An illustration of two aging people in a wheelchair and a computer in front of a robot.

ElderTech

Is  Healthtech Failing Our Aging Population?


Technology is supposed to make our lives easier, but new apps and devices often overlook seniors. And when it comes to health care, this is an oversight we can't afford.



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Tatyana Kanzaveli was in her early 50s when she received the news that she had colon cancer. Active and otherwise healthy, she was gobsmacked by the diagnosis, and desperate for answers. “Once I recovered from my shock, I started asking my doctors, ‘why this is happening to me?’ The doctors’ response: They had no idea. “We don’t have hypotheses, because we don’t have data,” she says they told her.

Modern medicine is revered for advances in treatments and ongoing breakthroughs in research, yet there is still so much that is unknown about the human body, particularly changes in our health as we age. It’s a problem primed for a technological breakthrough. We now live in a world where computers can fly airplanes and smartphones can compute our vitals. Yet, the successful merging of tech innovation and healthcare has yet to be achieved, even as “healthtech” has emerged as a rapidly growing field that’s getting plenty of media attention. So, when our health is on the line, can we really rely on technology to save us?

Technologists have stepped in where they can make a difference. Kanzaveli saw the lack of aggregated health data as an opportunity and immediately got to work, founding the Open Health Network. Their platform gives health-care companies and supportive organizations a framework to develop personalized applications and chatbots for patients, providers, payers, and medical researchers. It allows them to collect, manage, and share healthcare data as needed. It’s one piece of the big puzzle for managing health throughout our lives. As we age and face greater health challenges in our lives, aggregating that data should make it easier for health-care practitioners to help us face—and hopefully solve—these challenges.

While many health-care innovations can be generalized for problems that arise at any age, it’s becoming clear that for older people, some advancements matter more than others. A White House Task Force recently identified six areas where technology can impact the lives of our aging population: independent living, cognition, communication/social connectivity, personal mobility, transportation, and healthcare access. All of these directly relate to our overall health and wellness—being able to keep moving, maintain mental acuity, nurture social relationships, and having the ability to get help when we need it.

Luckily, we’re seeing impressive growth in wearable devices, smart home innovation, telehealth options, and mobile applications. Some examples: the Apple Watch cardiac sensors and fall detection, robotic home assistants, smart speakers like Amazon Echo and Google Home, mental acuity applications like brain games and puzzles, medication reminders like MediSafe and Pillboxie, food delivery services like Instacart, and TaskRabbit, which can be employed to get household helpers. All of these can provide greater independence in our lives as we age and face various health challenges.

For seniors and others with heart conditions, the American Heart Association has used the Open Health Network platform to develop a free app, My Cardiac Coach, where patients can learn about their conditions, track appointments, medication, weight, blood pressure, and more. The association also provides information online about how symptoms of heart attacks can present differently for men and women. By collecting this data, they will have the ability to learn more about these differences, potentially helping doctors make more accurate diagnoses, which can save lives.

It’s critical that the medical and research communities recognize that women age differently than men. Some age-related diseases impact women more severely. For example, of the 5.5 million Americans now living with Alzheimer’s disease, two out of three are women. Women tend to develop symptoms at a younger age than men, in part because gray matter shrinks as estrogen declines. And more women die from Alzheimer’s (whereas more men die from diabetes).

There’s also evidence that estrogen protects the heart, and as it decreases with age, the risk of heart disease—the leading cause of death for women and men in the United States—goes up. Women’s symptoms present differently, and since they’ve been taught to look for symptoms men get, they often wait too long to go to the emergency room. As a result, women need to be educated and treated in ways specific to their health risks and needs. When technology is involved, targeted data must be part of it. Many of the applications being developed today can now address these differences and help medical researchers and practitioners develop better treatment programs as a result.

Ada Health, for example, is a mobile application that anyone can download to a smartphone to enter their symptoms and explore potential diagnoses. Gaining in popularity, it won’t replace a medical doctor’s assessment, but it uses artificial intelligence to help narrow down possible options and provide users with privacy and peace of mind. Ada now has 7 million users around the world.

“We need more A.I.-enabled patient-centered solutions where patients can manage all aspects of their health in one place,” Kanzaveli explains. “If we are able to collect data, we can help people manage their health … and help doctors and researchers as well.” For her, building a platform meant that everyone could benefit in the long run. For Kanzaveli, an active entrepreneur who travels the world evangelizing the benefits of artificial intelligence for healthcare innovation, it’s a personal mission to build supportive infrastructure now—paving the way for future entrepreneurs and researchers.

With all of this progress, there’s still plenty of room for innovation—particularly when it comes to older women, 3 million of whom enter menopause each year in the United States (2 million naturally and another 1 million through cancer treatments and/or hysterectomies). Menopause and its onset—gradual or immediate—can bring with it a number of serious health problems, including an increased risk of heart disease and strokes, osteoporosis, urinary incontinence, and more.

Menopause startup Genneve came from the need for middle-aged women to receive specialized information and care. Genneve is building a telemedicine model, where any woman can book appointments by video with practitioners, after filling out an online menopause assessment. Jill Angelo, the 45-year-old founder of Genneve, is asking the same questions about her own health as many of her customers. “Menopause is a trigger point for so many things,” she says. Genneve is addressing the problem by creating an education hub to help women get their questions answered and manage varying symptoms.

Even with the vast size of the market, it hasn’t been easy selling investors on the idea of menopause as a target, since most investors themselves need to be educated. “Healthcare has a lot of modernizing to do,” Angelo says. When it comes to insurance, “we don’t even have the codes in place to address women in menopause,” she says. “When you look at the rates hormone therapy is covered for women, most do not have enough coverage.” Three million women a year and we don’t even have a code for it—let that sink in.

While education and information sharing are clearly critical to expanding solutions for healthcare nationally and globally, personal privacy continues to be an ongoing concern. That’s why Kanzaveli created a model where patients have control. The Open Health Network’s newly released PatientSphere module provides capabilities for patients who use the apps to be able to opt into sharing and/or selling their health data as they see fit.

Another component required for making health-care technology usable for everyone is accessibility. The onset of disabilities doubles for both men and women between the early 40s and early 50s and increases significantly from there. Often this means people with visual or other impairments require adaptations to continue doing everyday tasks. Product design, even when it is meant to take accessibility into consideration, can fail these people. Websites need to include alternative text behind images so those with limited or no vision can have the images described to them. Devices need scalable images and adjustable fonts, as well as some sort of tactile indicator to discern different uses. Handheld remote control devices with all buttons the same size make it challenging for users to discern which buttons are which.

As companies design newer devices, they also must consider the very basic differences in male and female body types. Consider wearables, like smartwatches. Most are designed with the average male in terms of size and use. A senior woman with small wrists can find herself dwarfed in a smartwatch, refusing to wear it, and rendering its monitoring of her high-risk condition useless.

The ongoing challenge for older people continues with the transition to digital. As appliances, electronics, and cars become ‘smarter,’ they often diverge from software design principles of ease of use. Research shows that if new products aren’t easy for new users to grasp and engage with, they won’t use them. It’s becoming more difficult now to find refrigerators, thermostats, televisions, and cars that don’t have complex controls with digital readouts. This can be confusing for older people, who grew up using knobs that were easy to see and feel.

The need for further healthtech innovation is clear. If it doesn’t happen now, we’ll be faced with many more challenges in the future. Fortunately, some technology companies are learning that diversity and inclusion means inviting people of all ages and abilities to the table when it comes to product design. We’re seeing the beginnings of a movement toward more ‘inclusive design.’ There’s progress being made by those who take the time to include older people into these conversations, and as resources expand, we’re seeing more research in new areas. Virtual Reality applications are being studied for managing chronic pain as well as depression. Fall detection sensors are being added to smartphones. And innovators can now take advantage of shared data being aggregated.

“The goal of health care is to keep people as healthy as we can for as long as we can,” says Kanzaveli. Medical science must take a pre-emptive, research-based approach to ensure that as we age, we have every opportunity to access the care that we need.

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