A new way to deliver care

Health Harmony by Intel-GE Care Innovations is a remote care technology platform that encourages patients  to monitor their health from home.  The platform enables seniors to use simple devices and peripherals, participate in interactive health sessions, access educational content and engage  in videoconferencing with their clinician. Above, a mother and daughter use  an Apple iPad to access the remote care technology platform. Health Harmony by Intel-GE Care Innovations is a remote care technology platform that encourages patients to monitor their health from home. The platform enables seniors to use simple devices and peripherals, participate in interactive health sessions, access educational content and engage in videoconferencing with their clinician. Above, a mother and daughter use an Apple iPad to access the remote care technology platform.

Remote patient monitoring devices can save lives, money and give senior living communities a competitive edge.

By Eric Taub

In 1997, Albert Kingston suffered a heart attack. Eighteen months ago, the 79-year-old retired publishing executive received a pacemaker. Early last May, the pacemaker began to fail. And yet, Kingston considers himself a lucky man.

That’s because a remote monitoring device used at his home determined that his pulse was erratic before any damage was done. 

Once the data was automatically sent to his healthcare provider, he received a telephone call and was told to seek medical advice immediately. Within days, he had a new modern pacemaker with its own built-in defibrillator. 

“That monitor saved my life,” says Kingston, who lives in Chandler, Ariz.

The monitor that saved his life was made by Philips, the Dutch electronics giant, maker of light bulbs, toothbrushes and Norelco electric razors. 

The product is just one part of a suite of vital signs monitoring devices that has come to be known as remote patient monitoring (RPM): products that are capable of checking weight, blood glucose, blood pressure, oxygen levels and more, and then transmit those results instantly to a medical facility or caregiver. 

When an individual’s specific defined parameters are breached, the caregiver is automatically notified via email, phone call or text message, allowing the caregiver to reach out to the patient before his or her condition worsens.

Timing is everything

With emergency room visits costing as much as $10,000, any chance to reduce ER admission can dramatically cut costs and improve a patient’s mental and physical health.

Traditionally, RPM companies have targeted institutions that can see a direct improvement to their bottom line if their clients stay healthy. That includes: the Veterans Administration, the largest RPM user; Medicare Advantage plans that receive set amounts of money to care for their clients; and hospitals, that are now penalized for readmissions for certain conditions within 30 days. 

But recently, RPM companies have begun to pursue the assisted living and skilled nursing markets as well. While those communities may not see an obvious direct financial gain, cutting costs and keeping residents in better mental as well as physical shape can only help improve their bottom line, say RPM executives.

Philips is far from the only company getting involved in RPM. In fact, it’s a crowded field populated by other large companies such as home security provider ADT, General Electric, Honeywell and Intel, not to mention a number of smaller players.

While available for over a decade, RPM is just now beginning to impact the healthcare market, thanks to the Affordable Care Act and skyrocketing healthcare costs.

“Assisted living communities pay a lot of money for amenities that no resident uses, like five-star chefs and gazebos,” says Kian Saneii, founder and president of San Diego-based Independa. The company sells a package of RPM devices, which include a scale, blood pressure cuff, a pulse oximeter and a glucometer, as well as motion sensors and a personal emergency response system. 

HDTV at heart of strategy

Independa takes a unique approach to RPM. The Independa package integrates its vital signs monitoring devices into a resident’s HDTV, supplied by Independa and manufactured by LG, which becomes the devices’ communications hub. 

And because the TV is the one product that the elderly keep on for long hours, it is an ideal communications device, able to display reminder notices to residents to take their medicine, ask them how they’re feeling, and let them visually communicate with caregivers and medical personnel.

The television can also help improve staff efficiencies, Saneii believes. Given that a family can see directly how their loved one is doing, calls to assisted living support staff asking them to check in on their parent will decline. On-screen calendars can also help remind residents to attend an event for which they have signed up, without requiring staff to fetch people throughout the community. 

“For assisted living residents, most living takes place in their room,” says Saneii. “And TV can keep them from going batty. As an assisted living community owner, I will sell more units if I have an amenity that sets me apart. This is one tool that can improve a resident’s quality of life.”

Independa sells its product suite two ways: directly to the end user, as well as bulk sales to communities. For an individual, the price ranges from $1,300 to $1,800, depending on the size of the display, and includes a one-year subscription. Bulk sales to communities are discounted depending on volume. Monthly subscription fees can be passed on to the resident. 

Different strokes for different folks

Still, the TV-as-hub approach promoted by Independa is eschewed by some of its competitors who think that it’s much simpler to get residents and their living facilities involved if they take a platform-agnostic view.

RPM companies that previously required customers to buy their specific monitoring hardware and communication hubs are switching to the “bring your own device” model, whereby their RPM software will work with any piece of hardware that a resident or community prefers to use — whether that’s a desktop computer, smartphone or tablet.

“Eighteen months ago we decided we didn’t want to be in the hardware business,” says Karissa Price, chief marketing officer for Intel GE Care Innovations, headquartered in Roseville, Calif. 

Not only can one use any smartphone or tablet with Care Innovations’ supplied monitoring products, but a community can also choose the monitoring devices it wishes to use, regardless of the manufacturer.

Care Innovations has long been involved in the assisted living industry, supplying communities with its QuietCare product, passive sensors designed to detect falls and movement and predict anomalies based on past behavior. 

For example, if a resident suddenly starts going to the bathroom multiple times per night, that could be the sign of an impeding urinary tract infection, a condition that can trigger dementia in the elderly.

The company is now adding vital signs monitoring to its portfolio. “The remote patient monitoring and sensor worlds are colliding,” says Price. “With hospitals getting dinged for readmissions, skilled nursing facilities are being told that they won’t get referrals from the hospitals if they don’t better control their patients’ health.”

Trial tests spread

In August, the Front Porch Center for Innovation and Wellbeing began testing Care Innovations’ RPM products. The California-based group is tied to the Front Porch Communities, a collection of independent living, memory care and retirement homes.

In an earlier test of remote blood pressure monitoring using 90 individuals spread across four sites, Front Porch found a statistically relevant decrease in blood pressure among participants. Individuals indicated they were more aware of their blood pressure and were taking better care of themselves.

This August, two residents in its Kingsley Manor assisted living home in Hollywood began a RPM trial, with that number expected to increase to 10 by November.

“We want to see how RPM will work if someone can call in via video link and remind the resident to take his or her medications,” says Davis Park, Front Porch’s director. “A lot of our residents do not want in-person visits from care providers. We believe that remote patient monitoring will be a major player.”

Philips has been selling RPM products for 12 years to individuals as a way to avoid moving into assisted living or skilled nursing and instead age in place longer. But Philips also believes that its products can help assisted living communities get more referrals from hospitals once the healthcare facility sees how concerned the assisted living community is in maintaining its residents’ good health.

In addition, Philips believes that its new, sophisticated software will help convince the assisted living market to take a look at RPM.

Two systems to become one

“The RPM industry has had pretty basic software,” says Manu Varma, Philips’ senior director of strategy. “By combining assisted living workflow software with remote patient monitoring software, we’re getting closer to a disease management approach. You need real-time information to help manage patients. Two systems do not make sense.”

Which is why companies like ADT, the well-known security firm, is integrating RPM products and services into its offerings. 

The company has struck an alliance with RPM industry pioneer, Ideal Life, to add the Ideal Life portfolio of RPM hardware and software into ADT’s connected home strategy.

Based in Toronto, Ideal Life is also moving away from the use of prescribed sensors into a device-agnostic approach. Its gateway transmits information via Wi-Fi or the cellular network. 

And tablets can be used to ask patients health questions if their vital signs are out of the norm. For example, if an individual’s blood pressure is high, the tablet can ask the patient how he slept, or whether he took his medication. 

The tablet can also be used to create a “virtual visit” with a clinician, giving the caregiver the opportunity to physically see the patient.

ADT already counts close to 1.5 million customers using its ADT Pulse suite of connected home products, which include room sensors, cameras, touch screens, thermostats and lighting. It will soon add medication reminders, and Ideal Life’s vital signs monitoring products as well.

ADT is planning a scenario in the next year whereby an individual’s LED lights will progressively change colors if he or she fails to take prescribed medication. Emails or text messages will be sent to caregivers via a tablet or smartphone, alerting them to a situation, such as a fall, lack of medication adherence or vital signs abnormalities.

In addition, the company will automatically integrate vital signs information into forms and electronic medical records, and then look at correlations, such as drug interactions, that might be causing or exacerbating various co-morbidities.

The next frontier

“We’re now talking to the assisted living industry,” says Jason Goldberg, Ideal Life’s president. “RPM can be the new way of delivering care. It’s not just pamphlets, but it’s giving the right information to the patient.”

Goldberg is promoting the idea that an assisted living community can create a new service for family members, helping them to be active in care. 

Placing RPM devices in homes before an individual moves to assisted living creates trust in the assisted living provider, Goldberg believes. “RPM provides a level of oversight that will attract residents, and help the community make more money.”