HIMSS 2017: For Senior Living, Wearables Demonstrate Growing Importance

Senior living facilities represent one of the most promising avenues for using technology to ensure older Americans stay both active and healthy. For instance, as highlighted in the Spring 2017 issue of HealthTech magazine, communities such as Masonic Homes of California and the adjacent Acacia Creek Retirement Community are taking advantage of appliances (including tablets, sensors, smart thermostats and more) through a pilot with CDW aimed at helping seniors maintain their independence.

In another study, CDW and technology partners such as Intel and Big Cloud Analytics are examining the use of wearables by 600 seniors across the country. Moulay Elalamy, vice president of information technology for Waltham, Mass.-based Benchmark Senior Living, which runs communities in seven states throughout the Northeast, and J. Patrick Bewley, CEO for Big Cloud Analytics, shared findings from the ongoing effort this week at the Healthcare Information and Management Systems Society’s 2017 conference in Orlando, Fla.

Among the findings: how such tools hold vast potential for monitoring activity trends and predictively mapping adverse events, particularly related to cardiovascular data.

For the study, participating seniors are wearing a Garmin Vívosmart HR activity tracker. Data generated is transmitted to Big Cloud’s analytics platform via a tablet tethered to the tracker, which is set up as a gateway in the senior’s apartment.

“There is the opportunity … to begin to be on the predictive side of the equation,” Bewley said. “There is a lot of work and a lot of rigor that has to go around that and we’re a long way from that today, but at least in the check-engine light kind of mindset, I think there’s some promise there.”

Pinpointing Signatures

Big Cloud Analytics CEO J. Patrick Bewley (left) and Benchmark Senior Living Vice President of IT Moulay Elalamy share findings from an ongoing wearables pilot focused on seniors. Photo: Dan Bowman

For instance, according to Bewley, retrospective analysis of data for Benchmark residents who had to be hospitalized enabled Big Cloud to pinpoint signatures in the information received. While Bewley and his team do not understand the dependent variable for that data, and ultimately end up sifting through more granular electronic health record information, patterns manifested from the wearable devices show variations from normal patterns for an individual.

“We started to find some mechanical things in the [wearable] data that would always show up,” Bewley said. “Without necessarily understanding the physiology involved, we understood that these things were always showing up and that in some cases preceding adverse events.”

Sleep heart rate, he said, is very telling. For instance, if he sees sleep heart rate getting up above 90 beats per minute, it raises a red flag.

Fundamental changes in sleep mechanics also precede these adverse events, he said, and in some cases, Bewley and his team have seen changes in activity patterns too. “We just started mapping these over and over again and trying to look for strong indications where things like this were starting to happen,” he said. “We mapped everything from falls to blood clot and condition, to stomach bleed to UTI and slurred speech. One of the things that was very consistent was this change in sleep mechanics. It was always consistently showing up.”

While Bewley said that such information generates discussions about development of a watch list for certain patients with specific patterns, Elalamy cautioned that such methods should not be considered a medical process yet.

“We’re not saying, ‘Hey, because of this data we can trigger assessments,’ ” Elalamy said. “We can get there, and ideally we’d like to get there, but we’re not making this a triggering event yet.”

Evolving Tools

Ken Smith, a senior research scholar and director of the mobility division at the Stanford Center on Longevity, believes wearables must evolve to better monitor people on a 24-hour cycle. Photo: Dan Bowman

Ken Smith, a senior research scholar and director of the mobility division at the Stanford Center on Longevity in California, also has high hopes for the future of wearables, particularly for seniors. He believes, though, that such tools must evolve to better monitor people on a 24-hour cycle in order to create a more holistic picture of a person’s day.

“I think we are really entering Phase 3 of wearables now,” Smith said during an educational session at HIMSS. “Phase 1 I would call pedometers, where you could tell that you had movement. Phase 2 was all of these activity devices, mostly accelerometry-based, and you could get clever with what you do with the data. Now in Phase 3, you’re probably seeing a lot of discussions around optical methods measuring heart rate, blood pressure, all sorts of different biofeedback mechanisms.”

Smith believes this will enable researchers to look at data much more meaningfully and start to create data sets around 24-hour cycles that can then help to better characterize how people spend their day.

Beyond Phase 3, Smith said he thinks wearables will be able to predict mood and depression by monitoring internal body noises. While he ultimately believes new wearables will be a product of industry demand, he’s excited for the final phase of the Center on Longevity’s 2016-2017 design challenge, centered on innovating aging in place. For the competition, university students from around the world are focusing on developing designs that boost the quality of life for individuals aging in their homes.

“The average life expectancy really in the last 100 years has doubled in most developed countries, but we haven’t necessarily kept up with that in terms of our culture and in terms of the way we treat older people,” Smith said. “What we’re looking to do is make it a good thing that most of our population is actually having the opportunity to live to advanced ages. We work under this mantra that to the extent that people can reach old age mentally sharp, physically fit and financially secure, that those really provide the pillars of a positive aging experience.”

Read articles and check out videos from HealthTech’s coverage of HIMSS 2017 here.