For three months early this year, 63-year-old Ronald Lang was one of the most plugged-in patients in America. Lang, who suffers from congestive heart failure and multiple sclerosis, was pilot-testing the Intel Health Guide, a device that let doctors monitor his health remotely. Each day after he woke up, he'd step on a scale and strap on a blood-pressure cuff that were attached to the Health Guide. The device collected his vitals and zapped them to his doctor's office. From there, nurse Marie DiCola scoured the data, and if she noticed anything amiss, she dialed up Lang and chatted with him over Health Guide's videophone.
Health Guide is at the leading edge of a new technology trend called "aging in place" that's designed to help seniors stay longer where they're most comfortable—at home—rather than having to move into nursing or assisted-living facilities. Aging-in-place equipment is placed in a person's home, monitors symptoms on the spot, and sends reports to doctors and family members in real time. Companies developing these products, just now being deployed by a handful of health plans and home care agencies, believe aging-in-place tech can drastically cut the rate of medical complications that force seniors into hospitals and other intensive-care facilities. That, in turn, could shave millions of dollars a year from U.S. health-care bills—a tantalizing proposition at a time when health reform is at the top of the political agenda.
As 77 million baby boomers race towards their golden years, the world's leading technology innovators are building this new market with a range of futuristic gizmos. There are beds that can monitor patients' vital signs as they sleep, stoves that can turn themselves off when their owners forget, and video games that can detect early signs of dementia. Besides Intel, the aging-in-place market has attracted the likes of General Electric (GE), Philips Electronics, Honeywell, (HON), Bosch, and dozens of technology startups.
The overall market for technology to assist older patients is expected to grow to $20 billion by 2020, according to consultancy Aging in Place Technology Watch.
Health Guide epitomizes the kinds of in-home gear that can reduce the hassle factor for clinicians and patients, especially those dealing with chronic but easy-to-monitor diseases. Heart failure patients, for example, must measure their weight and blood pressure frequently, because changes in either metric can signal the type of trouble that requires emergency intervention. But distinguishing between a minor setback and a serious situation depends on being able to figure out how the patient is feeling.
DiCola was able to assess symptoms both by talking to patients and examining them visually. She downloaded real-time data for as many as 25 patients every day, and spoke to many using Health Guide's videophone. "I could make decisions about treatment," she says. "If they needed to see the doctor, I got them into cardiology right away."
For patients like Lang, who often didn't need to see the doctor, the desktop access to DiCola was comforting. "I used to have to get dressed, go to the doctor's office, wait, and pay my $10—just for them to take my blood pressure," Lang says. "Then the doctor would say: 'Everything is fine. Take your medicine.'" Health Guide let Lang to do all of that from his living room.
Louis Burns, vice-president and general manager of Intel's digital health group, says the company examined the demographics and saw an "overwhelming, undeniable" opportunity. There are not enough nursing homes and assisted-living facilities to house everyone who is going to be facing a chronic disease, he says, and furthermore, the health-care system does not have the resources to pay $2,000 or more per resident per month to institutionalize sick seniors. And most aging people prefer to stay at home, where they are most comfortable. A survey late last year by AARP revealed that nearly 80% of baby boomers expect to stay at home as they age. Technology "could enable institutions to run more efficiently, but also allow them to extend their service into people's homes," Burns says.
Monitoring by Sensors
Intel has enlisted a big ally to help position itself in this burgeoning market. In April, Intel and General Electric announced they would spend $250 million over the next five years to co-develop products that will help seniors manage chronic conditions from home. As part of the deal GE will resell Health Guide. The partnership will also give Intel access to monitoring technology, which could ultimately enhance Health Guide's capabilities. GE markets a product called QuietCare, which uses sensors stationed throughout the home to keep an eye on seniors as they go about their day-to-day lives.
As helpful as aging-in-place tech may be, there's one big question that has yet to be answered: Who's going to pay to put it into seniors' homes? "Right now this is a niche market made up of affluent people who want to monitor their parents," says Scott Lundstrom, vice-president for research at IDC Health Insights. "The technology is going nowhere without a reimbursement model that supports it." Intel and other companies are trying to convince public and private insurers that it's an investment worth making. During a road show to launch Health Guide, Intel referred to a study published by the Veterans Administration late last year. It found that remote patient monitoring decreased hospital visits significantly—for instance, 20% for diabetes patients and 56% for patients with depression. The technology cost $1,600 per patient per year on average, the VA reported, as opposed to $77,745 for nursing home care. "We're quietly working on the issues, trying to get people to understand home is a critical part of care," Burns says.
Intel has pilot tested Health Guide with Aetna (AET) and other insurance companies. Lang, who lives in Cypress, Calif., was part of a test conducted by SCAN Health, a nonprofit health plan in California and Arizona. "It became obvious, as we looked at the growth of the aging population and the number of caregivers we had, that relying on an entirely people-based model would be untenable," says Hank Osowski, senior vice-president for corporate development at SCAN. Osowski isn't ready to commit to any specific systems, but he says remote monitoring will certainly be part of SCAN's model. "We are willing to fund these tools, because at the end of the day it will result in better outcomes."
In 2003, Intel and 400 other technology companies and health-care organizations formed the Center for Aging Services Technologies (CAST), an advocacy group that's fighting to improve the reimbursement outlook for aging-in-place technologies.
As for Lang, he has gone back to his rickety scale, hard-to-use blood pressure cuff, and occasional visits to the doctor that are often unnecessary. "In plain, simple English, the doctor is a very busy man," Lang says. "When I had the Intel equipment, I came to rely on it. I would really like my machine back."
Weintraub is a senior writer for BusinessWeek's Science & Technology department.