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

“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

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.

• Per the website, Audicus offers hearing aids that cost $499-699 per ear, with a 45 day money back guarantee and one year warranty. Consumers are supposed to first get an audiology evaluation on their own.
• Hearing is indeed a hugely important issue for many older adults. It’s key to quality of life, including getting help from family and caregivers.
• I also find that many older people seem to dislike using their hearing aids (I’ve never understood if that’s because they are hard to use or don’t actually work well or perhaps don’t look good.) So making it easier and cheaper for people to augment their hearing is certainly worthwhile.
• Upon taking a quick look online, it seems hearing aids often cost considerably more ($1600-$3500 per this 2014 AARP article). If this is true, this company’s product sounds like a good deal, especially if they honor the 45 day trial period without too much hassle.
• Because I thought this product sounded so promising, I did a quick search online for reviews. Although I didn’t find many consumer reviews, I learned quite a lot from this Ziphearing blog post written by Hearing Instrument Specialist Jeff Hall, which addresses some pros and cons of the Audicus model. According to Hall, a downside of getting hearing aids by mail is that it’s much harder to have them programmed and customized to the needs of the individual (since he says this is better done in person, which sounds plausible to me).
• I also found this SeniorPlanet blog post endorsing the value of HearingAidForums.com for practical tips and useful advice.
• In short, it seems that seniors should do their homework before deciding to purchase a heading aid, whether from Audicus or anyone else.

Constant Therapy: “Constant Therapy’s mobile solution helps people improve their brain function after a stroke, brain injury, dementia, or learning disorders with personalized science-­‐based exercises and powerful data analytics. It is used in hundreds of institutions such as Kaiser Permanente & Massachusetts General Hospital, and is helping thousands of patients & caregivers.”

• It took me a while looking at the website to figure out just what this is. It seems to be iPad-based exercises for brain rehab, although it could presumably used for “brain training” to delay cognitive impairment and cognitive decline.
• The product is supposed to be “science-based,” however there are no scientific references on the website. Via a quick search online, I found only one conference abstract related to this particular product.
• Patients and families can try the product free for 30 days, and then it costs $20/month to continue, with discounts for purchasing a longer subscription.
• This kind of product can probably help people. However, I think it’s hard for people to detect the benefit of such an intervention on their own, which is why we need data showing people benefit from investing their time — and money — on this type of product.
• If it’s being used in “hundreds of institutions,” including big ones like KP, I hope it’ll eventually be possible to find out how well it worked there. KP is usually on the ball about making sure their interventions improve outcomes.

First Derm: “On average, it takes 38 days to see a dermatologist in the USA. With First Derm™ you take a picture of your skin problem, send it to our board-certified dermatologists, and receive an opinion in hours of what it could be, treatment(s), or if you need an in-person dermatologist appointment.”

GeriTech thinks:

• Meh. One of my top skin concerns for older adults is whether something might be skin cancer. In general, I would just advise my patients to wait the 30 days and see someone in person, preferably who can look at several spots & biopsy if needed.
• It costs $40 for the “case fee” (looks they charge extra if you want a faster answer, and less if you’re willing to wait 48 hours instead of 24) and the website says that 30% of the time, they tell people to go see a dermatologist in person. They also don’t provide prescriptions.
• In general I’m not a fan of entirely asynchronous medical care (meaning you’ve never talked to the doc in person and you never will). I think for almost everything that ails older adults, it’s better care and more satisfying for patients to get to talk to a doctor, even if it’s via video or phone.
• Obviously there are competitors to this service. This one is providing almost the same asynchronous service — but they include a prescription. And for a very similar price point ($44) you can have a video dermatology visit on HealthTap; they say they’ll write a prescription & email you the consult note too.

Medella Health: “Medella Health is developing smart contact lenses that continuously and non-invasively monitors glucose levels, and transmits that information to a mobile phone, so patients can better manage their diabetes.”

GeriTech thinks:

• Contacts to monitor glucose?? Please. As a former contact lens wearer, I can tell you that contacts are a royal pain. You would have to be extremely motivated to be monitoring your glucose, to wear these.
• In other words, you’d have to be a Type 1 diabetic, and this might end up being a fantastic product for them. But most older adults are Type 2 diabetics, and for the many of them who do not take insulin, the benefit in having them monitor glucose daily is debatable. (It’s certainly burdensome, and many older Type 2 diabetics are busy with other chronic illnesses, caregiving, and other aspects of life.)
• My first thought was “weren’t they saying last year that Google was teaming up with someone to do this?” This seems to be a competitor, backed by Peter Thiel.

Medisafe: “MediSafe™ is the leading mobile medication management platform that reminds patients to take their medications via mobile solutions, to improve adherence rates and curb growing health care costs. The personalized application –downloaded by more than 1.4 million users worldwide – alerts family, friends and caregivers if patients miss a dose.”

GeriTech thinks:

• I actually used MediSafe earlier this year, to help me keep track of a medication I had to take for a few months, and also for my course of antibiotics when I had strep.
• I was not impressed as I didn’t find it intuitive and found myself often annoyed by it.
• For example, once my antibiotic course was finished, it would still remind me to take the medication. (This is dumb; antibiotics are almost always taken for limited time periods but when I first entered the medication there wasn’t an easy way to specify that it was for 10 days only.) When the reminder pops up, I couldn’t find an easy way to edit the medication and say I’d stopped taking it.
• In other words, I found myself annoyed with the management of two medications. Many older people take 5, 10, even 15 daily medications, and their medications are frequently being changed and adjusted by their many doctors. So an app has be really super usable, which I would say this one isn’t.
• I did find the little pop-up reminder useful, to not forget to take the medication. But maybe I’d be less thrilled if it were popping up six times daily.
• My guess is that seniors will be served better by some kind of improved Mediset, that keeps the pills arranged by dosing time and adds a reminder. Perhaps Pillpack will partner with someone who adds the reminder and “did you take your medication?” tracking technology.
• FWIW, iMedicalApps gave this product a favorable review. Note that the reviewer is a psychiatry resident and it’s unclear to me whether he actually tried to use the product for several days. This app also has an impressive number of generally favorable reviews on Google Play, although I’m guessing most of those users are not aged 50+.
• If you know a real live older adult who is using this app to manage at least 4 medications, please let me know how it’s going in the comments below!

ollo wearables: “Controlled by voice, ollo is a wearable 4G smartphone that combines a personal digital assistant with real time health monitoring. We enrich every moment of the day by making communication easy and intuitive, whilst smart monitoring software provides constant peace of mind that all is well.”

GeriTech thinks:

• Cryptic website, no specifics on the product and how it works. Media page lists articles from 2013. Last blog posts from summer 2014. No idea what to think, other than they need to keep paying attention to their website.

Sharefund.com: “Sharefund is a crowd-sourcing platform that enables families (and communities) to secure help with rides, meals, visits, chores and funds from chosen social networks when caring for an ill or aging loved one.”

GeriTech thinks:

• This is another platform for getting friends and family to help a person in need, by providing a way to organize and communicate about chores, services, etc.
• What is unclear is how this differs from services like LotsaHelpingHands and CaringBridge. Also, these services are free but as best I can tell only CaringBridge is non-profit and says it’s supported by donations. For any other free product, one of course should be able to find out what the business plan is.

Splitsecnd: “Keep your loved ones safer while on the road with splitsecnd. It is the most affordable and only portable device that, in any car, provides automatic crash notification, real­time GPS tracking and, at the push of a button, directly connects to a 24/7 emergency response center.”

GeriTech thinks:

• This is a small device that plugs into the car’s 12V outlet (it has a USB port to accomodate phone chargers, etc.). The device itself doesn’t require a cell phone. It costs $99 plus $10/month subscription, or you can get it for $15/month with a one year contract.
• The website describes lots of benefits for the parents of teenagers. You can track texting, see where the vehicle is, etc. You can also reportedly use the device to find your parked car.
• In general, I would think car manufacturers would start offering this technology built into the car. But it’s nice to be able to add it to a car on your own.
• So how would this work for an older driver? I can see why some families might want an older driver monitored, but will older drivers agree?? Also, what kind of useful monitoring would this provide? If an older person is getting lost while driving, they probably shouldn’t be driving in the first place. I suppose this could help you find them if they don’t come back for a long time. But can you use this data to convince an aging parent to give up the keys? To convince the doctor that the parent should give up the keys? Not sure.
• Bottom line: this is intriguing and I suspect will take off among families with teenage drivers. May or may not get traction with older drivers, especially since families may opt to equip vulnerable seniors with a wearable device that could provide alarm button, GPS, fall alert, etc.
• This product would probably be more useful if it came with a program that analyzed a senior’s driving and indicated whether further assessment of driving abilities should be considered.

Veridrop: “Veridrop has developed a unique platform and an electronic device to help patients administer and track their eye drops medications. It is a bold step that will change the way we install eye drops and overcome the challenges associated with traditional eye drop delivery methods.”

GeriTech thinks:

• This company’s website appears to be brand-new and has no info whatsoever.
• As a general internist and geriatrician, I admit I have little sense of how big a deal it is when patients don’t take their eye drops regularly. We would need input from ophthalmology to tell us how big a problem this is.
• When it comes to tracking medication, I continue to pine for technology that can tell me how often patients use their PRN medications, esp orals and inhalers.

Zenamins: “Personalized vitamins on subscription packaged in daily doses and delivered to your home. No more pill bottles running out at different times or filling out weekly pill cases. Each pack is customized based on 1) what you already take, 2) questionnaire leading to a suggested pack, or 3) blood/genetic/activity data.”

GeriTech thinks:

• Mail-order blister-pack mediset technology for vitamins and supplements. Costs $30 for a 4 week supply of 3 supplements, with each extra supplement costing an extra $5/4 weeks.
• I tried the “help me create a vitamin pack” on the website, saying I was a 70 year old non-smoker. (Actually, you can only specify if you’re older or younger than 50, which you do after you specify whether you’re pregant or nursing.) When asked if I cared most about promoting “bone health” “heart health” “joint health” “energy” “brain health” or “hair/skin/nails”, I answered all the above, because they all sound like things the older women I know would be interested in.
• After asking me to tell them if I was known to be deficient in vitamin D, magnesium, vitamin B12, or iron (I didn’t answer, since most older people don’t know if they are), the site proposed a vitamin pack containing the following, for the price of $65/4 weeks:
  • Women’s 50+ MultivitaminFish Oil 1200mg
  • CoQ10 200mg – $5 upcharge
  • L-Carnitine
  • Calcium 600mg + D3 400IU
  • Glucosamine/Chondroitin/MSM 1 pill
  • Ginko Biloba
  • Biotin – Vitamin B7 5000mcg
• I can see how this service will appeal to some, but I have gripes. Briefly, the evidence for vitamin supplementation maintaining health is spotty to say the least, with the exception of Vitamin D which is recommended by the Institute of Medicine and others at a daily dose of 600-800 IU depending on age. This particular website has no information or links to reputable information about the vitamins and related research.
• The data on supplements depends on the supplement in question; none of it has ever struck me as super-compelling. (For health promotion I think it’s much bettter use of my time to encourage a sensible balanced diet, exercise, stress reduction, purposeful activities, and a healthy weight, plus avoiding brain dampening medications whose harms surely outweigh the benefits of “brain healthy foods”.) Furthermore, the quality of supplements for sale is often questionable and earlier this year the NY attorney general busted several major retailers for the quality of their products.

What I’m most interested in