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Wherefore, wearables?

September 17, 2017
by David Raths
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Wearable health technology is all the buzz in the consumer market with tools such as Fitbit and Apple Watch. Acute care settings are using wearables to reduce inpatient costs and monitor patients from home. In senior care settings, however, wearables have so far seen use primarily as security devices such as electronic ID bracelets and wander management devices or alert pendants/bracelets. Now some startup companies are aiming straight for the senior demographic, developing lightweight sensors with an eye on monitoring everything from vital signs to sleep patterns and gait.

Wearable technology is definitely moving beyond the consumer market and into clinical settings. A recent report by the Consumer Technology Association predicts the United States could reach a “critical mass” of physicians using patient-generated data from devices such as wearables by 2020. A white paper from CDW Healthcare noted that 17 percent of Americans over age 65 use wearables to monitor vital signs and track fitness, not far below the 20 percent of Americans under age 65. The report also noted that seniors’ adoption of wearables is increasing more than five times faster than that of the general population.

The rate of adoption of technologies such as wearables depends on the business model of the care organization, notes Laurie Orlov, the founder of Aging in Place Technology Watch, a market research firm focused on technologies and services that enable boomers and seniors to remain longer in their home of choice.For instance, skilled nursing facilities might be interested in adopting a technology if it keeps a person from having to return to a more expensive form of care at the hospital,” she says.

Here are brief profiles of six wearable technology solutions already in use or with potential for the senior care market.

EarlySense Inc.

Founded in Israel with U.S. headquarters in Waltham, Massachusetts, EarlySense Inc. developed a contact-free bed sensor and advanced algorithms to monitor and analyze cardiac, respiratory, sleep and motion parameters. Although its solution was initially designed for the hospital setting, last year the company launched a product called InSight for use in rehabilitation and skilled nursing facilities.

Tim O’Malley, president of EarlySense, calls InSight a simplified and lower-priced version of their hospital product. “When we would introduce our hospital-based product, which is a traditional-looking patient monitor, into skilled nursing and rehab facilities, we would hear that it looks and feels too much like a hospital product.” he says. “Their needs are different. They wanted a simpler interface without losing the capabilities.” InSight shrinks the monitor to the footprint of a smartphone, but with two or three times the depth. Providers plug it into the wall, and have the same processing and communication capability as they would with the hospital device.

The company notes that in clinical studies, EarlySense’s solution has been shown to assist clinicians in early detection of patient deterioration and in identifying and preventing potential adverse events such as patient falls and pressure ulcers.

“The gap you see with a lot of wearables is that they don’t have the clinical utility,” O’Malley says. “They don’t have the accuracy. If you have a sick patient, a wearable has to be able to cover the spectrum of heart and respiratory rates, and many wearables don’t have the level of accuracy built in. We come from the medical world and are moving out from there into the skilled nursing and rehab space. Eventually we are going to be offering the same types of thing in the home.”

Leaf Healthcare

When Barrett Larson, MD, was in medical school and helping with rounds in the hospital, he was shocked by how much damage pressure ulcers caused. “Here we were with all this 21st century technology around us but someone could still suffer from something like this,” he recalls. “It seemed absolutely tragic. It really stuck with me. I felt compelled to do something about it.”

In 2010 Larson co-founded Pleasanton, California-based Leaf Healthcare, which includes a wearable, wireless, disposable sensor that providers apply to a resident’s skin like they would an EKG electrode. It is waterproof and lasts three weeks. It turns on and automatically detects that it is attached to a person and starts analyzing their movement and activity. “Under the hood, it is doing computation and analysis and sending a simple mobility report to the nurse,” Larson explains. The first application has been for personalized pressure injury prevention—analyzing which residents need to be turned, how often they need to be turned, and by how much. “It helps deliver ‘prescription-strength’ mobility,” he adds, meaning just the right dose of mobility for that patient. “Based on a patient’s risk profile, it can dial in a specific turning protocol. That way, patients can be turned as often as necessary but not more often than necessary, so you can work smarter, not harder.”

Although Leaf’s initial target market was acute care hospitals, Larson acknowledges there is a huge need in nursing homes. “Nursing homes are littered with pressure ulcers,” he says. “We have started to go after that market.” Leaf is currently taking part in a National Institutes of Health-sponsored research project involving nine nursing homes.