As technology continues to transform the healthcare industry, Electronic Caregiver stands out as a leader in the connected health space. Their innovative solutions blend cutting-edge technology with personalized care, empowering patients to take control of their health and wellbeing. Ahead of Connected Health Summit's in-person sessions, Anthony Dohrmann, Founder and CEO, ECG - Electronic Caregiver, dives into Electronic Caregiver's approach to connected health and explore how their solutions are making a difference in the lives of patients and caregivers alike.
How have business models for at-home health and care changed and evolved over the past few years?
Use of TeleCare and connected care solutions in both private pay and through reimbursed offerings are filling the gaps between visits for home care providers and improving care management for providers. Connected Care at home improves treatment adherence, enabling early identification of how patients are responding to treatment, alerting caregiver and providers to changes in health status, and expediting faster, earlier, more informed interventions. Upgrading care to a level of continuous oversight in the home is the support that carers, providers, older adults and payers need to improve outcomes, optimize coordination, and to reduce liabilities and gaps in data between visits to the physician.
What is the current state of the at-home health devices and services market, in each of the verticals you serve?
The home care industry is still typically slow to adopt connected care services. They are focused on competing for the limited number of customers who can afford hourly in-person services. Home care professionals are service-based professionals, not sales-based professionals. They deal with human contact, not connected technology outside of business scheduling, billing and management tools. A transition is coming, and home care providers will have to step up. Advocate Aurora not only purchased MobileHelp and subsidiary Clear Arch, but they also purchased Senior Helpers. United Health Care Group acquired Optum, then Vivify, followed by Louisiana Home Care. 96% of Americans cannot afford even part time care where 20 hours a week can average 24,000 a year. No operator should feel comfortable denying service to 96% of inquiring prospect with no alternative solution to recommend. There is an estimated 35%-40% more market share who will adopt connected services with remote care support, who cannot afford live care. Home Care providers should adopt Connected Care and TeleCare services now to avoid being left behind. Integrating even the most basic services for emergency response and support to care management should be added at a minimum, to existing clients. The cost added to 80 hours of monthly service is negligible and an easy value-add to sell. The benefits are far reaching. Home Care providers compete for a small market segment and that makes retention an important key performance indicator. Adding emergency response and remote care management between live visits helps ensure caregivers have a client to come back to.
Providers are limited on time and hostage to tight staffing and strict workflows. During the Covid-19 pandemic doctors and care teams experienced the wider capabilities of TeleCare and Remote Patient monitoring. We’ve seen increasing adoption, increasing satisfaction from patients, and patients themselves remarking Connected Care services make self-care and adherence easier, and less stressful. The challenge of in-home technology deployment, monitoring, patient support, and meeting Medicare requirements for usage and remote care service delivery, is there are too many moving parts for most providers. Providers who attempt to purchase, disburse and service technology themselves may succeed with a few dozen patients, but they’ll never deliver the fuller benefits, or receive the data insights, from the broader patient population at scale. For that, they need a managed solution like Electronic Caregiver. Providers make no investment, receive seamless, customized support to suit their patient demographics, disease profiles, workflows and staffing, and experience the full and positive potential Connected Care is capable of.
Has demand for more preventative and predictive approaches to care changed? Or is the market for this more or less the same as it was a few years ago?
The Covid Pandemic drove TeleCare and Connected Care adoption to unprecedented levels. These solutions involved not merely the typical video chats with a doctor, but added continuous patient monitoring and oversight which has improved care coordination and outcomes. As the results continue to emerge, I don’t see any going back to pre-covid health service models. The level of acquisition activity of TeleCare, RPM, PERs and Home Care, ranging from United Healthcare to Advocate Aurora, provides clear insights toward how the market is trending. These companies are acquiring in-home technology, patient monitoring and home care service organizations to fully integrate seamless technology augmented service offerings. With 33% of providers at or past retirement age, and 96% or more of the population unable to afford in-home live care, combined with a high demand aging population currently doubling in overall number, the ability to extend capable, affordable services to more people is the only path forward. Technology on its own cannot deliver the level of care on its own, but technology integrated with expertly trained and managed intermediary TeleCare infrastructure, can. Family caregivers and medical providers cannot do all the heavy lifting themselves, and they can’t be there all the time, observing all the details required to capture actionable and often critical data. With TeleCare and in-home technology everybody wins.
Delivering care at home is of course a pretty different model compared to what we’ve done in the past. What are some of the challenges that come with delivering care at home?
The biggest challenge for older adults, chronically ill patients and family caregivers is access to affordable home care solutions. Reimbursed medical based home health is typically offered for only short-term durations. Private duty home care hourly rates average $20 to $30 per hour. Home care providers can’t seem to make effective deployment of caregivers financially effective in less than four-hour service deployments. Wage pressures push expenses up and competition leads to thin operating margins. To make it worse, part time caregiving averaging 80 hours per month is unaffordable to 96% of the market. By implementing technology-based business models home care providers can serve larger customer segments where demand for affordable support is high. Home Care providers need to diversify their skills and offerings, embrace technology to fill the gaps, and embark on a more holistic approach to serving much larger market opportunities.
What are some of the new ways consumers are monitoring their health at home?
Traditionally, step counting, physical activity support, and calorie counting are common among consumers. Much of it is fitness-based although medication reminders and telehealth visits with doctors, especially physician-on-demand services like Teladoc, have brought a level of convenience and efficiency to care management and managing illnesses. Some of the missteps we see are lack of consumer awareness and the frequent limitations associated with older adults, the disabled and the chronically ill. If a patient, for instance, has declining hearing or vision, or mental health challenges, is medicated, forgetful, copes with chronic pain or arthritis, then putting apps on small smart watches and mobile devices is not the best engagement solution. It’s bad judgement on the part of developers. Their “customer” can’t and won’t use it, especially for an extended period of time. We all need to take more patient-centric approaches to human-centered design practices. Our solutions need to deliver more utility and versatility than ever before, while being more elegant and simplistic as it relates to user interface. Even a technology suitable for a 35-year-old who will likely have a smart phone at age 85, will still suffer setbacks and impairments to dexterity, agility, hearing, vision, memory and cognition. Developers might take note that the technology that well services the older adult, might just be more preferred by those that are younger. Humanity enjoys working less and benefiting more. The right technology for the aging can deliver that experience for those in earlier years.
New sensors and new computing paradigms – 5G, edge computing, AI - are enabling new types of services to be deployed into consumers’ homes. For example, audio and video analytics for medical use cases, wireless fall detection while in the home, etc. Can you talk about the new features that define the innovative edge of connected health devices? What technologies do you think will have the biggest near-term impact on connected health applications in the home?
Incorporating cutting-edge technology is a blessing and a curse. Human-centered, highly engaging design requires a high need for expansive utility, but in a simplistic and elegant form factor. The simpler for the consumer or patient, the more complex the back end usually is. For security and privacy concerns, placing more function on the computing edge is preferred to limit open connectivity for the cloud, especially when using voice technology. Technology like facial recognition can be useful for how and when protected health information is displayed, which requires visual sensing and analytics. Once visual analytics is introduced, you add the capability to observe activity, sentiment, movement, gait and balance and even verification of medication consumption and response. Trends and AI predictive modeling can be trained if frequently engaged. Voice coupled with touch screen operation will accommodate more users and preferences. APIs, NFC, Bluetooth and RF capabilities mean solutions can be integrated with home automation, emergency response, wearable devices, CGM devices, all interoperable with health network automation. For the Addison Care system by Electronic Caregiver, we incorporated edge, cloud, voice, touch, mixed reality, RF, Bluetooth, visual sensing, TeleCare integration, physician-on-demand, fleet management, care plan management, and a wide variety of culture and personalization features. It’s not for the faint of heart. Silicon Valley said it was impossible and the attempt would cost $400m-$500M. It wasn’t impossible; Addison, the Virtual Caregiver, is in homes, but the process took 10 years and over $110M to perfect. It involved interactions with thousands of patients and older adults, and hundreds of varied providers. This level of R&D requires patients, a lot of pivots, tremendous time investments, unwavering focus with a lot of capital.
What technologies do you think will have the biggest near-term impact on connected health applications in the home?
There’s no question that form factor, simplicity and human-centered interfaces can make or break customer and patient engagement, and retention rates. You can promise all the benefits in the world for the customer, but if they can’t or won’t use the technology nobody benefits at all. I believe how we interface, education, capture information and response from users is the master key to transforming care at home. There are a reported 300,000 health applications on mobile devices and most receive minimal use at the start, and dwindling engagement over time. I believe we’ve demonstrated the future with Addison Care. I believe a dynamic, personalized 3D interface using both touch and voice will be the centerpiece of any home technology, appliance, robotic device or TeleCare solution. I believe interfaces need to adapt to form unique bonds with a variety of users and preferences, including but not limited to style, gender, language, ethnicity, and should be able to root a relationship between human and technology by mirroring and sharing certain experiences. When we talk about aging, diminishing function, the emotional impact of a troubling diagnosis, mental health or pain, the technology should be able to assist with psychological and emotional stimulation and influence. There are times a patient needs to feel motivated, times they need to be calmed, times they need to be encouraged, times they need to be distracted. For in-home care the interface should have the power to stimulate a dopamine, oxytocin, endorphin or serotonin response. The combinations of features and effects to achieve this goal requires a diverse team ranging across technology to cognitive psychologists, an abundance of creativity, and integrating technologies into a form factor in a way that’s never been done before. To see it, simply experience an Addison Care system by Electronic Caregiver, Inc.
What is the most valuable contribution wearables can make to the health space?
Wearables offer a wide array of data collection benefits including general vitals and health tracking, activity levels, sleep patterns, and fall detection. I believe the use of wearables can be limited. Once we go to wearables, we now have to concern ourselves with certain realities that impair reliable or lasting use. Ideally, we would capture data continuously without users having to add, suit up in or apply remote sensors. Once we have to worry about what users are wearing, whether it’s applied right, whether it’s powered or recharged, whether it’s comfortable or might create pressure ulcers, whether it’s been remembered, we introduce points of failure. In the area of users medicated or aging, the more things they have to remember, fidget with, adapt to, recharge or which may limit their options, it’s common to see apprehension, refusal or discontinuance of use. The more we data and observation we can experience through passive sensing, especially in during the activities of unimpaired, undisrupted daily living, the better results we’ll get, along with increases user satisfaction. In some areas, such as continued glucose monitoring or more complex heart monitoring, the wearable is currently the most advanced solution. In the case of CGM devices, the tradeoff over daily finger pricks is the more comfortable alternative to the norm. I like some of the health monitoring devices placed in comfortable patches. The more we can do to make it easy, and the more support we can provide for those who may need to remember, the better the outcomes we’ll experience through wearable implementations.