Senior service providers retool business model with eldercare technologies

Why be a fish swimming upstream?

Keith Perry, CEO of Sears Methodist Retirement Services of Texas, didn't want to be that fish.

Because approximately 90 percent of seniors want to remain in their home, Perry questioned the merits of increasing the number of retirement centers, which cost about $55 million each.

"Maybe I have this all wrong," Perry recounted during a panel discussion on how senior-service providers are changing their business models. The panel, which met on Monday, was part of the fourth annual Healthcare Unbound conference under way this week in San Francisco.

And, so, 18 months ago, Sears Methodist Retirement Services developed its Senior Safe@Home program, an experimental project that features an open-architecture software component to allow a single dial-up connection to handle both data flow and voice calls--even if the voice portion involves party lines in rural Texas communities. The goal is to support seniors, even those who live 150 miles away from the nearest doctor.

And while all participants in the program receive round-the-clock phone access to a nurse, each senior's home is equipped with technology and monitoring equipment appropriate to his or her needs.

"We're a service company and look at technology to deliver the appropriate level of service," Perry said.

Sears Methodist Retirement Services also uses data mining to red flag abnormalities in seniors' behavior and medical condition. Perry says it's too early to tell if the program is a success, but the company does hope to expand the concept to 14 states this fall.

Other members on the panel noted their efforts to retool their operations. Sandra Elliott, director of consumer technology and service development for Meridian Health, said her organization decided to seek high-profit-margin business by providing data-rich services that consumers would be willing to pay for, rather than develop a low-margin business that would be covered by third-party payers--insurance companies and government agencies. As a result, Meridian has identified technology providers in each of its categories based on seniors' needs.

But Elliott cautioned that while Meridian's goal "is to put consumer technology in the hands of the consumer as soon as possible... buying behavior is very important to understand before you launch these solutions--understanding their needs, how they buy, the right products, the right time for them to buy. Unfortunately, the right time to buy is the moment of crisis...if we don't have the right solution for them when they are ready to buy, it's not going to work."

She also observed that the move to supply a continuous stream of health data to a senior's doctor, who would be responsible for translating it into meaningful information and acting upon it, would be a significant shift from the current custom of delivering snapshot-in-time data.

Doctors are not the only ones to make adjustments. Nurses are also undergoing adjustments at the Visiting Nurse Service of New York, said Michael Monson, vice president of performance improvement at the VNSNY, which plays the dual role of care provider and payer for such services.

The organization began a pilot program two years ago that entailed putting 500 monitors in various patients' homes and managed care facilities. The nurses were retrained to visit patients only when the data revealed a problem, rather than basing visits on a fixed schedule. The program had the effect, in some cases, of also reducing nurses' income, since they were being paid on a per-visit basis. Monson said they are working on retooling the payment methods to reflect the time a nurse spends to monitor a patient from afar.

"What really matters in this type of program is nurse acceptance of the technology...if you don't have the nurses buy into the program, it will be an uphill battle," Monson said.

He noted, however, the pilot has, in most cases, dramatically reduced the number of hospital visits the pilot participants have had to make.