Mature Market Experts Gem of The Day: Serving Aging Populations with Remote Monitoring Technologies

42-17073549 telehealth mature market experts

Mature Market Experts: more mature market news and stats more often – Serving Aging Populations with Remote Monitoring Technologies – Estimates by the U.S. Census Bureau expect the population of Americans aged 65 and older to increase by more than a factor of two between 2010 and 2050 [1]. At the same time estimates of healthcare expenditure increases between 2007 and 2017 show an increase to nearly 20% of GDP in this period [2]. These estimates were made prior to the recent financial crisis that began during the Fall of 2008. Further compounding this increasing demand and the concomitant increase in costs is the availability of allied healthcare professionals. Some studies [3] identify the likely decrease in the number of physicians entering any number of key specialty areas, including cardiology (20% decrease by 2020), geriatrics (35% of current demand met today), rheumatology (38 day average wait for a new appointment), and primary care (on the verge of collapse). Those of us who are baby boomers are on the leading edge of this demand and, in order to mitigate and minimize the cost impacts on our children, it is our challenge and responsibility to innovate and meet these challenges without passing along unnecessary burdens to our children and grandchildren.

For most of us, aging means more frequent and severe afflictions. Taking care of our health by improving diet, exercising, and maintaining an otherwise active lifestyle is essential to ensure a high quality life. Even with increased vigilance chronic ailments can affect us later in life, brought on both by our genetics and consequentially due to the lifestyles we’ve led in our youths. Ailments such as dementia, coronary artery disease, Alzheimer’s, myocardial infarction, congestive heart failure, macular degeneration, osteoporosis, hypertension, chronic obstructive pulmonary disease, diabetes, and others take their toll. Managing chronic diseases is costly from a logistical perspective in terms of time and money. However, even more to the point, effective and quality oversight of patients with chronic ailments requires regular review, screening, and monitoring of patients. This is further complicated by the need to serve patients who lack the means or are physically incapable of leaving their homes for extended periods. Telehealth and remote monitoring are a means by which a case manager—an individual assigned to oversee the care of chronically ill patients within a home-health setting—can review patient information on a regular basis (for example, daily) and support both the patient and the primary care provider. Furthermore, Intensive care units and emergency departments are becoming more crowded. Individuals with insurance are going to EDs because they cannot find satisfaction in terms of prompt scheduling with their gatekeepers (family practitioners). The quantity of individuals with chronic ailments is on the rise (stroke, CHF, diabetes, COPD, etc.) This is in part due to the fact that people are living longer. At the same time the Medicare and SS systems will not be able to sustain the growth in population over age 65. This means that working individuals will increasingly bear the financial burden for us “boomers.” As a result of increased longevity and the fiscal challenges, the retirement age will increase.

So, what do we do? Well, several things: first, technology in the form of remote data collection, reporting devices and software will become more prevalent: glucometers, BP cuffs, spirometers and associated software will be more readily available for direct communication with personalized electronic health records. If the purpose of a typical visit is to take BP and diabetic assessments, this can be handled most by collecting data at the point of care (home) and transmitting to the physician’s office for assessment. Such also applies to nursing and assisted living facilities. Next, the technical infrastructure required to transmit and store these data will be required. Paying for this infrastructure could come from a number of sources. One possibility: most everyone nowadays has access to cable television. Cable companies could offer devices that integrate with existing modems to collect and transmit data to the FP, together with complementary emails to next of kin (e.g. “Your mother’s BP as of 8:10 this morning was 145/89”). Other technologies that can be used to evaluate and monitor chronic ailments such as macular degeneration can further reduce costs by providing video cameras at point of care whereby ophthalmologists can review retinal changes without requiring an elderly individual to be transported at expense and time to a hospital or office. In addition, support for remote consults via VoIP and video can be supported over the same network. This empowers the remote provider with the ability to interact with the patient All of these technologies are in use in remote pockets around the world today. But, they will become more prevalent. These technology implementations will reduce costs and provide for more personalized care in comfortable settings (homes). Of course, nothing takes the place of the tactile hands-on. But, for routine visits the above will be invaluable. In terms of the software technologies, personalized medicine will become the norm (eventually). Telehealth will be key. But, also, support for automated workflow in the acute care environment will need to be augmented. This means fully integrating all data into the enterprise HIS.

 The U.S. Department of Health and Human Services through its Office of the National Coordinator for Health Information Technology published operational scenarios focused on providing key information to assist in harmonizing standards on the implementation, certification, and policy implications for robust remote patient monitoring [4]. Included in this assessment are requirements on interacting with personalized health records and enterprise health information systems. The approaches to advancing remote monitoring include both seamless communication from medical devices at the point of care (i.e., in a patient’s home setting) and with a case manager and primary care provider both through electronic transfer, storage, and display of health information and remote video and audio interaction with patients in the same home health setting.

 Technology is not the silver bullet, but those described above are key enablers for remote health monitoring. Of course, the use of technology carries with it the implication that sufficient underlying infrastructure exists. This is not always the case in remote areas of the country. Satellite, cable, and fiber optic technologies are fairly extensive within the continental United States, but pockets and regions exist in which this is not the case. Therefore, a combined effort to extend the communications infrastructure must continue together with a unified effort to standardize and train and “in-service” individual care providers on these technologies must occur. One of the best mechanisms for enabling this is through the local hospitals and their satellite clinics.

[1] Source: Population Division, U.S. Census Bureau, August 14th, 2008; Table 12: “Projections of the population by Age and Sex for the United States: 2010 to 2050 (NP2008-T12)”

[2] Cinda Becker, “Slow: Budget Danger Ahead,” Modern Healthcare, March 3rd 2008.

[3] “Recent Studies and Reports on Physician Shortages in the U.S.,” Center for Workforce Studies, Association of American Medical Colleges, August 2007.

[4] “Remote Monitoring Detailed Use Case,” U.S. Department of Health and Human Services, Office of the National Coordinator for Health Information Technology, March 21st, 2008.

So, how long do we have? Well, the sooner the better. Successful telehealth and remote monitoring programs exist throughout the United States and worldwide today. We should ensure that our elected representatives direct healthcare expenditures towards several specific areas to promote growth and alignment to meet the objectives of remote monitoring. These include continuing alignment on electronic personalized health records, expansion of our underlying communications infrastructure, and promoting common standards of communication among these records so that, regardless of location, a patient can communicate his or her information to any physician and allied health professional within the country. In summary: common storage, homogeneous communication, standardized formats.




Mature Market Experts Gem of The Day: Martha Stewart and KB Homes Team Up For First Retirement Community

martha_stewart mature market experts

Mature Market Experts: more mature market news and stats more often: KB Homes and Martha Stewart team up on active 55 retirement community – Martha Stewart and the mature market? KB Homes and Martha Stewart have teamed up for their first active 55 retirement community. According the KB website, the new retirement community is coming soon to La Quinta, CA, and is inspired by classic California Spanish style architecture. Martha has a huge fan base and heads up a powerful media company, so there are obvious opportunities to spread the word for KB Homes. If you visit the KB site, you’ll see one of Martha’s video cut-ins.

Martha seems to be taking a real interest in the Baby Boomer / mature market space . . . she opened the Martha Stewart Center for Living at Mount Sinai Medical Center in October 2007.

Martha Stewart and her mom at the Martha Stewart Center for Living Grand Opening.

Martha Stewart and her mom at the Martha Stewart Center for Living Grand Opening.

Martha Stewart also headlined a Senate Aging Subcommittee hearing in April of 2008 designed to push for the expansion of recruitment and training of Senate Aging Subcommittee to meet the needs of the 78 million mature market members about to join the Medicare ranks, as well as provide assistance to the 44 million Americans serving as caregivers.


As someone who has helped sell A LOT of retirement community real estate, I can tell you that peer to peer testimonials, unstaged and unscripted is one of the most powerful tools you can use. While I was at Erickson heading up the advertising, we never used models or stock photography. Why? Because I believe Boomers / the mature market have an incredibly refined  B.S. detector.

Mature Market Tip: Start Saving Now – Assisted Living Crunch Predicted

<MED2097 Mature Market Experts

The mature market . . .  boomers . . . seniors, we write about them every day. Why? Because Americans are getting older – in fact, way older. We are on our way to a profound shift in our population; one which will have costly impacts on our nation. The U.S. Census Bureau projects  that by 2030, when all of the nation’s 76 million surviving baby boomers will be 65 and older, nearly one in five U.S. residents will be 65 and older. This age group is projected to double by 2050, increasing to 88.5 million from the 38.7 million we currently have in 2008. The Census Bureau projects that the 85 and older population growth will be even bigger, tripling from 5.4 million in 2008 to 19 million in 2050.

On the one hand it is pretty clear that there will soon be a lot of older Americans. So the next question is, how many of them will require assistance, and what type? Lest you think the impact will be small, consider this comment from the Dartmouth geriatrician, Dr. Dennis McCullough: “…nine out of ten people who live into their 80’s will wind up unable to take care of themselves, either because of frailty or dementia.” According to Dr. McCullough, “Everyone thinks they will be the lucky one, but we can’t go along with that myth.”

The International Longevity Center’s Caregiving Project for Older Americans is very concerned that older Americans are not doing enough planning now. The Center estimates that about 1.4 million older Americans currently live in nursing homes, nearly 6 million receive care at home, and significant numbers go completely without needed help. They report that “…the growing disparity between the demand and supply of care giving services will only worsen with the aging of baby boomers in this country.”

The National Clearinghouse for Long-Term Care Information says that “…at least 70 percent of people over age 65 will require some long-term care services at some point in their lives, and over 40 percent will need care in a nursing home for some period of time.”The Clearinghouse cautions that contrary to most people’s opinions, “Medicare and private health insurance programs do not pay for the majority of long-term care services that most people need – help with personal care such as dressing or using the bathroom independently.”

It doesn’t take much imagination to figure out that the coming demographic tsunami will overwhelm our assisted living, independent living, home care, and nursing homes infrastructures. Currently most assisted living facilities in this country report occupancy rates at 90% or higher. The New York Times reported recently that after several years of overbuilding followed by soft markets, “The National Investment Center found fewer than 23,000 units under construction in the 100 biggest metropolitan areas.” If you take an arbitrary average about 1.5 persons per unit, our future residential shortfall looks to be severe.

In another New York Times article Kathryn A. Sweeney, a managing director for United States Senior Housing for GPT Group, an Australian real estate company, was quoted in a similar vein about the eventual housing shortage: “If you plan to be a resident, you need to be saving your pennies now,” she said.”

About the Author: John Brady is publisher of  Visitors to that site will find a directory of eldercare facilities, a Forum, and helpful articles on dealing with eldercare.

Joppel Solves Medicare Confusion

For any of you who’ve been challenged by the intricacies of Medicare, supplemental coverage and drug coverage, you’ll be glad to know there’s finally a solution.

Joppel is a free service created by a team with over 65 years of experience in healthcare to assist seniors and their caregivers navigate the difficult task of choosing appropriate health insurance. According to John Hobson, president of Joppel, “We wanted to create easy to use, consumer-friendly tools that provide transparency of information and allow the consumer to compare all plans side by side.”

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Mature Market Experts Stat of The Day:Medicare Selects Four Companies Where Beneficiaries Can Maintain Their Own PE Health Records

Mature Market Experts Stat of The Day: The Centers for Medicare & Medicaid Services (CMS) today announced the selection of four personal health record (PHR) companies to participate in the new Medicare PHR Choice Pilot in Arizona and Utah.


This pilot program will, beginning in early 2009, offer beneficiaries with Original Medicare the opportunity to choose one of the selected PHR companies to maintain their health record information electronically.


The four selected companies are Google Health, HealthTrio,, and PassportMD.  These choices offer beneficiaries a range of product choices from ones that are free to ones that have “concierge” service as well as a diverse set of connections to health care providers, pharmacies, and other sources of health information.


“This pilot is a major step forward for Medicare.  It will provide information and tools that will empower consumers to manage their health better,” said HHS Secretary Mike Leavitt.  “Importantly, the pilot provides beneficiaries with a choice of products to meet their individual needs.”


PHRs are tools that can help consumers manage their health and health care services.  A PHR is a record of health information that is under the control of the consumer or patient.   Sometimes it only contains data entered by the individual or his or her provider, but it can also include information from a health plan – as is the case in this pilot, where Medicare will provide health information from its claims database.


A PHR, which is controlled by the consumer, is different than an electronic health record (EHR), which is owned by and under the control of the physician.  A PHR may only contain data entered by the consumer or his or her health care provider.


Through this pilot beneficiaries who select one of the participating PHR vendors can add other personal health information if they choose.  Medicare will also transfer up to two years of the beneficiary’s claims data into the individual’s PHR, if the beneficiary requests it.


Depending on the specific product, beneficiaries may be able to authorize links to other personal electronic information such as pharmacy data. PHRs also may offer links to tools that help consumers manage their health such as wellness programs for tracking diet and exercise, information about drugs and medical devices, health education information, and applications to detect potential medication interactions.  Beneficiaries can elect to allow family members, health care providers, or whomever they choose to have access to their PHR.  This can allow caregivers to help manage loved ones health or be critical to a physician caring for you in an emergency.


Each company has privacy and security standards to protect the information transmitted and stored in their PHR records.  More information on the specific security and privacy policies of each of the participating companies can be found on their websites.


CMS’ contractor, Noridian Administrative Services (NAS), led the intensely competitive selection process.


“At Medicare, we strive to find innovative ways to better serve our beneficiaries,” said CMS Acting Administrator Kerry Weems.  “We encourage beneficiaries to consider whether a PHR is right for them.  We plan to evaluate beneficiaries’ satisfaction, issues or concerns about PHRs, and whether PHRs seem to improve the health and associated costs for caring for beneficiaries as part of this pilot.”


More information about the selected companies may be found at these web links:


For Immediate Release:

Wednesday, November 12, 2008


CMS Office of Public Affairs

Mature Market Experts Stat of The Day: Hip and Knee Replacements

Is the mature market more physically active than the last generation? Yes. In fact, this December when I speak at the 6th Annual International Council on Active Aging Conference one of the topics I’ll be covering is the booming mature market enrollment rates at health clubs. Not everyone is a aspiring 73-year old college basketball player but today’s senior understands that the key to being healthy is being active.

One of the results of this trend is skyrocketing numbers of boomers and matures getting hip and knee replacements:

“Not so long ago, hip and knee replacements were seen as being for those age 65 and younger. But advances in materials, types of procedures, even anesthesia, are making it more likely for surgeons to accept patients age 80-plus. The result? From 1997 to 2005, the number of knee surgeries rose from 328,800 procedures to 555,800 procedures, and hip replacements increased from 290,700 to 383,500 procedures.”

Source: The Erickson Tribune

Also, see this video from Nightly News on the effects this new trend is having on Medicare.

Mature Market Experts Stat of The Day: How To Save 237,420 Medicare Patients

Mature Market Experts stat of the day: “If all hospitals performed as well as 5-star facilities, as ranked by an independent healthcare ratings company, 237,420 U.S. Medicare patient deaths could have been prevented between 2005 and 2007. That’s the upshot of a new study that finds you have a 70 percent lower chance of dying at a facility that is top-ranked by HealthGrades compared to its lowest-ranked ones across 17 procedures and conditions that were the reasons for the hospital visits.”

More than half of the Medicare patient deaths were associated with four conditions: sepsis (a systemic response to infection), pneumonia, heart failure and respiratory failure. Researchers have long documented how hospitals can kill you. Blame is placed on everything from exhausted doctors and staff to antibiotic-resistant microbes.”


Related reading: Death rate 70 percent lower at top hospitals