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.

Although not meant to be used as a primary screening tool, the technology further evaluates skin lesions that doctors have already flagged as suspicious, the FDA noted in an agency news release.  

The handheld device uses AI-powered spectroscopy to assess the characteristics of lesions at both the cellular level and beneath the skin’s surface.

“We are entering the golden age of predictive and generative artificial intelligence in healthcare, and these capabilities are being paired with novel types of technology, like spectroscopy and genetic sequencing, to optimize disease detection and care,” DermaSensor Inc. co-founder and CEO Cody Simmons said in a company news release. “Equipping PCPs [primary care physicians], the most abundant clinicians in the country, to better evaluate the most common cancer in the country has been a major, long-standing unmet need in medicine.”

The device, also called DermaSensor, provides real-time results using an algorithm based on data culled from more than 4,000 malignant and benign lesions, according to the company.

“The device should be used in conjunction with the totality of clinically relevant information from the clinical assessment, including visual analysis of the lesion, by physicians who are not dermatologists,” the FDA said, adding that DermaSensor is for use in patients ages 40 and up.

Along with helping to spot melanoma, the most deadly form of skin cancer, the device can also assess moles for basal cell carcinoma and squamous cell carcinoma.

One in five Americans will have developed a form of skin cancer by the age of 70, according to the American Academy of Dermatology, which puts the cost of treatment in the United States at more than $8 billion. Most skin cancers are curable if detected early.

The FDA added that it is requiring additional validation testing in patients from representative demographic groups, including those who are at lower risk of skin cancer.

More information

The Skin Cancer Foundation has more on skin cancer.

SOURCE: US Food and Drug Administration, news release, Jan. 16, 2024; DermaSensor Inc., news release, Jan. 17, 2024

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.

Oh, and also yourself.

Care — whether that’s giving or receiving — bookends all our lives. Yet for some reason, the bulk of the focus is either squarely on the front end of that journey, when children enter the picture, or the back end, when parents and other relatives begin to age.

But what about the middle and the transition from one phase to another? For us to thrive as a society, I believe we need to start thinking about care, not as something that happens at the start or end of life, but something that is continuous — something that enhances life and doesn’t diminish it.

Currently, we’re not set up for this reality. But by radically rethinking the care economy, we can be. To flip the script and reframe how we offer care in this country, there are three conversations we need to have. Let’s take a look at each.

1. What does care look like at every stage in my live and my loved ones’ lives?

It doesn’t matter what season of life a person is in, we can all benefit from having a safety net of care. That peace of mind that comes from knowing measures are in place to protect you. But safety nets require preparation, and herein lies the rub.

By default, babies come with time built in to anticipate and plan their caretaking, usually with the help of others, whether that includes a partner, coworkers, friends or family. For the other side of life’s bell curve, it’s a bit more challenging. One minute your parents are spry, hiking Machu Picchu, and the next, they’ve fallen and broken a hip. Things can change at any moment. And they do — without nine months of preparation to “senior proof” your loved one’s home so they can continue to live independently.

How do we prepare for those unexpected situations? Communication. Instead of waiting for a parent to become vulnerable, we can talk with one another about caretaking for all the stages that comprise our lives. Perhaps it’s when they have their first grandchild. Do they want to live closer? With consistent planning and regular check-ins about what lies ahead (both the potential and inevitable), we replace fear with transparency. And in doing so, we can prepare for these events and provide our loved ones with a safety net instead of a rude awakening.

2. How does care help me live my best life?

Not to answer a question with a question, but what if, instead of viewing care through a lens of crisis and catastrophe, we viewed it as self-care? To some, this may seem like a stretch beyond radical, but hear me out.

When we shift our viewpoint of caring for others and receiving care as an opportunity for independence and freedom, the act becomes empowering, enriching, and a sign of agency, confidence and strength.

The process starts by completing three relatively straightforward steps:

• Acknowledge you need help.

• Ask for help.

• Accept the help.

Although simple, executing on those three steps can be difficult. They each require some degree of vulnerability. And who likes that feeling? This is especially true of the caregivers who belong to the sandwich generation, those people (primarily women) in their 40s and 50s situated between the young and old and responsible for caretaking both.

For women, it’s easy to assume the role of caregiver — for everyone. At peril to ourselves, we fall into the stereotype of feeling like we have to be invulnerable and completely self-reliant. When you consider that mothers in the sandwich generation feel more stress than any other age group, it becomes clear that functioning as a village unto ourselves is unsustainable.

It’s only when we become able to model for others that it’s OK to ask for and receive assistance that we can get off the island of one and instead provide safety and assistance to one another.

3. Who is in my care village, and how do we lean on each other?

Growing up, my care village consisted of three generations, with no fewer than seven kids running amok at any time. If my parents were working, then there always was an aunt, uncle or grandparent to help — and there was no shame in asking. If one person needed a break, someone else stepped in — caregiving was a shared responsibility, and the idea of a care village embodies the principle that everyone, regardless of age, deserves a supportive community around them. That’s not a common model anymore, especially in a Western culture dominated by the nuclear family. And although everyone’s care village is different, it doesn’t mean we all still don’t need one.

When you consider the concept of a village, it’s important to think beyond only family. Not everyone has family in the traditional sense and oftentimes, they can be fraught. A village, on the other hand, is accessible and available to all — it just may be your next-door neighbor, your former spouse, or the people you play cards with each month.

With a village, it doesn’t matter who “resides” there; the important thing is to have that connectedness of care. And just as its members don’t have to live under one roof or even next door, a village also might not even be a person, it also could be technology.

With advancements in AI and machine learning, technology that can connect caretakers to people both on and offline, and a proactive internet of things that allows caregivers and care receivers to get ahead of a future incident, our villages become exponentially vast.

This affords peace of mind. Because I worry — and not just about the older members of my family. I think of my daughter at college and her personal safety and security, my friend out on a Tinder date, and my real-estate agent relative, who makes a living showing houses to strangers.

It’s not likely that they’ll take a nasty spill or encounter anything untowardly, but if there’s a way to help them feel more cared for and safe, then I’m here for that. I’ll know my care village is a vibrant and dependable one. And this puts us all one step closer to leading a life with dignity, independence and the joy of possibility.

Chia-Lin Simmons is the CEO at LogicMark and a tech veteran with more than 25 years of industry experience. She previously worked at Google, Audible and additional companies before joining LogicMark in 2021. LogicMark provides personal emergency response systems, health communications devices, personal safety apps, services and technologies to create a connected care platform.

The opinions expressed in each McKnight’s Senior Living marketplace column are those of the author and are not necessarily those of McKnight’s Senior Living.

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A senior living community’s approach to finding the best wellness technology should begin with an examination of the needs of its residents and staff members, according to a new report developed with a group of providers and other experts.

A International Council on Active Aging Forum think tank of 60 leaders in senior living, community-based services and technology companies met in the fall to formulate recommendations on helping communities develop a wellness technology, or well tech, vision, as well as implementation strategies. The group’s work was compiled in “The promise of well-tech,” a report released Tuesday by ICAA.

“It was extremely valuable to have both the senior living leadership and the technology companies in the same room,” ICAA CEO Colin Milner said in a press release. “The providers detailed what they look for when selecting a technology, and the companies shared insights from their points of view. Everyone walked away with a better understanding of needs and opportunities.”

Well tech, according to ICAA, includes resident-facing technologies that enable communication, engagement and self-care; technologies that enable staff members to communicate and engage with residents; and technology that helps organizations deliver services and lifestyle opportunities.

The report outlines eight principles that participants said should guide every community’s technology vision, including:

1. Technology strategies should serve the organization as a whole.
2. Involve people who will use the technology in decision-making.
3. Examine the utility and usability of technology for each user.
4. Technology must include troubleshooting, training and long-term support.
5. Long-term partnerships between providers and technology companies are necessary to maximize value.
6. Data should be analyzed to find meaningful patterns and trends.
7. Training on data collection and interpretation for staff members and leaders is a must.
8. Cross-functional teams must analyze data to track wellness outcomes.

Well tech can generate data to prove the value of wellness, personalize services for residents and increase self-care, all while enhancing communication among staff members, according to the report.

The document outlines a planning process that communities can use when considering wellness technology, including discussion question examples and a toolkit of checklists for developing a vision, performing an audit and needs assessment, implementing technologies and evaluating outcomes.

“Technology has tremendous potential to help aging services providers deliver the wellness opportunities that make life worth living,” Milner said. “Grounded by an alignment of mission and values, organizations that buy and companies that sell can develop products and services that benefit the users they are intended for and the businesses themselves.”

Fifty-five percent of US CEOs surveyed cited “economic downturn/recession” as a high-impact issue for 2024.

“Both factors also topped the 2023 list of high-impact issues. While we believe a global recession is unlikely in 2024, we do expect slower growth in the wake of tighter monetary policy to tackle inflation,” the authors noted. “Adding to global CEOs’ concerns is that less than 30% believe their organizations are adequately prepared to navigate either a recession or inflation.”

Several leaders of senior living and care industry groups recently told McKnight’s Senior Living that they expect that operators will continue to face inflationary pressures and capital market challenges in 2024, but that some effects may lessen before the year is out.

The Conference Board survey, conducted between Oct. 24 and Nov. 24, asked 1,247 C-Suite executives, including 630 CEOs, for their views on top business threats and opportunities in 2024.

The top five external issues that could affect businesses, according to respondents, are an economic downturn / recession, inflation, global political instability, labor shortages, rapidly advancing artificial intelligence technology and higher labor costs.

“Close to 90% of CEOs see AI increasing the efficiency/productivity of labor and their firms overall. They also see gains in innovation and creativity,” according to the survey. “But there is work to be done to create an organizational culture and structure to maximize AI’s productivity. Almost 80% of CEOs say adopting AI will require new capital expenditures, and 94% say it will require new skills and training.”

Respondents said they were less concerned about the effects of industrial policy in their region, wealth or income inequality, backlash over environmental, social and governance policies, shortages of semiconductors/rare earths and shareholder activism.

Internally, the executive respondents said they mostly were concerned with attracting and retaining talent, accelerating the pace of adding AI, enhancing product and service innovation, improving customer experience, reducing costs and upskilling and reskilling talent.

Respondents said they were less concerned about focus on AI governance policy, a full-time return to offices, accelerating the shift to renewable energy sources, the increasing cost of healthcare benefits and unionization efforts.

“Amid elevated inflation and a potential downturn, CEOs’ plans to grow profits in 2024 include introducing new products/services, investing in technology, increasing sales via marketing, and entering new markets,” according to a press release issued in conjunction with the report