On April 12 & 13, 2017, AARP hosted its sixth Innovation@50+ LivePitch event, an event that allows a group of chosen start-ups to pitch to a consumer audience and a panel of venture capitalists.
This year, the event had a “dual focus on Caregiving Health Technology and Financial Technology.” AARP presented two slates of 10 start-ups, one for each focus area, each with its own panel of judges.
In this post, I’ll list brief descriptions of the finalists for the Caregiving Health Technology group. I’ll 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.
Here are the judging criteria, as described in the event FAQs:
The Judges will focus on these five critical elements (judging value of 20% for each element):
- 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
- Creativity/Differentiation -Why would someone use this product and/or service over alternatives?
- Scalability- Is this 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(judging value of 25% for each element):
- 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?
In terms of my judging criteria, I’m mostly interested in:
- Functionality: is it easy to use, for everyone who is involved? (E.g. for the senior, for the family, and for any involved clinicians.)
- Effectiveness: does it work? As in, does it measure what it’s supposed to measure, or do what it is supposed to do? And does using product or service this improve outcomes of interest to seniors, their families, their clinicians, and/or payers?
- Potential to help an older adult or family with a common aging health concern: is this likely to help people with a problem that matters to many people? Does this address a need that I see many seniors and families struggling with?
GeriTech’s quick take on the Caregiving Health Tech 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 note that I haven’t tried any of these products in depth.
Aegle Palette: “We founded AEGLE Palette in 2015 after we pained through the burdens of managing preventable chronic diseases from hypertension to diabetes. Our core purpose is to prevent and revert chronic diseases by empowering patients and providers with complete nutritional and lifestyle data.”
- Hard to know what to think based on the blurb, other than being pained by the phrase “we pained through the burdens of managing preventable chronic diseases.”
- Per their website, “Palette is smart placemat residing on your dining table that accurately tracks your meals’ nutrition. It then sends that information to your physician so they can accurately diagnose and analyze your health, all in the background – so you don’t have to worry.”
- There is an app that provides customized nutrition recs. They also propose to send the user’s nutritional and lifestyle information to the doctor. This is supposed to be part of a preventive care approach that will make it easier for doctors to monitor lifestyle factors and intervene, and will also save insurance companies money.
- Unclear how the app actually captures your nutritional intake.
- My assessment: tech entrepreneurs LOVE lifestyle prevention, but I wish they would work more on other things. Hard to tell from this website whether this app is likely to work well, or work better than other options for addressing lifestyle factors.
- No idea why this is considered Caregiving Health tech.
AgeWell Global: “To improve the psychosocial well-being and health of less able older adults through tech-enabled, peer companions (AgeWells) who address emotional, social, and physical health through regular home visits, periodic phone calls, and algorithm-driven referrals to health care providers and links to social networks in their communities.”
- If I understand correctly, this program essentially trains older adults to be community health workers, and then deploys them to go visit less able older adults.
- I really like that this program taps into the strengths and abilities of older adults; this has obvious benefits for the “AgeWells.” NPR did a short story on this organization in 2014, and referred to this as “Grannies taking care of grannies.”
- AgeWell has also developed a mobile health screening tool, which their senior community workers use during their visits. This is “designed to identify evolving health and social problems based on recorded observations and responses.”
- The website reports a successful pilot in 2014, in which “the AgeWell model achieved a 50% increase in well-being scores amongst participants within the first month of service and a 95% reduction in signs of depression, improvements that were sustained for the pilot’s duration. Pilot participants with identified medical and social problems were also successfully referred to appropriate providers.” But I was unable to find anything about this pilot in the published scholarly literature.
- There is a pilot ongoing in New York City, and another one planned for Florida.
- Overall, this sounds like a promising idea. They could use some signs of validation, however. I hope they will publish results from their pilot programs. I would also like to know more about what’s included in their mobile screening tool, and how that tool’s performance has been tested and validated.
- Lastly: this is a cool idea but also doesn’t sound like Caregiver Health Tech.
BrainCheck: “BrainCheck is an innovative, rapid, mobile cognitive tracking platform. Our vision is for cognitive health assessments to be a routine part of life for everyone. In under 10 minutes, we assess multiple cognitive domains, and deliver results immediately, tracking changes from a person’s baseline and from the population average.”
- This program offers a computerized cognitive testing platform. There is a “Sports” section (seems oriented towards concussion concerns) and a “memory” section. A testing session can be done through a computer browser or on an iPad. The tests are based on known neuropsych tests.
- I tried the memory test for free. It took a little over 10 minutes, and included immediate recall, Trails, Stroop, Matrix, Digit Symbol Substitution, and delayed recall. At the end it showed me my performance for a number of cognitive domains, by showing me where I was compared to a population (presumably of my old age). I was interested to see that I scored “low” on executive function.
- Paid accounts can review past test information, and can have “performance reports to share with your care team.” I would have liked to see what these performance reports look like, but none are available in free account.
- Overall this is a moderately interesting idea to me. I would like to see more scientific validation of the tests; the founder is a Stanford neuroscientist, but I still feel one should be able to review some peer-reviewed studies of this software.
- It would be good to know more about how precise the results are for an individual (if I take the test every day for three days, assuming I’m generally in the same cognitive state over the three days, how much variation will there be?) and how well they correlate to other known cognitive tests (e.g. MOCA). It would also be useful to see exactly what the user got wrong; I expect both clinicians and users themselves would want access to this information.
- Yet again: I don’t see why this is Caregiver Health.
Ceresti Health: “Ceresti empowers family caregivers to tackle chronic conditions and care challenges for loved ones living with Alzheimer’s Disease and other dementias. Our personalized digital health programs provide caregivers with education, support, care plans and coaching to improve patient care and reduce healthcare costs.”
- This company offers a “12-week digital health program to train and support family caregivers to provide proven, effective and appropriate care for a person living with dementia at home.” It includes a pre-configured tablet that uses mobile networks for internet access, a “dedicated caregiver coach,” and a personalized curriculum. The program requires “approximately 15-20 minutes every day for 5 days per week for 12 weeks.” Topics covered include:
- Communicating effectively with a person living with dementia
- Anticipating and managing dementia-specific care challenges, including behaviors
- Helping a person living with dementia with activities of daily living
- Best ways to engage and stimulate a person living with dementia
- Accessing support from community resources and from others
- Making decisions to ensure appropriate long-term care for the person living with dementia and financial security for the family caregiver
- The family program costs $999 for the 12 weeks. At that point the family caregiver can either return the tablet or opt to enroll in the “Sustain” program, which costs $100/month for “technology only” and $250/month if the caregiver wants continued access to their coach.
- Ceresti also offers a “Prevent” program to reduce acute events and a care transitions program, but few details are available about these on the website.
- Overall I find this is a very interesting idea. Questions and concerns:
- How good is the educational progam itself? Have they digitized a validated caregiver education program?
- How good are the coaches? What kind of background and training do they have? How does one communicate with them; phone or email?
- Eventually one would also want to know how this improved outcomes, both for the family caregiver and for the person with dementia.
- Lastly, the price is considerable. It’s not unreasonable, especially since they include a tablet and the mobile service to go with it. But many families will probably hesitate, unless there is an option to get your money back after a few weeks if you don’t like it.
GoGoGrandparent: “GoGoGrandparent helps older adults access and use on demand transportation and offers extra tools for caregivers.”
- This service appears to basically provide a touch-tone phone interface to Uber, plus alerts and information to family caregivers (via app). The older user can also touch 0 to talk to an operator.
- Pricing: “Our operator’s arrangement and oversight fee is $0.19/minute from when we start monitoring a service to when we stop.” Users will still need to pay Uber; it’s not clear to me whose Uber account would be used (perhaps a linked family member?)
- This idea seems moderately interesting. It might be helpful to those older adults who don’t have a smartphone but are amenable to using an Uber-like service. I’m not sure it would work well for older adults with more than minor cognitive or mobility difficulties.
iBeat: “iBeat is an emergency response network making the world safer by giving people the fastest access to care in an emergency. The company’s breakthrough smartwatch continually monitors users’ heart activity. In an emergency, iBeat will instantly alert the user, their loved ones, and 911, helping ensure immediate care and potentially saving the user’s life.”
- This is a smartwatch that continually monitors heartrate, and “detects if your heart suddenly slows or stops.” There is also a step-counter. Data can be reviewed through an online dashboard.
- No smartphone required.
- Device is water-resistant, and they say the battery lasts 5-7 days.
- Can notify “friends, family members, and emergency services.” When a heartrate irregularity is detected, the watch asks if you are ok. If you say “No” or don’t respond within 10 seconds, the watch notifies the dispatcher. The dispatcher can then contact 911, and can notify friends/family.
- Unclear how one communicates with the dispatcher in an emergency; I guess the watch has a speaker and microphone?
- The iBeat will be available to ship at the end of 2017. The watch can be pre-ordered for $179; full price will be $259. Purchasers can have three free months of monitoring, and after that monitoring costs $20/month. Monitoring covers the cost of cell service and 24/7 dispatcher support.
- Overall, this seems to be a combo of heartrate monitor and PERS device. I’m not convinced that continuous heartrate monitoring will be all that useful to older adults. This could be tested: randomize seniors to iBeat vs a comparable PERS w no continous heartrate monitoring, and see if outcomes are better after a year.
- But it still might have some value as a PERS device, especially if it’s comfortable to wear, attractive, and if it’s easy to communicate with the dispatcher.
- Some limitations: if you fall and break your hip, if you have a stroke, will the device notice? Or will you have to be alert enough to call the dispatcher?
Kinto: “Kinto is here to help you care for your aging loved one better. Caregivers with Kinto are given the support they need through a set of useful digital tools and access to a community of like-minded people. It is our mission to help you care for your loved ones the way they deserve.”
- This seems to be a smartphone/mobile device app, attempting to do multiple things for caregivers:
- Med management
- Coordination with other family members, and/or health providers
- Documenting “check-ins” to track how an older relative is doing (e.g. mood, pain, etc)
- Practical advice/information
- Connection to other family caregivers
- Keeping track of to-dos
- Lots of other companies have attempted to create “the comprehensive smartphone-based helper for family caregivers.” I can see why the idea appeals but it’s hard to do. Unclear from the site how this company is going to do it better, or even reasonably successfully. The app will have to have good usability, good features, and good information.
- Personally, I’m a little skeptical of apps that try to take on this many domains. It is hard to do even one of these really well.
Marvee: Marvee is a voice-driven, care-companion service imbued with alerts, home safety and family interaction functions, providing awareness, peace of mind and social engagement. Marvee provides those hindered by vision, mobility or aging an easy way to communicate with family and caregivers, just by using their voice!”
- This service seems to require Amazon’s Alexa (the voice-activated computer assistant) and an Alexa-enabled device, such as Echo.
- Older adults can tell Alexa to “tell Marvee to send I’m ok,” or “tell Marvee to check on me.”
- Families can also create “family news” items, which will be recited to the older adult once he/she tells Alexa to ask Marvee for family news.
- Basically this seems to be an attempt to make it easier for older adults to stay in touch with family or call for help, by leveraging a voice-driven interface, instead of asking older adults to use a tablet, smartphone, or computer.
- I know that entrepreneurs have been interested in leveraging Alexa for older adults, but not yet clear to me that this will take off. A cognitively intact older adult might prefer to keep using the phone (or smartphone/tablet, as more of them are doing). After all, wouldn’t you rather hear your family member’s voice, rather than Alexa’s robo-voice reporting the family news?
- An older person with dementia might find Alexa confusing and unfamiliar, plus the ask-Alexa-to-tell-Marvee format seems potentially confusing to manage. (Marvee is the virtual assistant for Alexa, your first virtual assistant. Am I the only one who finds this a little funny, and also potentially confusing?)
- Overall, I’m not going to be interested until I hear from real families that their older parents like using Alexa and like a service such as Marvee.
PillDrill: “PillDrill, Inc. develops simple and clever technology products to improve everyday health. The company’s first product, PillDrill, is a smart medication tracking system that intelligently modernizes the pill taking experience. PillDrill is easy to use, adapts seamlessly to any medication routine, and works whether a person manages their own medication regimen or someone else’s.”
- This is a medication management system with several interesting hardware components:
- A medication hub, which provides reminders of when to take pills. The hub requires a power outlet and wifi.
- Scannable tags which you place on standard medication bottles. When you take a medication, you wave the bottle’s tag near the hub, and the hub records the medication as taken.
- A weekly pill organizer, which can store a week’s worth of AM and PM doses. Each of the 14 dose pods is equipped with a scan tag, so that the meds can be logged as taken.
- A “mood cube” whose five faces offer the option of great, good, ok, bad, and awful. The user can wave the relevant face over the Hub, to log pain or mood.
- The sytem also includes an app, so that family caregivers and others can be notified when medications are taken. The app can also be used to log doses while away from the Hub (e.g. while out at lunch).
- The system costs $199; no monthly fees. This covers the hub, 12 attachable scanning tags, two weekly pill strips, and the mood cube.
- My impression: This has some weaknesses but overall is a very interesting product to me! Making it easy for patients to log their medication intake is something that we sorely need.
- In particular, although I’m not sure the company has focused on this use case, this type of technology might work very well to log the use of “as-needed” medications, such as pain medications.
- Some questions/concerns/thoughts I have:
- Many older people take several medications at a particular time (e.g. 9am). From the hub display, not clear how it would show it was time to take more than one med at a time.
- Unclear how easy or hard it is to enter a new medication into the schedule, or edit a medication’s dose/schedule. This issue is important, since older people’s med schedules can change often and if it’s hard to update the system’s schedule, people may not want to keep using it. Allowing users to take photos of their med labels might be a good way to make it easy to enter scheduling info.
- Can the scannable tags that you stick on bottle be reused? Or do you have to buy new ones every month?
- Logging mood and pain is a good idea. Would be good if user had a way to add some notes, perhaps by pressing a button on the hub and recording some comments. (These can be transcribed by google voice.)
- The challenge with using the PillDrill pods is the same as for any medi-set: someone has to fill it! But might be interesting to combine use of this with Pillpack, which delivers one’s medications in dosing packets. Each dosing pack could be poured into one of the PillDrill pods.
- Overall, I find this medication management system very promising.
Siren Care: “Around the age of 45, people living with diabetes begin developing nerve damage which lead to foot ulcers. Research has shown that temperature monitoring can reduce ulcers by 72%. Our team has developed a smart sock with sensors embedded inside the fabric that tracks temperature and can find injury in real time. Siren Smart Socks are a tool that fits easily into the lives of people living with diabetes. We help people keep their independence and reduce healthcare costs.”
- This is a pretty niche product. The question is, does it improve outcomes and would people at risk for foot ulcers wear these regularly?
- A pack of 7 pairs of socks can be pre-ordered for $120. The full retail price will be $180/7 pairs.
- The website cites a randomized study in which participants who monitored foot temperature experienced fewer diabetic foot complications than controls. However, temperature was monitored using a handheld infrared thermometer twice daily. I did not see any research on the socks; at a minimum, one would like to see that they can track temperature changes as well as the handheld device.
- Personally, I’m not very interested in this product. It might fill a need for a subset of diabetic patients who are very motivated and also at high risk for foot ulcers. The price will put many people off, these socks would probably have to be subsidized by their insurance company.
2017 Caregiving Health Technology Alternates
I’m going to briefly comment on the three alternates as well.
EllieGrid: “EllieGrid is first smart pillbox designed especially for people below the age of 70. Organize all of your pills in seconds, receive reminders, and gather compliance data with a fun and fashionable accessory.”
- Not sure what to think of this being “designed especially for people below the age of 70”? Is that because it’s too technically complex for people who are older? Or because people over age 70 often take more than 7 medications?
- This is a nearly flat, rectangular pillbox with a sliding cover. It contains seven compartments, each for a type of pill. The cover design matches the size of the compartments, and when it’s time to take a given med, a little LED lights up on the cover.
- The pillbox claims to record whether the medication was taken, but unclear how it notes this. Is it just because you slid the cover open? Do you have to tap something on the companion app, or on the box?
- You probably do need to use a smartphone to use this, as it uses Bluetooth.
- It’s being presold for $99.
- This product has some interesting features. Probably isn’t suitable for most older adults (would be hard for people with cognitive impairment, not suited to taking lots of meds, not clear it can manage PRNs). But it might fill a good niche for people who are younger, or who just don’t have a complex med regimen.
Silvernest: “Silvernest’s innovative roommate matching service successfully pairs aging homeowners with pre-qualified housemates based on detailed behavioral profiles and selected demographic preferences. This full-service solution then further allows users to employ full background checks, communicate securely, create state-specific leases and easily manage automatic rent payments all seamlessly within Silvernest’s platform.”
- Not much to say about this. Seems good for helping independent older adults find a suitable roommate. Living with someone can provide social and financial benefits. Could be especially good for people living in expensive cities.
- Unlike a service such as Room2care, this doesn’t seem geared towards helping older people find someone who can provide more than a little friendly companionship. But that may just as well.
SteadyMD: “SteadyMD is a platform for virtual concierge medicine. For a monthly fee, patients can select a specific doctor based on the doctor’s expertise on their lifestyle or medical condition. After an initial one-hour video call, the patient is connected to their dedicated doctor via our feature rich chat application (very similar to slack), same day phone calls and same day video calls. Our doctors see much fewer patients than a typical primary care doctor.”
- Platform promising affordable access to “concierge” primary care. Includes texting to the doctor and same day appointments. Costs $79/month (requires 12 month commitment; first appt free, can cancel within first 90 days and get prorated refund).
- The website features some older adults, but at this price point, from the provider perspective, I cannot imagine this would be sustainable for the virtual primary care of anyone who is more medically complicated. If the platform mostly enrolls healthy younger people who prize convenience and have minimal medical needs, then you can cross-subsidize the increased time and effort required to help an older person with a few (or several) chronic disease. But really, I think it’s better for doctors to be paid more for taking care of more medically complicated individuals.
- Unclear whether SteadyMD’s providers have expertise in older adults.
GeriTech’s Top Picks
There were definitely some interesting services and products in this group.
The one that I am most interested in is probably PillDrill, assuming it works well and isn’t too hard to enter/change the medication schedule. I am also hoping it would help for tracking PRN medication use, which is a clinical issue that entrepreneurs don’t seem to appreciate much.
I’m also interested in Ceresti‘s dementia caregiver training. Historically caregiver training has been done very locally and in-person. Providing a high-quality program virtually could be a big step forward. But remains to be seen how good the actual program is; the best would be to digitize a validated program AND study outcomes of Cerestia users (and publish the findings).
I am skeptical of continuous heartrate tracking, but otherwise think that iBeat has some good ideas in terms of creating a better PERS device (personal emergency response system).
And I LOVE AgeWell‘s idea of training older adults to be community health workers specialized in visiting other older adults. But I’d like to see more information on their mobile health screening tool, and on outcomes.
The consumers voted for SirenCare. The VC judges voted for GoGoGrandparent.
I am especially surprised that the consumers voted for SirenCare…it sounded like a very niche product to me.
As for GoGoGrandparent…maybe it will appeal to more people than I think it will. (Or maybe it will work better for people with cognitive impairment and/or mobility difficulties than I think it will.)
So which innovation are YOU interested in?
Share your thoughts below, I’d love to know.