Telemedicine, Aging in Place, more milk

by Louis on May 21, 2014

I walked the show floor of the American Telemedicine Association Conference in Baltimore Monday. Lots of ER, operating room and hospital products. A few exercise/wellness products. Lots of talk about connection, integration, systems, clouds, etc. I agree with Elizabeth Patterson from Totier, “More new interesting approaches shining light into the black box”.

My interest is devices, dashboards, software, platforms and cloud solutions for remote patient monitoring that claim to be effective for aging in place in individual homes.  These are important because the ACA, readmissions penalties and so forth indicate increasing expectations for homes to be care delivery sites. As an in home provider (I started offering home modification services over 20 years ago) this was a chance to ask some questions of the sharp minds in the tech sector (or is that silo?).As an advocate for Aging in Place 2.0 I went to see if telemedicine is on board to create the data driven, dynamic flow of resources into homes. My concern is that hospitals and payers have unrealistic expectations from the existing in-home providers. My hope is technology providers who do their homework, find out what really exists, and use their capabilities to build capacity. I am disappointed.

telemed show

Samantha Barnes of Healthspot Station

I got my narrative down to a question that comes from experience not just as a provider, but as a caregiver as well. I suggested the monitoring stuff could be used for tablet based caregiver reporting (what happened today, client’s condition, etc. as well as GPS time card). Not a problem. I suggested the caregiver could be charged with daily tasks like…reporting milk supplies. Not a problem. I secured agreement this could be important for maintaining nutrition – controlling diabetes, for example.  I asked: “How will the report get the milk delivered?” Unanimous response: Not a clue!

The back story. My dad lived in “independent living” near my sister. He had the good habit of checking his milk before he went to bed, coupled with the bad habit of calling my sister if he was too low for breakfast. She got up from what she was doing, went to the store and slammed the milk down on his counter. Unfortunately this was sometimes the “quality time” she got with my dad. Just as bad is an electronic message to some other daughter just as she goes into a meeting on the opposite coast.

We need to build the connections from the report to the delivered milk, not use technology to create another inconvenience or guilt trip for a family caregiver. This one example among many similar disconnect stories is the reality we need telemedicine technologies to solve in homes!  I know it sounds complex but have you used lately? Amazon seems simple but I am sure it is more complex than what I see and similar to what I am asking. McKinsey wrote about the missing value proposition for in home monitoring technologies but no one is listening.

What is behind the curtain of the home and community based services (HCBS) network? Caring business owners and agency heads with old fashioned business models in a severely fragmented market sector. The private pay/out of pocket in home service segment is so fragmented it hardly exists for financial reporting purposes. “How big is it?”, I keep asking. I get shrugs in repy.

Systems integration improvements to this sector will benefit the providers and their workers with more efficient operations and improved economic viability AND improve the customer experience for home dwelling clients AND use medical and financial resources (human and $) more efficiently. This win, win win, matches the triple aim goals. It needs to happen NOW because even tomorrow is starting to look too late!

The vendors at the American Telemedicine conference talk connection, integration, systems, yada yada yada. They collect data but where does it go? They they have blinders on to the daily reality facing families and providers doing long term care in homes. The future of health care is not technology. The future of healthcare is getting individuals the care and services they need in the environment they choose with dignity and respect as cost effectively as possible. Technology will play a significant role but can’t until inventors and entrepreneurs take off the blinders, see how things work in the real world and decide to tackle the problems.  They are missing the need AND the opportunity.


{ 5 comments… read them below or add one }

Kevin Jones May 21, 2014 at 2:35 pm

Hi Louis, our focus is delivering health and activity data to caregivers, so we don’t deliver the milk ourselves, but we believe it will “take a village” of inter-operable technology and service providers since the problem is too big for any one company. We know of some technology companies that help families connect to caregiver resources who can deliver the milk. May I suggest


Rob Wray May 23, 2014 at 10:46 am

Louis: Appreciated the post. I was wandering the exhibits at the ATA conference at the same time you were. My desires were more limited– to find a working technology/integration model just for the health stuff, not the logistics of auto-refill of milks and toilet paper supplies. (I think a conference of PeaPod and grocery stores might provide a better glimpse of that future!) To a large extent, I, like you, was disappointed. The future is indeed coming– just slower than we want it to! (smile)


Kenneth Gelber May 28, 2014 at 4:15 am

Dear Louis

Sorry I missed you at the show. We had a booth which was fairly well visited.

I am writing because of your observation about “entrepreneurial blinders”. While I am new to this industry, I am long in the tooth as a sales/marketing person.

I think you hit the nail on the head. PEOPLE BUY BENEFITS! You can have all the bells and whistles and all the advantages over competition. If the end user (could be doctor or patient) does not perceive a benefit the product or service will fall flat.

My most successful clients get this very clearly. Many times it is the already successful business person and not necessarily the health care pro that laser focuses on what drives success.

While I am based in Israel, where we also manufacture, I am an ex-pat American. I would like to hear your thoughts in greater detail if you have some time and I would be happy to give you a call.Of course if you have any questions, feel free to ask.

Best regards,
Ken Gelber


Jacquie Cook June 22, 2014 at 1:30 am


Your perceptions of the fragmentation of services and support are right on!
I spent four years caring for my then 93 year old aunt 24/7.

Even thought I have a high level of technical competence, I felt quite isolated and challenged to find the resources which both my aunt and I needed.

She has since passed but I am now dedicated to working toward coordination of services, support and information which is so needed by caretakers to provide the dignity and quality of life our older generation requires and deserves.

I, like you, believe in “thinking outside of the box”.

Let me know if I there is a roll for me in your “pursuit of the future” in the care-taking industry.


Gary Weiner August 22, 2016 at 5:40 pm

As we rapidly migrate to use of tablets, smartphones and PC to communicate on 2 way video with our medical service provider, the 2AM panic on who can I call for opinion is solved…for $20 – $45 a call can be made to ask a question….see if I need to visit an Emergency Room.


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