Aging in Place is Getting Much Bigger

I wrote last week about white spaces in healthcare technology, which I think more accurately are white spaces in healthcare generally. Neither of the examples I gave — healthfinch and Ring-a-doc — are meeting changes that are a part of Meaningful Use. They aren’t for data sharing, patient engagement, care coordination, population health, self management, or e-prescribing.

Both were created to help providers be more efficient and both sit on top of an EHR (or at least interface with an EHR.) Similar areas could be targeted to create efficiencies for providers. If you’re looking for ideas for a product, spend a few weeks at a practice observing how things are done and I guarantee you’ll find lots of opportunities. My wife is building her own solo practice right now (we realize that’s an uncommon thing to do these days, but it seems like the right thing for us). In the process of helping her get things set up, I am seeing tons of areas for improvement, and she’s not even in practice yet. Of course it’s a matter of being able to filter things that are one-off solutions and those that have a larger market potential.

My main point is that the examples I gave last week, and what I’m seeing with my wife’s experience, aren’t the areas that most people coming to healthcare would be thinking about. There are other, larger and more obvious macro trends that people can follow to better understand what’s coming next and where to find white spaces. In a later post, I plan to cover areas of Meaningful Stages 2 and 3 that present clear white space opportunities. I’ve also covered the clear opportunity and trend, at least from a funding and business model perspective, to help reduce costs and improve benefits management for employers.

But another obvious opportunity that I haven’t mentioned lately is aging in place, helping elderly and remote caregivers manage health. I’ve written several times before about the AT&T report of a few years ago that found that 23 percent of US households act as primary caregivers for family members. That’s a very big number of people who have the burden of caring for a loved one, and many times that loved one that is not living under the same roof.

This post was triggered by a report by AARP earlier this week that found significantly changing ratios of elderly and potential caregivers. As baby boomers age, we’re going to see a much higher percentage of people over the age of 80, many of whom will have health issues and will need strong support systems. The problem is that this growth in the over-80 segment is faster than the growth of the typical caregiver segment of ages 45-64. The current ratio is seven caregivers to one person over the age of 80, but this is trending down. By 2030, it will be four to one, and by 2050, three to one. These are long-term trends, but they are significant.

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Even today, at the seven-to-one ratio, caregivers need more tools to help aging loved ones age at home or age in place. Aging in place in not just desirable for people, it’s also cheaper than nursing homes. What caregivers really need in caring for the elderly are tools to help monitor them, tools to connect with them, and tools to assure elderly people have access to medical support as needed. Obviously technology can play a significant role in aging in place and we see lots of companies targeting this area. But the need is massive, and obviously growing.

GreatCall is a good example even though it was slightly early to the market. It has moved well beyond the mobile phone with big buttons that it started with and now offers a smartphone tailored to elderly as well as health and medical services built into its phone. Just as some younger people might want a Facebook phone, elderly people and caregivers would probably lean towards a phone and service that has health and wellness services at its core. That’s what GreatCall has created.

GreatCall announced the newest version of its Jitterbug smartphone this week, which was pretty good timing. A section of the press release is devoted to the health services that are included with the phone — urgent response, medication reminders, and nurse line access. All of these services are premium offerings. I’ve become a big fan of GreatCall. As it grows its user base, it will continue to add its own offerings and add premium services from third parties. GreatCall also announced a partnership with Robert Bosch earlier this year.

GreatCall isn’t alone, and this market is massive. Robert Bosch, the company I mentioned above, also offers Health Buddy for remote monitoring. And of course Qualcomm has the 2Net platform to aggregate sensor and app data for remote monitoring. This remote monitoring data, if used properly, could go a long way to helping people age at home. One more example I like is Independa, which is similar to GreatCall but offers a tablet and smart TV platform for engaging the elderly.

There are lots of companies in this space, and investors seem convinced enough to place pretty bets in this area. Putting it that way maybe it’s not too much of white space; but, I think the market is so big and so varied that it’s far from tapped. It will be interesting to see how this segment of the market, which to date has grown mostly by selling direct to elderly and caregivers, becomes more integrated into care delivery through payers and ACOs. It’s very similar to the quantified self market in this regard. We’ll have to wait and see.


Travis Good is an MD/MBA involved with health IT startups. More about me.

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