Elder Care by Remote - BusinessWeek

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By Arlene Weintraub

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 (INTC) Health Guide, a device that lets 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 was attached to the Health Guide. The device collected his vital signs and zapped them to his doctor's office. From there, Nurse Marie DiCola scoured the data, and if she noticed anything amiss, she dialed 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," 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 installed in a person's home, monitors symptoms on the spot, and sends reports to doctors or family members in real time.

As 77 million baby boomers race toward their golden years, the world's leading tech innovators are unveiling a range of futuristic gizmos. There are beds that can monitor patients' vital signs as they sleep and stoves that can turn themselves off when owners forget. Besides Intel, the aging-in-place market has attracted companies such as General Electric (GE), Philips Electronics (PHG), Honeywell (HON), Bosch, and dozens of tech startups. The companies say these products, just now being deployed by a handful of health plans and home-care agencies, can drastically cut the rate of medical complications that force seniors into hospitals and other intensive-care facilities.

Health Guide epitomizes the kind of in-home gear that can reduce the hassle factor for patients and clinicians, 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.

In the program Lang was a part of, Nurse 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 in to see a cardiologist right away." For Lang, 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.'"

Executives at Intel envision a suite of products that can give any house the characteristics of an assisted-living facility, but without the sterile environment many seniors despise. A survey taken late last year by AARP revealed that nearly 80% of baby boomers expect to stay in their homes as they age.

Intel has enlisted a big ally to help position itself in this market. In April, Intel and General Electric announced they would spend $250 million over five years to co-develop products that will help seniors manage chronic conditions from home. As part of the deal, GE will sell the Intel Health Guide. The partnership will give Intel access to monitoring technology, which ultimately could enhance Health Guide's capabilities. GE already has a product, QuietCare, which uses sensors stationed throughout the home to keep an eye on seniors as they go about their day-to-day lives. GE is marketing the product through home health-care companies and to assisted-living facilities. For an individual who wants the system at home, it's not cheap—the cost would be about $70 to $110 per month, depending on the size of the unit and the length of the monitoring agreement.

Amsterdam-based Royal Philips Electronics is also focusing on the aging-in-place market. Since 2006 it has spent $6 billion snapping up home health-care companies, including Lifeline, a maker of personal emergency alert systems that cost subscribers from $35 to $75 per month. Philips also purchased breathing device maker Respironics, as well as Raytel Cardiac Services, a provider of remote cardiac monitoring services. And recently Philips developed the smartBed, which contains tiny, high-tech electronic sensors that can measure patients' vital signs, movement, and breathing as they sleep. (The product is part of a research project and not commercially available.)

As helpful as aging-in-place technology may be, there is one big question yet to be answered: Who is going to pay to put the systems 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 others are trying to convince public and private insurers that it is 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, it reported, as opposed to $77,745 for nursing home care. Intel says it's currently talking with health-care organizations that may provide the full package of service and support directly to consumers. It is also evaluating monthly service programs.

Intel has pilot-tested Health Guide with Aetna 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 system, but says remote monitoring will be part of SCAN's model. "We're willing to fund these tools," he says, "because at the end of the day it will result in better [patient] outcomes."