Telehealth: The future of senior living

My father-in-law, who has early onset dementia, recently fell three times over a six-week period. During one of the episodes, he was not found until 24 hours later. He was admitted to the hospital for a week because of a pressure injury he developed from being on the ground for so long. He now wears a telehealth device that provides him with 24/7 monitoring and uses a medication reminder system that alerts caregivers if he does not take his medications.

In many ways, advancements in technology, particularly those made to products and services in the consumer marketplace, have shifted what our seniors expect from the world around them. Accessibility, ease of use and general enhancements to quality of life are among the most obvious expectations seniors have. However, technology has offered senior living residents and their families another expectation—independence. Yet, some forms of technology, like remote monitoring devices that track a residents’ locations and activities, can be perceived as invasive.

According to a report by Grand View Research Inc., the U.S. telehealth market is expected to reach $2.8 billion by 2022—and for good reason. Telehealth offers the healthcare industry many cost saving and efficiency-boosting solutions. This is particularly relevant to providers across the care continuum as they prepare to accommodate the baby boomer population better. Despite the clear clinical, financial and operational benefits, many barriers limit telehealth’s emergence into the senior living industry.

In particular, there is an increasing demand for an expanded workforce of trained and compassionate professionals. The senior living industry will need to recruit 1.2 million new employees by 2025, according to analysis of data from the Bureau of Labor Statistics.  No small feat. Yet, questions arise on how exactly this expanded workforce will adequately meet the modern expectations of tomorrow’s senior living residents.

For many care providers, clinicians and family members, the benefits of telehealth solutions such as remote monitoring devices are obvious. By incorporating a device that can track everything from residents’ blood pressure and weight to geographic location and physical activity levels – one may argue that independence is enhanced since they could spend more time doing the things they want and less time at diagnostic check-ins and follow-up appointments. Some devices also offer fall monitoring technology with two-way communication to a 24/7 support center – further safeguarding seniors’ claims to independence.

There are grand scale benefits to this technology as well. Industry estimates found more than 25 percent of annual hospital admissions for senior living residents may be prevented through telehealth technology. For example, a study investigating telehealth’s impact on reducing readmissions in home care programs across New York state found a total savings of $1.2 million in averted expenses with sweeping reductions to 30-day readmission rates.

Still, some feel that telehealth devices infringe on residents’ privacy. Balancing the desires of family members who wants 24/7 monitoring of their loved one with the needs of residents and staff members is a serious challenge for providers. Creating and maintaining privacy and dignity for residents is critical to the success of the telehealth industry and will require consistent vigilance. Wendy A. Rogers is a psychology professor at Georgia Tech studies such systems and seniors’ reactions to them. She says it all comes down to a sense of control. If residents can “control who has access to information and the information they have access to—they are quite positive about the idea.”

Privacy concerns aside, access to telehealth is still largely dependent on the socio-economic status of senior living residents. A recent study, published in the journal Telemedicine and e-Health, examined the use of telehealth in senior living communities across the United States. Researchers found more senior residents used telehealth platforms to interact with their physicians in care communities where technology, literacy and engagement were higher. This is an unfortunate reality particularly because the benefits of telehealth, including better access to support and advice from physicians and improvements to health literacy and self-management, would have the greatest impact on those who reside in lower socio-economic communities.

Access to telehealth in senior living may be further compromised by the Trump Administration’s proposed cuts to Medicaid. Broad cuts to health and social welfare programs, including Medicaid, target a number of programs that are particularly important to telehealth, according to an article by CTEL News. While it is yet to be determined how exactly all this will play out, it’s important to consider that 24 states currently reimburse for remote patient monitoring devices in Medicaid fee-for-service in some form. The Center for Connected Health Policy’s report concludes that, “While many states are beginning to expand telehealth reimbursement, others continue to restrict and place limitations on telehealth delivered services.”

No matter where you stand on the topic of telehealth, it’s only a matter of time until it becomes a staple of our healthcare delivery system. As providers continue to be held accountable for care delivered within and outside their four walls, it’s difficult to look past the value telehealth solutions bring to the table. The only question left to ask is “When?”

Shawn Scott is senior vice president of corporate sales at Medline where he has developed several programs and partnerships to help long-term care facilities perform at their best, including abaqis with Providigm. Scott is active on the boards and committees of several organizations, including the National Center for Assisted Living (NCAL), American Health Care Association (AHCA), Advancing Excellence in Long Term Care and Senior Living Executive Council. He can be reached at sscott@medline.com.