tech and geriatrics that you come across
  • having me interview you (then you don't have to write anything yourself)

Last but not least, a shout-out to some of the people who've helped me get going this past month:


Wen Dombrowski, MD and a geriatrician, social media maven, and healthcare tech connector who has been key to introducing me to the healthcare tech community.

Eric Widera and Alex Smith, MDs and founders of Geripal.org, who encouraged me to take these next steps into blogging and Twitter.

Christopher Langston of the John A. Hartford Foundation, who posted the very first comment on GeriTech.org, and encouraged me to keep going.

Julie Menack, geriatric care manager and aging-in-place tech maven, for giving me ideas on what to learn more about.

Mark Phillips, product manager at GE Healthcare IT, who noticed this blog early on and appreciates the perspective of working clinicians.

Jim Sabin, MD and an organizer of the Over 65 project, for his interest in this project and in learning from each other.

There are of course more, but I do have to get back to my day job now. If you're still reading, thanks for your interest in Geritech.org, and I hope to hear from you soon!

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