GeriTech’s Take on AARP’s 5th Health Innovation @50+ LivePitch

On Wednesday April 27, 2016, AARP hosted its fifth Health Innovation@50+ LivePitch event, an event that allows 10 chosen start-ups to pitch to a consumer audience and a panel of venture capitalists.

This year the event’s description seemed a bit different than in prior years, with a new emphasis on caregiving: “Innovation@50+ is a one day pitch competition for emerging startups in the healthy living space with a focus on caregiving.”

As in prior years, there did not seem to be much judging or input from anyone whose primary work and expertise is to improve the health of people aged 50+, or to improve the lives of family caregivers for that matter.

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 the lives of family caregivers— 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, third, and fourth cohorts.

GeriTech’s quick take on the AARP LivePitch finalists

Here are the AARP descriptions of the companies/products presented at the LivePitch event, along with my initial reactions. I took a quick look at everyone’s websites, and for certain web-based products tried them out for a little bit, but have not tried any of these products in depth.

Cake: “Cake is the easiest way to do end-of-life planning. We break down a daunting and difficult task into simple, bite-size chunks, and provide experts who can answer your questions. Your online CAKE profile is a living document of your end-of-life preferences that is easy to access, update, and share.”

GeriTech’s comments:

  • Seems to be a website to help people articulate and store end-of-life preferences and documents.
  • Potential users should wonder how it’s different/better than some other services in this space, such as MyDirectives, Everplans, and Vimty
  • The free part of the website uses “Cake Cards” to ask the user yes/no questions re end-of-life preferences, and then generates a profile. I tried this free part and went through 30 cards. There was a question about whether I’d want CPR if I was unlikely to benefit, but also questions about what people should wear at my funeral.
  • Also offers phone/email consultations with a “concierge”: individual 40-minute calls are $120 or for $15/month you can subscribe and get two calls/yr plus unlimited email assistance and extra calls at a discounted price of $70.
  • There seems to be no information on the site about who these expert concierges are and how qualified they are to advise people on their advance planning. That’s a major flaw in my view.
  • Bottom line: interesting concept but I would not recommend to patients and caregivers at this time.

Medivizor: “Medivizor provides people with serious or chronic medical conditions, or their medical teams, all the cutting edge information they need know – personalized just for them.”

GeriTech’s comments:

  • I tried signing up as a caregiver of an older person with dementia, just to see what it’s like. The initial registration asks about the presence of a number of common conditions but NOT dementia or Alzheimers. I indicated diabetes, BPH, incontinence, UTIs, and said my relative is 89. For each condition, I was invited to add some specific details (e.g. past surgery for BPH, whether there’d been more than 3 UTIs in past year, that sort of thing.)
  • The site created a looonnnng list of articles and resources for me. I could sort them by condition, or by categories such as “clinical trial, research, treatment, guidelines, community, lifestyle, expertise”
  • I selected articles for diabetes. Nothing seemed specific to diabetes in the old or frail. That is kind of a deal-breaker for me.
  • I’m sure this site is helpful to a certain type of user, but right now it doesn’t seem well suited to supporting the information needs of older adults with multiple chronic conditions. (Or their caregivers.)
  • Seems to be free to use. This is nice for users but raises the question of “what IS the business model?” In the long run a website or service needs to have a way to finance itself.
  • I would say that any website trying to serve Medicare beneficiaries or the caregivers of older relatives MUST prioritize health information grounded in the geriatrics knowledge base. Until Medivizor does that better, I probably won’t recommend it to families.

Penrose Senior Care Auditors“Penrose provides the first and only app-enabled senior care auditing service, called Penrose Check-Ins, to ensure seniors are okay and provide families peace-of-mind. During the Penrose Care-Check, an auditor visits the senior and using the app, assesses 150-items related to their well-being and reports back to the family. Other auditing services include the Penrose Pre-Check, Quick-Check, Inventory-Check, and Safety-Check.”

GeriTech’s comments:

  • This is very interesting. As best I can tell, the founder of this company created a new “senior care auditing” industry in early 2014, because she was concerned about the conditions in her father’s residential facility.
  • The company now offers auditing services to the public for $75-$99. They also seem to have a good line of work going, certifying others to do senior care audits. They offer audits in all 50 states.
  • As with any new industry, you need to wonder a little who defines certification and what it means. This has a lot of overlap with the work of geriatric care managers (who now officially call themselves “aging life care professionals”) and I am curious as to how a certified senior care auditor’s abilities compare to the evaluation of a geriatric care manager.
  • Standardizing the assessment process (for a facility and an older person’s wellbeing there) IS very valuable.
  • I don’t see any peer-reviewed research on senior care auditing. It would be interesting for experts to evaluate and assess the process this company and others are using, and compare it to other ways of assessing quality in facilities and the wellbeing of older adults.
  • In general, this seems like a valuable service to offer, provided the quality is actually reasonably good. Maybe I can eventually get an auditor to visit one of my patients in a facility, and then I’ll be better able to gauge what they are doing. Sounds promising overall.

PicnicHealth“PicnicHealth helps patients and their families manage their medical records. We collect records on a patient’s behalf, maintain a single up-to-date medical chart, and coordinate between providers.”

GeriTech’s comments:

  • This is personal health record (PHR) service. They promise an intuitive web interface and obtain a patient’s medical records with a combination of retrieving data from patient portals and requesting additional information from doctors’ offices.
  • There is no free version; it costs $99 to set up an account and request one’s record. One can pay an ongoing monthly subscription for additional requests per year, mobile access to the documents, etc.
  • I do believe that a good PHR service would be worth paying for, but without using it for a few older patients, it’s impossible to tell whether this one has good enough usability and functionality.
  • The other PHR services I’ve tried have been disappointing, and not liked by families. This reinforces the importance of testing services under real-world circumstances.

Savor Health“For people with cancer whose nutritional issues cause poor clinical and quality of life outcomes, Savor Health is a technology-enabled provider of cost effective, personalized nutrition solutions. Through its smart, personalized recommendation engine and a network of distribution partners, Savor empowers cancer patients and their caregivers to take control of their nutritional needs.”

GeriTech’s comments:

  • This site offers access to registered dieticians with “oncology specialization from the Academy of Nutrition and Dietetics.” A custom menu plan is $200; 15 minutes of nutritional coaching is $40. They also deliver fresh meals to the home.
  • I don’t see anything about insurance covering this service, or reimbursing it. It would be interesting to know more about how this service complements dietician consults usually covered by Medicare. (I know Medicare provides some coverage if the person has kidney disease or diabetes; not sure if it’s covered for cancer.)
  • A quick look at the literature finds that there is research on nutritional interventions and cancer outcomes. Families considering the service should probably start by asking their oncologist for advice on accessing RD services.
  • This will presumably be a useful service for some, but it would be nice if there were an option to request insurance reimbursement.

SeniorHabitat“SeniorHabitat is the first centralized, tour booking, and informational website that simplifies care transitions while decreasing time, costs, and hospital readmission rates. SeniorHabitat facilitates healthcare decisions by helping seniors, caregivers and hospitals navigate the overwhelming process of senior care facility selection to improve care transitions.”

GeriTech’s comments:

  • This website seems to have features for families and for facilities. It’s not clear to me that they cover facilities outside NY; I wasn’t able to search for anything in the Bay Area.
  • For families, there is a selection tool to help find suitable facilities and a tour booking feature. For those looking at facilities due to impending hospital discharge, there is some kind of notification feature to inform the hospital discharge planner of their choice.
  • For facilities, the service offers data analytics, to help facilities anticipate demand.
  • Unclear how this compares to something like OpenPlacement.
  • Unclear how they make money and who pays for what.

SensaRx“SensaRx is an NYC-based startup, emanating from the Founder’s family struggles to care for his grandfather with Alzheimer’s disease. The company launched the SafeWander Button Sensor in November 2015, and is focused on patient safety and caregivers’ wellbeing in both assisted living facilities and the home.”

GeriTech’s comments:

  • The SafeWander button appears to be a body position sensor that an older person wears while in bed. When they sit up or get up, an alert is sent to the caregiver’s mobile device. The package (which includes a “Gateway” device that needs to be plugged in near the bed) costs $249.
  • The story of the founder can be read here. His grandfather used to get out of bed at night and fall; this lightweight sensor technology was developed as a way for the family to intervene when a vulnerable older person gets up.
  • As far as I can tell, this device doesn’t have GPS or the capability to track someone who wanders out of the house, which is what I usually think of when I’m told something will help with “wandering.”
  • Some caregivers certainly have a need to know when a person is getting up. However there are other solutions available, and family caregivers describe a number of creative hacks here. Unclear how this compares.

SingFit“SingFit combines a growing body of scientific research on the health benefits of prescribed singing with a proprietary music platform in order to mass distribute the benefits of music as medicine. Focused on dementia care, our debut product SingFit PRIME is the winner of the USC Keck School of Medicine Body Computing Prize.”

GeriTech’s comments:

  • This is a service that enables facilities and others to provide music therapy to dementia residents. I like that this has been developed by trained music therapists.
  • There is also a SingFit iOS app for consumers; free for 12 songs and $5/month for access to a larger library. No customer reviews since April of 2015 however.
  • I like the idea of programs and services that use technology to scale up and improve access to a known useful therapy. However, I would like to see the program independently evaluated by other experts, and peer-reviewed research would be nice too. In this interview the founder of SingFit says that “In a study with a major long term care provider we found 40% elevation in mood for residents who take part in SingFit sessions from pre to post intervention.” This sounds terrific but more on this should be presented somewhere. (Nothing currently in Google scholar.)
  • Overall this seems promising. We certainly need non-pharmacological ways to improve the quality of life and wellbeing of people with dementia, so very useful if this product can reliably provide this.

UnaliWear“Kanega Watch allows discreet support for falls, medication reminders, and a guard against wandering in a classically-styled watch with an easy-to-use speech interface rather than buttons. Works wherever you are, 24×7 – and doesn’t require a smartphone (because it’s built in). Artificial intelligence learns the wearer’s lifestyle to provide predictive, pre-emptive support.”

GeriTech’s comments:

  • This company was founded by a woman who wanted a more attractive and effective wearable for her mother to be able to get help if its ever needed.
  • This device is supposedly being beta-tested and per the company will be available to consumers this summer.
  • It’s supposed to be able to do a LOT of things: call for help if the person seems to fall or is immobile for a long time, remind one to take medications, provide an emergency dispatcher if you request help by voice (or presumably it thinks you are in trouble), and help guide you home if you request it to do so. Watch the video on their website to see an older woman using it for directions, medication reminder, and to call for help.
  • Unclear to me whether it has GPS and whether it can help find a fallen person outside the home.
  • The device talks to the user. I wonder if people with cognitive impairment will find this confusing. Many older adults also have hearing impairments.
  • It’s nice that it doesn’t require a smartphone connection. How often does the battery need to be charged? That too is unclear.
  • There is a certainly a need for more attractive and usable personal emergency response wearables. We’ll have to see what people think once this one is actually available.

Well Beyond Care: “Well Beyond Care is the only company that teaches families and individuals how to find and manage affordable non-medical in-home care, while solving the chronic problems of caregiver truancy and turnover, and at the same time offering a pathway to transitional care to help HHAs accomplish their Clinical Outcomes and Customer Service goals.”

GeriTech’s comments:

  • This seems to be a platform for finding and hiring paid care aides for the home. Users are also assigned to a “Nurse Care-Pair Manager” who helps coordinate care somewhat. Per the FAQ, the nurse care-pair manager can do things like “Connect you with Healthcare Professionals or your own Healthcare Team”. The platform charges $3/hr on top of the caregiver’s hourly rate, to cover maintaining the platform and the nurse care-pair service.
  • There also seems to be an option to hire an RN or even a geriatric care manager for additional help.
  • It would be interesting to find out just what kinds of help the nurse care-pair manager provides, and whether most families find it meets their needs or not.

And the Winners Were:

Penrose Senior Care Auditors won the Judge’s Choice award and SingFit won the Consumer’s Choice Award; see the PR release here.

I can envision both these companies providing a useful service for older adults and families, and look forward to their service being reviewed and vetted by others.

I do feel we really need better options when it comes to PERS systems and PHR systems, so am hoping to eventually hear from people who have used PicnicHealth and Unaliwear with their older parents.

Comments

  1. Thanks for the thoughtful reviews. You’ve provided a important service.

    From the perspective of a entrepreneur looking at this market segment I’d agree that peer-reviewed third-party evaluations are important, and a gold standard.

    However getting the researchers on side is a lengthy process (i.e., finding interested researchers with appropriate interests, skills, resources; writing the study proposal; obtaining a university’s research ethics review committe approvals; applying for funding; staffing; enrolling subjects; etc.), and pretty well requires the manufacturer to provide market-ready devices for the researchers’ use, and then a study period (two years in one proposal from a researher at UCSD) and then time for the researchers to write up the results and find an appropriate publisher, and then wait for the publication date. Best case, fastest timeline is on the order of three years. That’s really fast in research/academic years, but a full generation in product-development years.

    Simply put, CogPro Cognitive Prosthetics Ltd (like other startups) can’t, won’t wait three years after we have developed a minimum viable market-ready product. We’ll launch, and be very clear that we’re committed to conducting such research, and we’ll welcome your reviews and other similar reviews, and we’ll publish actual users’ feedback, and learn from that. And we’ll be looking to sell our devices to other market segments, all so that we could still be in business when that peer-reviewed paper is published.

    For the technology for the aging market (hardware division), we’ll offer our general purpose products as try-it-and-see versions, with our commitment to communication and continuous upgrading.

    • Leslie Kernisan, MD MPH says:

      Thanks for your comments. Regarding research, I didn’t mean to suggest that a company should ensure that peer-reviewed research has been done before they launch their product or promote it. As you correctly point out, completing peer-reviewed research is a long and complicated endeavor.

      That said, I think it is necessary for us as users or clinicians or public health professionals to consider how we might corroborate a company’s claims that their product or service is beneficial. If a product takes off and is widely used, we should hope that someone will study the effects so that we can all understand what the benefit appears to be.

      Even small preliminary studies can be useful, especially if they are done by people who don’t have a financial stake in the outcome. Peer-review helps ensure that the methods used for the study are adequate to the task.

      Ultimately, for me the questions for any service or product are:
      – Does it help? How does it help? And how well does it help?
      – Does it help enough to be worth the expense/time/hassle of installing and using it?
      – How does it compare to alternatives, esp alternatives that are cheaper or better understood?

      These are questions that a company usually can’t or won’t answer. So we must have other ways of getting this information.

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