Narrowing the price gap between hearing aids and PSAPs

The hearing aid industry offers pricey hearing aids for people with ‘defined’ hearing loss.  The FDA wants you to understand that it regulates hearing aids – which it defines as helping the medical condition of hearing loss. The FDA then observes “sound amplifiers for consumers with no hearing loss who want to make environmental sounds louder for recreational use.“ Recreational ? Hearing aids that they do regulate are now made by a small number of companies and are sold with audiologist services for $1000 up to $4000 per device – most people need two – and have a lifespan of up to 7 years.   That price includes a hearing test, fitting, initial batteries and more.

Why do hearing aids cost so much? According to hearing industry experts, the price differential is based on the inclusion of audiologist services. And in a few other words from AARP, very few companies control the bulk of the market.  And although it has been recommended to decouple the product from services, so far, that hasn’t happened, perhaps related to the efforts of those few companies. Retailers like Walmart, BestBuy, and Costco all sell hearing aids – coupled with Costco-provided audiologist -services – Costco’s site offers its own branded for $1600 per pair.

As hearing aid prices are disrupted, the PSAP and other hearables disrupt the industry.  If Costco is pushing the hearing aid industry price down, at some point that price meets the upper end of the PSAP market of $500/pair of PSAP maker like Clarity, SoundWorld Solutions or Tweak Focus. The underlying technology in hearing aids and that of Personal Sound Amplification Products (PSAPs) is not different. The go-to-market channels, however, are quite different.  Retail stores, online websites offer PSAPs for buyers who adjust the device themselves – the which the FDA calls the ‘audio version of reading glasses.’ And Consumer Reports calls them ‘hearing helpers.’ But are they really? Or are they hearing aids in disguise because the FDA does not currently regulate them? Maybe they are hearing aids that you adjust yourself? How do they sync up with the more recently introduced 'hearables' which encompass a plethora of firms?

Consider that the terminology dance must mystify consumers.  Note that hearing aids are not covered by Medicare – nor are PSAPs. Note that one in three between age 65 and 74 has hearing loss and nearly half of the 75+ have some level of hearing loss. Note that hearing loss has been linked to dementia, to social isolation – which has been linked to poorer health outcomes.  (Further, wearing hearing aids has been linked to fewer hospital visits.)

Cut to the chase – the FDA should get out of the consumer’s way. Regardless of what it is called, improving ability to hear among older adults is a health and quality-of-life positive, and could be related to lowering healthcare costs.  The companies in this industry (Hearing Aid and PSAP) need to help the FDA help the older consumer who lacks either device. Decouple the product from the services, allow consumers to make their own choice of where to buy and with what service they need, and track price and competition – and measure the numbers of people who report improvement in quality of life, health status, and social engagement.

category tags: 

hearing loss

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from Tips For Aging In Place https://www.ageinplacetech.com/blog/narrowing-price-gap-between-hearing-aids-and-psaps

Voice First in Senior Living -- What's Happened and What's Next?

Senior Living organizations are eager to try new technology.  Over the years, consider the pilots of Rendever (virtual reality) at Brookdale, Benchmark’s pilot of Google Home and Samsung tablets, or  CarePredict in LifeWell facilities – just a few of the many. Some pilots are even documented in the form of case studies – about what worked – or what might not have worked.  Pilots are typically newsworthy at their start. And they may produce a list of lessons learned upon completion – or a set of considerations for future pilots. So where does Voice First technology fit into the senior living equation?

The newest of technologies – voice first – sparks interest.  Credit Front Porch for being one of the first in voice first – piloting and writing up the results – empowering the participants to both speak requests and control their environment with smart home commands.  But pilots of Voice First technologies are widespread today – see Commonwealth Care Alliance and Orbita.  AARP Foundation, and Libertana Home Health, WebMD. or Answers by Cigna. And new entrants are emerging to tackle Voice First in healthcare – see Suki’s recent raise of $20 million – perhaps hoping to beat Amazon to the behemoth’s own healthcare punch.

Senior living companies have launched Voice First pilots and projects.  Carlsbad by the Sea (including smart home features), The Branches of North Attleboro (including smart home), and Park Creek Independent Living (pilot just launched – including a free device).  There are numerous others – some with press releases like the Park Creek one, or noted in senior living publications, as with Front Porch. Expect more pilots of Google Home, Samsung SmartThings and wearables that can respond to voice command.

Senior living - please report successes and lessons learned.  For senior living organizations, many questions, not so many answers just yet. Who buys the device – the resident or the community on behalf of the resident? How are they managed and deployed – by an IT staffer? Remotely set up or in person?  WiFi upgraded before deployment?  Who receives notifications from smart home technology?  Are concierge services part of the plan – initiated at the front desk?  Or in apartment? Integrated with other senior living technology? And is Voice First now a mandatory feature of resident engagement solutions?  If not now, then by when and with what caveats? What are the biggest concerns, for example, might they be protection of user security and privacy?

category tags: 

voice/AI technology, senior living

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from Tips For Aging In Place https://www.ageinplacetech.com/blog/voice-first-senior-living-whats-happened-and-whats-next

Four technology categories to remotely monitor a paid caregiver

The boom in home care has side effects -- turnover and risk. We want to trust home care workers with aging parents.  After all, most cannot afford private pay assisted living – which can exceed $3000/month in most locations – and assisted living occupancy is projected to be flat -- likely because people see the cost and defer move-in. Given expanding life expectancies at age 65 – an average of 20 more years for men and more for women, the possibility of ‘aging in place’ in a private home may be growing.  As a result, the demand for private home care will grow, but so will the costs – especially for finding workers willing to do this difficult work for low pay. As of 2017, median home care turnover was 66.7% (compared to 30% for CNAs in assisted living).  With so many workers coming and going, especially for care recipients with the most taxing care requirements, what technologies may assist families and agency management for monitoring care?

Cameras.  It is possible that having an in-home security camera can deter issues with home care aides if the aide knows that the camera is there. In New Jersey, a law called "Safe Care Cam", the first in the US, enables family members to borrow a camera for free for 30 days if they suspect abuse.  Home security cameras and security systems (which have cameras) can enable both monitoring and the possibility of a two-way audio conversation with the worker. For those who want to monitor without a caregiver knowing, the camera could be mounted inside an alarm clock or a smoke detector.  

Motion sensors.  These low-cost items can detect movement and alert whoever is monitoring – as well as be part of a larger ‘smart home’ solution.  These technologies can include ‘bed exit’ alerts as well as fall detection – useful in circumstances when the care recipient is left alone at the end of a day or for a period of time.  Fall detection, for example, is increasingly likely to be part of a Personal Emergency Response System (PERS) offering – or medical alert market. Either way, detection of motion (or absence of motion) via well-placed sensors with well-placed sensors can be important in monitoring whether a worker is paying attention to care.

Voice reminders and voice ‘drop-in.’  A growing number of families may be willing to use a Voice First technology – like a smart speaker -- for communicating with in-home seniors or caregivers. This might mean setting up an Amazon Echo (Dot or Show) for in-home use.  In those cases where an Amazon device is at two locations, one person can 'drop in' to check on another.  It is feasible to integrate a calendar of reminders for paid workers, for example, a schedule, to please give a medication at a certain time.  This can be done with the Echo line or the Google Home/Google Assistant environment.

Electronic visit verification (EVV).  2018 is the year of the electronic visit verification, subject to compliance with a CMS mandate by January 2019. EVV answers the key agency supervision question -- did the worker arrive it at the appropriate place and at the right time to provide care? This technology will be commonplace, despite efforts to delay making it mandatory, in situations in which a service is reimbursed by government. Because agencies have a mix of reimbursed and private pay business, plus struggling with high turnover among workers, private pay home care work is likely to be tracked with EVV technology -- whether or not it is subject to the mandate.

category tags: 

Home Care, tech-enabled home care, IoT and home monitoring

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from Tips For Aging In Place https://www.ageinplacetech.com/blog/four-technology-categories-remotely-monitor-paid-caregiver