GeriTech

In Search of Technology that Improves Geriatric Care

featured

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

[Read more…] about GeriTech’s Take on AARP’s 4th Health Innovation @50+ LivePitch

My Process for Meaningful Use & Chronic Care Management

What is actually involved, in providing good ongoing medical care to a frail older adult who is medically complex?

I’ve been thinking more about this, since earlier this week I attended a Code for America event about meaningful use. And in an interesting coincidence, Christopher Langston of the J. Hartford foundation published a blog post yesterday titled “Making Electronic Health Records Responsive to Needs of Older Adults (Really Meaningful Use).”

Now, since my consultative geriatrics practice is direct-pay and I’ve opted-out of Medicare, I don’t have to use a certified EHR that is going to help me attest to meaningful use.

Nor do I have to figure out how to qualify for the new chronic care management (CCM) payment.

But of course I use my EHR (MD-HQ) very meaningfully. And the clinical work I do meets the 99490 criteria:

  • Multiple (two or more) chronic conditions expected to last at
    least 12 months, or until the death of the patient,
  • Chronic conditions place the patient at significant risk of death,
    acute exacerbation/decompensation, or functional decline,
  • Comprehensive care plan established, implemented, revised,
    or monitored.

(The one criteria I don’t meet is that I don’t provide 24/7 access to my services, although all my patients can access their clinical information — including detailed clinical notes — via my patient portal. Because my practice is small, solo, and consultative, everyone has to have a PCP and that’s who they can call after hours or on weekends. It’s not ideal but oh well.)

Helping an older person with health is like managing a complex ongoing project

One could write a long book listing everything that goes into providing ongoing health help to an older adult.  Especially since this usually means also helping family, as well as the paid individuals providing assistance.For an older adult with functional impairments, it’s easy to have a very large number of people involved, when you consider specialists, home health, family, residential facility staff, paid in-home caregivers, geriatric care managers, etc. And usually we have lots of ongoing health issues to collectively address.

So those are the circumstances in which I usually do my doctoring. In this post, I’m going to focus on what I’ve noticed when it comes to what I need from my EHR, and my personal clinical workflow.

First of all, it’s important to have a way to capture and store all the relevant data that emerges between face-to-face visits. This includes things like: [Read more…] about My Process for Meaningful Use & Chronic Care Management

Aging in Place Safely: Dr. K vs APS vs the latest start-up

This week, I did a lot of thinking about aging in place and safety.

That’s in part because I ended up going to head-to-head with a local Adult Protective Services agency (APS), who was worried that my 91 year old fiercely independent patient with dementia was not safe to keep living in her own home as she’s doing.

Also, my Twitter friends brought my attention to the latest darling of the aging innovation press: a new start-up called Honor, promising “Home Care Built For Our Parents, and For You.” (Founded by an ex-Googler! Raised $20 million!)

So, seems like as a good a moment as any to write about what it can take, to support an older person in aging in place, and what might get in the way.

(Note: I haven’t read it but I’d be remiss if I didn’t mention that gerontology professor Stephen Golant has recently published a book arguing that the aging in place model is being oversold; see this good article about the book “Aging in the Right Place” for more.)

Betty, a 91 year old woman who wants to age in place

“Should she still be living at home?”

I get asked a variant of this question all the time. It’s what families worry about and why geriatric care managers sometimes consult me.
[Read more…] about Aging in Place Safely: Dr. K vs APS vs the latest start-up