As artificial intelligence becomes increasingly integrated into tools used by senior care and living providers, its uses can be broadly placed into two categories: data analysis and automating routine work.

Some of the best new AI tools that LTC providers should be aware of include the newly expanded Microsoft 365 Copilot and the website scena.ai, according to a new brief guide on AI from LeadingAge. 

The latter was used to generate the opening video at LeadingAge’s conference. 

“At its core, generative AI is a subset of AI that focuses on creating content, whether its text images, music or entire virtual worlds,” a digital avatar told the crowd. “With the right application, generative AI can assist in aging services.” 

While many of these AI tools, and their applications, have been widely available for months, organizations like LeadingAge have been working to advance adoption of these tools, because the LTC industry often lags behind other sectors in onboarding new tech, many healthcare experts have noted. 

Coming into this year, staffing shortages remain an ongoing issue for LTC providers, so the more administrative tasks an organization can devote to AI, the more existing staff and caregivers can focus on resident care.

As for data analysis, AI’s predictive power, which can help predict and prevent falls, was seen as one of the most promising tech innovations in LTC, according to a recent podcast panel for McKnight’s Market Leaders including AHCA President Mark Parkinson.

Seniors themselves may be more open to AI being used in their healthcare systems, or at least accept its presence, a recent report found.

In addition to listing some AI tools and providing a broad overview, the recent LeadingAge post also listed several AI guides for organizations to review, including a report from NetHope and a recent research study published in JMIR Aging.

Long-term and post-acute care organizations have not received the same support as other care settings for creating interoperable patient data tools, putting home health and hospice providers at a disadvantage, according to new research by the Department of Health and Human Services.

Electronic health records (EHRs) are used by the vast majority of long-term and post-acute care (LTPAC) providers. Within the home health and hospice industries, roughly 78% of providers have adopted an EHR, according to the study. And while their functionality is largely the same as those used in other care settings, EHRs used by home care and hospice providers fall short when it comes to their interoperability capabilities. 

A key reason for this, HHS found, is that LTPAC organizations have not been incentivized to use interoperable technology in the same way as other healthcare providers.

“Due to thin operating margins, lack of adequate financial incentives has made it difficult to fund and implement interoperable HIT systems,” HHS said in its December report. “Organizations need a system or market reason to exchange data. Without the proper financial and policy incentives, it will be difficult to make organic progress toward interoperability.”

Meanwhile, other care settings have been able to benefit from government programs that encourage use of interoperable health data tools. Hospitals, for example, were selected to participate in Promoting Interoperability Programs, which offered financial incentives for implementing interoperable HIT.

And since hospitals and other acute care settings received this head start, many LTPAC providers have not been able to lay the groundwork to create interoperable HIT systems.

“Providers and vendors do not have a clear understanding of what data reporting and interoperability requirements will be in the future,” the report noted. “LTPAC organizations and vendors are left to do what they think is best, with limited guidance resulting in the lack of standardized and codified data to support interoperability,” the report said. 

LTPAC organizations have long petitioned lawmakers for help with creating interoperable patient data tools. And while hospitals were successful in earning this support, home health and hospice providers have not been able to do the same, HHS said in its report.

Still, the “next big step” in nationwide health data interoperability may be yet to come. The Trusted Exchange Framework and Common Agreement (TEFCA) has been slated for launch in the first quarter of 2024, and will create interoperable functionality among five EHR systems. LTPAC stakeholders have expressed hopes that TEFCA might benefit, rather than overlook, home health and hospice providers.

Telehealth expansion has been supported by many healthcare and government leaders in the post-pandemic world, including President Biden, as a way to ensure everyone has access to coverage and essential health services.

However, adding broadband access to rural or underserved communities may not be a silver bullet that enables telehealth use in those areas, a new study shows.

This means that long-term care providers, particularly those in rural areas, need to make sure that digital literacy training and cultural factors are in place for telehealth use.

Study authors were most concerned with policymakers and whether they were viewing telehealth issues too narrowly.

While the study, which looked at 170,000 Wisconsin Medicaid beneficiaries, supported the idea that telehealth helped remove geographical barriers to important healthcare services, the researchers concluded that actual telehealth use is separated by what they termed the “digital divide.” This includes a mix of factors including age, ethnicity and tech literacy.

“Although telehealth expansion has been touted as a low threshold policy intervention to expand access to care,” the study authors wrote, “leveraging telehealth to improve access for underserved populations will require more nuanced attention to the specific mechanisms linking telehealth and health care utilization to avoid inadvertently deepening disparities for select populations.”

After the pandemic, those who adopted telehealth skewed older, urban and female, the study found. While the researchers held back on making a definitive conclusion for why this cohort would be more amenable to telehealth use, they speculated that it was broadly due to better knowledge and trust in the healthcare system. The study showed greater telehealth use for lower-income and education individuals — but only for audio-only interventions, which are only a small fraction of telehealth care.

While seniors are often slower to adopt new technology, it is not the older adults themselves who are hesitant to use telehealth, but rather clinicians who worry that telehealth visits are insufficient to address more complex medical needs, McKnight’s reported last year.

Shakira wrote that “hips don’t lie” and unfortunately seniors’ sore, stiff hips often shout the truth about the natural digression of fitness and mobility that comes with aging. 

However, recent research on a “hip-assist” robotic device, which goes around a users’ waist, could help users improve stride and balance to regain a healthy fitness level. 

Mobility issues can affect a senior’s quality of life in and of themselves, but also lead to dangerous secondary effects such increasing the risk of falling.

Although many recent wearable robotic tools aimed at seniors are meant to deal with specific conditions such as Parkinson’s disease, the hip-assist robot appears to be more broadly for seniors with even mild mobility concerns.

“Aging is closely related to the loss of muscle mass, and a significant reduction occurs, especially in the lower limbs, which can lead to physical dysfunction,” the study authors wrote. “Technological development of [daily assistance robots] has been actively conducted as a concept of health management and assistance in daily life.”

The wearable robotic device, developed by scientists in Korea along with Samsung Electronics, fits around a user’s waist and, depending on the exercise, can employ both resistance and assistance to help users. The robot also is programmed for specific tailored workouts, study authors noted.

Over the course of a four-week exercise program, senior study participants were able to shed body fat, increase their stride length by 12% and “significantly” improve pelvic movement, the study showed.

Although the short timeline of the program was not enough to significantly build muscle strength, users still made noticeable gait and balance improvements, the researchers noted.

Samsung has not clarified when the EX1 robot will be commercially available, but previous reports indicate that they were hoping to have released the robot in 2023. Although that window has passed, presumably the study provides a meaningful checkpoint for validating its use. 

Another recent tool that addresses seniors’ balance is a smartphone app that monitors body sway and also includes fitness recommendations, McKnight’s reported Wednesday.

Developers behind a new veterans home are hoping the facility serves as a design model for how to accommodate “the personal technology ecosystem.” 

As seniors are rapidly adopting technologies like smartphones and wearable devices, senior care and living providers need to be increasingly sure facilities have the infrastructure for these tools, such as sufficient wireless connectivity and charging outlets. 

That can also include knowing which software and interoperable systems to utilize as well, as one report noted.

Engineers with the firm IMEG Corp., who helped build the new 138-bedroom veterans home in Augusta, ME, said it is especially important for new senior living projects to implement these innovations during the planning phase.

While IMEG is undoubtedly using the Maine example to broadcast its own consulting abilities, it is important for senior living providers to make sure they are working with designers so they are not spending more money retrofitting new buildings for technology after the fact, or scrambling to catch up with the latest trends. 

The Maine Veterans home has a gym equipped with virtual reality capabilities and other rehab tech tools, the developers touted. 

Other senior living facilities have taken on the “smart gym” design model, such as Blakeford Senior Life’s Nashville campus, which has equipment and software to help with personalized elderly fitness regimens, McKnight’s recently reported.

However, while many senior living facilities boast impressive tools and devices, from cleaning robots to VR headsets, an important aspect of the current tech ecosystem to keep in mind is how many personal devices new senior living residents bring with them — and what they expect to be able to use, the IMEG developers note.

The senior living industry has been notoriously slow to adopt new technologies, many experts have pointed out. Only 30% of senior living organizations had upgraded their network systems over a five-year period, according to a report from 2022. Other accounts suggest that even when adopting new tech, many senior living providers end up abandoning tools.

Not all senior living providers have the resources available to design or implement these tools on their own; this is particularly true for rural communities.

Many healthcare leaders, and even President Biden, have raised this point and called for more investment in resources and technology for underserved senior living populations.

PointClickCare, already long-term care’s largest health records and technology platform, has expanded its footprint by acquiring American HealthTech, the companies announced Wednesday morning.

The move continues a trend, said industry expert Majd Alwan, PhD, the chief strategy and growth officer for Thrivewell Tech, a digital transformation agent that helps providers. He was not involved in the deal.

“It’s another step in the consolidation of the market and the acquisition of smaller players who have not been able to grow,” Alwan said. “It has been going on for quite some time.”

He said that AHT clients are among the winners because they will gain access to a platform that is “continuing to grow and evolve.”

“I’m really impressed with the level of integrations and add-on software that’s available” under the PCC umbrella, he added.

It also marks the end of an era for AHT, a “home-grown” platform that originated with a single provider and grew into a commercial offering as peers adopted the platform. Alwan said he originally encountered AHT as the long-time former leader of LeadingAge’s Center for Aging Services Technologies, or CAST.

A database he created with that group most recently showed that AHT had 3,300 skilled nursing, assisted living and continuing care retirement / life plan community clients as of 2023. PointClickCare counts more than 30,000 healthcare entities as clients, spanning the SNF, assisted living, independent living, CCRC and rehab sectors, along with a minority of acute-care partners.

PCC co-founder and CEO Dave Wessinger declined to disclose financial terms of the deal, nor how many providers might be affected. But he told McKnight’s that almost 40 AHT employees will be joining the privately held PCC.

“We are acquiring American HealthTech because we see great growth potential together,” he said. 

“Thanks to our robust and most-comprehensive data set, we will be able to provide AHT’s customers’ care teams with important updates to products and solutions they will need as care delivery continues to evolve, and as the needs of their patients become more complex — including access to technology that can provide deeper connectivity with acute care settings through a more comprehensive network,” he added in a statement.

More than 27,000 long-term and post-acute care providers, more than 100 hospitals and health systems, more than 3,600 ambulatory clinics, every major US health plan and more than 70 state and government agencies currently use PointClickCare, the company said.

AHT was a wholly owned subsidiary of Computer Programs and Systems Inc., or CPSI, which provides electronic health records systems and related services to post-acute providers.

“As part of our ongoing business transformation, we have decided to divest AHT and therefore discontinue development of the AHT product,” explained CPSI President and CEO Chris Fowler in a joint statement from the companies. Fowler said the two companies “share similar cultures and values,” making the merger an “ideal fit for AHT, its clients and employees.”

Wessinger told McKnight’s that the transaction comes at a pivotal time in PCC’s evolution.

“In 2024, we are laser-focused on addressing critical gaps in healthcare to better serve high-needs populations through an expanding care collaboration network,” he noted. “Through this acquisition, we continue to fulfill the mission of modernizing healthcare by helping an expanding number of providers improve patient outcomes across care settings, including skilled nursing and senior living communities.” 

PointClickCare’s integrated platform delivers real-time, actionable insights at the point of care to ease transitions and foster better post-discharge outcomes, the company said. It added that it possesses the industry’s “most expansive dataset.”

“PointClickCare’s mission has always been, and continues to be, addressing critical gaps in healthcare to better serve high-needs populations through a robust care collaboration network,” Wessinger added.

In senior care and living settings, a lot of fall prevention data and technology is controlled by caregivers or curated by software systems. 

However, at least one new intervention tries to empower seniors more directly with the ability to forestall a falling emergency. 

A new smartphone app helps seniors control their balance by monitoring a users’ body sway while they are standing still. The app, which also includes fall prevention exercises, is intended to help seniors adjust body coordination to prevent falls from occurring, the researchers said.

One out of four seniors in the US are likely to fall at some point each year, the researchers note. Even as new tech aims to reduce falls or subsequent fatalities, the number of self-reported fall incidents in healthcare facilities has risen in recent years, and was up 27% in 2022, according to McKnight’s Clinical Daily.

Data used to build the app was collected at the Motion Analysis Research Laboratory run by Binghamton University in New York. The researchers used a sophisticated motion analysis system, which involved motion-capture tech, to find the relationship(s) between gait speed and balance.

When researching use of the app itself, 94% of the senior study participants completed exercises and tests via the smartphone intervention, the study authors said.

“Participants self-reported enjoyment, difficulty and exercise effectiveness,” the study authors wrote. “Results of this study demonstrated the feasibility and effectiveness of delivering balance intervention through a smartphone-based application.”

While it’s unclear from the study how such an app might complement other monitoring or therapy tools in senior living communities, the researchers did acknowledge that the smartphone intervention would not work for all seniors, such as those with more severe mobility impairments. 

Future studies could be aimed at reviewing how stroke or Parkinson’s patients use the app and its exercise regimen, the study authors said.

A data leak over the summer may have given hackers access to health records and personal information for both residents and staff at 40 nursing homes, according to the healthcare services provider whose servers were compromised. 

The company, HMG Healthcare, said earlier this month that it first identified the leak in November and traced the data breach incident back to August. 

Although the exact information stolen is unidentifiable, HMG has taken steps to try and mitigate harm and make sure data was not spread further, as well as increasing their “data security protocols,” the company said in a letter sent to affected employees and residents. 

“We sincerely apologize for any inconvenience and concern this incident causes you,” HMG CEO Derek Prince said in a statement. “HMG will continue to do everything we can to correct this situation and improve our protections for you and others going forward.”

These kinds of costly leaks are why new cybersecurity is one of the highest tech priorities for healthcare organizations, McKnight’s reported last month.

Senior care and living operations remain one of the most vulnerable industries to these attacks, due to a number of factors from weak passwords and staff errors, to outright theft, security experts have warned.

One recent settlement involving a data breach ended up costing one senior living operator, Acts Retirement-Life Communities $1 million.

The HMG leak possibly occurred due to a ransomware attack, and the company may have been forced to negotiate with the hackers to prevent further damage, one cybersecurity company exec speculated. 

“Because they were compromised and couldn’t completely guarantee nothing was visually seen and copied via screen shot or other means, they had to publicly disclose the breach,” said Bobby Cornwall, vice president for strategic partner enablement and integration at SonicWall. “They would need to be careful with their statement and disclosure so as not to be put in a situation that could result in larger fines due to HIPAA violations.”

Mark Zuckerberg has the Metaverse. Spiderman has the Spiderverse. And now seniors have the “Great American Elderverse,” an immersive space for seniors who want to use virtual reality to socialize. 

The Elderverse concept, co-developed by Mynd Immersive as an expansion of their existing VR programming, was unveiled at the CES conference in Las Vegas last week. 

Mynd’s existing VR tools, which include a headset and tablet, were already meant as a way to get seniors to interact with peers — or in the case of long-term care communities, with their caregivers — Mynd executives had previously said.

The new Elderverse differs in several ways, Mynd CEO Chris Brickler told McKnight’s Tuesday. 

The new platform does away with the tablet and starts users out on a lush virtual coastline, from which they can jump to any number of entertainment or therapy options, including a meditation island, “world tours,” or even virtual church sessions. 

“From a tech point of view, it’s a big evolution for the company,” Brickler said. “For a senior who is cognitively healthy and can handle the adventurous aspect of navigating the world, it’s a foray into what younger adult audiences do [with open world video games].”

Not only is the idea for seniors to use the Elderverse world to interact with one another, but their family members also can use the tech or follow along with their smartphone, viewing a 2D replication of what an Elderverse user is looking at, and talking with them in real time, Brickler explained.

The concept of communal virtual spaces is gaining traction within senior living. While tech companies like Mynd are trying to create virtual worlds, the more grassroots Thrive Pavilion, which runs off Meta Quest headsets, has been steadily growing and offers a suite of VR programs for seniors to socialize, McKnight’s reported over the summer.

The overall picture of VR, mixed and augmented reality, for seniors and everyone else, has been termed “extended reality” by tech users and developers alike.

In addition to Mynd Immersive, other partners in the Elderverse project include: VR goggles maker HTC VIVE, the CTA Foundation and AT&T. 

The Elderverse won’t be available until the second quarter of this year, Brickler said, adding that they are still “rounding up” donors for the company’s project goal to introduce VR therapeutics to 500 underserved senior care communities over the next few years.

The company continues to work on its VR therapy program for seniors in memory care, Brickler said, noting that, among its current pool of content is a VR “medication management” tool that lets seniors practice organizing their pills without real-world consequences.

Other innovations could include custom avatars for individual seniors, as well as a continual revamping of VIVE’s headset gear as technology switches from bulkier helmets to goggles and glasses. 

A high number of senior living and care residents have dementia on admission, or develop it during their stay, despite never receiving a formal diagnosis. 

When these “secret” dementia patients, however, have an emergency – say, a fall – and are hospitalized, they can catch the new care team unaware and struggling to make appropriate clinical decisions. 

To avoid this pitfall, new research is looking at electronic health records to flag individuals who might have dementia, possibly undiagnosed, so that when they arrive at a hospital, the care team is ready. 

The study authors used the example of a person who has had a fall and being unable to accurately describe his condition and medical history, or to communicate his own sound judgments about future care to a hospital team.

Up to 40% of older adults with mild or early-onset dementia do not have dementia diagnoses, one study shows. The new research, led by a team from Cedars–Sinai Medical Center in Los Angeles, noted that “early detection of dementia in the inpatient setting” is less than 50%. 

The research found similar numbers when using AI to analyze EHR records of study participants: Of the 64 patient records reviewed that had no dementia diagnosis, the AI found 33 shown signs of altered mental status or cognitive dysfunction. Overall, that involved approximately 10% of the EHR records reviewed, which included both people with confirmed dementia and those who showed no record of cognitive decline.

“These types of algorithms provide an opportunity to accurately identify hospitalized older individuals for inclusion in quality improvement projects, clinical trials, pay-for-performance programs and other initiatives,” the study authors concluded.

To make sure clinicians are able to take advantage of the new information the AI can give them about patients, Cedars-Sinai also instituted a training program to make sure all care staff knew how to respond to possible dementia. 

Data sharing between points of care and different EHR systems is becoming increasingly important for healthcare providers, as health records are constantly updated from new data collection tools. 

Although the dementia research foretells a positive outcome for both patients and their caregivers, the flip side of that is the unintentionally morbid study on EHR discrepancies — also from California — that showed that care teams were filling medications and appointments for patients who already had died, the McKnight’s Tech Daily recently reported.