I have spent most of my career focused on product development and design, most recently for Wellinks, a digital health company focused on cardiopulmonary conditions, which predominantly affect older adults. I know firsthand the dedication required to create solutions that are beneficial to all users. Engaging older adults isn’t impossible, but it isn’t a passive process. Companies must be willing to put in the time and energy.

Over the years, I have had valuable conversations with older adults and providers alike, constantly tweaking our approach and striving to find the perfect recipe for digital health tools that meaningfully engage older adult users outside of a brick-and-mortar physician’s office. For those interested in helping to make tech easier for older adults to adapt, in designing tech for older adults, or in taking a peek into the design process, here are four strategies I’ve found successful.

1. Demonstrate value up front.

For those who may not use technology regularly, it can be more difficult to see the big-picture effect of maintaining consistent engagement with digital solutions. Being asked constantly to input data without seeing any results can be frustrating, and it can make users question why they’re even engaging in the first place.

With this in mind, we should strive to create digital health tools that constantly demonstrate their value, making clear how each user action helps drive results and make a difference in the care journey. By helping users see both the short and long-term benefits — such as celebrating quick wins or establishing a baseline for daily readings — we can excite them about their results and empower them to continue adapting to new solutions.

2. Meet users where they are.

In many cases, people are fully excluded from digital health opportunities if they don’t have access to or feel comfortable using technologies such as smartphone apps. Rather than expecting older adults to learn completely new modes of technology, companies providing digital health services should be flexible with their offerings.

For example, if someone doesn’t own a smartphone or tablet, then there always should be options for them to engage with similar resources via email, text message or voice calls. Kicking off a user’s digital health journey with methods already familiar to them helps create a foundation of trust and comfort, making them open to being coached through incorporating new technologies down the road. If we commit to meeting users where they are, then we will open doors to quality care for a broader population.

3. Build technology as a window for personal connection.

It’s a common misconception that virtual care replaces human connections. Although it is true that digital health tools can offer alternatives to in-person physician visits, it’s best to think of those solutions as new windows for building human connections.

Fostering positive relationships with care providers helps users avoid the feeling of aimlessly inputting information into an app. Connecting with older residents and patients virtually builds trust and comfort in the process. Those relationships are the key to addressing the care gaps between in-person visits and improving continuity of care.

4. Prioritize accessibility.

When designing digital health solutions, it’s essential to make components user-friendly and accessible to encourage the consistent engagement necessary to be effective. Virtual care designers should prioritize things such as page scalability, screen reader compatibility, clear information hierarchies and a focus on making all elements as simple as possible. Keeping accessibility front and center in product development lets users know you are dedicated to their success.

Older adults managing chronic diseases have plenty to gain from accessing virtual care solutions, and the onus is on those of us offering those services to ensure that our tools work for those who need them most.

Excluding older adults from technologic advancements based solely on their age and perceived unwillingness to learn is an overused excuse. So what if virtual care tools didn’t exist when our seniors were born? For many, neither did computers or microwaves, but this reality hasn’t stopped our grandparents from learning to comment on our social media posts or heat up their coffee. Why should it keep them from receiving quality healthcare?

Research conducted during the pandemic identified a 300% increase in the overall use of telemedicine services among older adults, indicating both willingness and ability to adopt those tools.

The senior living industry must resist the misconception that technology always is a barrier for older people and instead normalize adapting offerings to maximize value for all users, regardless of their age or level of familiarity with tech. Doing so creates meaningful opportunities for those users to gain more confidence in their self-management abilities, establish a better understanding of when intervention may be necessary, and check in more frequently with medical professionals invested in their well-being.

Especially in senior living communities, where older adults are more likely to experience mobility challenges and require assistance attending in-person doctor visits, we have a heightened responsibility to provide more accessible healthcare options that meet residents where they are. With more than 60% of adults aged more than 65 years owning smartphones as of 2021, the foundation for reaching residents already is there. Building it up and integrating digital health solutions is a natural next step.

Virtual care is here to stay, so it is time we start working harder to make those solutions an option for everyone.

Ellen Su is chief product officer for Wellinks, a digital health company focused on cardiopulmonary conditions.

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.

Have a column idea? See our submission guidelines here.

In an attempt to reduce rehospitalizations, researchers have developed a new app that allows hospitals to speak the same language as the nursing homes receiving their newly discharged patients.

The info-sharing app aims to improve the exchange of patient information and better inform the care provided to nursing home patients. It bridges the gap between medical records systems that use different data storage technologies and offers patient information in a format influenced by nursing home workers themselves.

The development stems from a study that started with a team of experienced nursing home nurses identifying key data points and helping shape the way the tool works and its visual format. The process was detailed in JAMDA, the Journal of Post-Acute and Long-Term Care Medicine.

“The reason that people go to a nursing home after being hospitalized is due to their needs for additional support for medical complexity. Receiving information that is inaccurate or delayed ties the hands of the clinical providers in the nursing home, making it more difficult to provide safe and appropriate care at the time of transition,” co-developer and study author Kathleen Unroe told McKnight’s Long-Term Care News on Friday. “Medications for pain or other medical conditions could be delayed due to a lack of up-to-date information.”

Some conditions, especially behavioral health needs, also may be missed by receiving facilities, and those facilities may be unequipped to treat such needs.

“Not only can this place the patient’s health at risk, it can also put the health and safety of other residents (in the patient’s home or in a SNF), as well as provider staff, at risk,” Centers for Medicare & Medicaid Services Director David Wright wrote in a memo to hospitals earlier this year. “These situations can cause avoidable readmissions, complications, and other adverse events.”

Robust info sharing helps staff

Preventing unnecessary readmissions is one of Unroe’s main areas of focus as a research scientist for the Regenstrief Institute at Indiana University.  She said she has been bewildered by the lack of consistency or movement toward interoperability between healthcare settings.

“This is an issue we have had the technology to solve for a long time, and I and other clinicians are frustrated that the situation varies so much by facility and by discharging hospital,” she said. “I appreciate that CMS is pushing hospitals to take responsibility for transmitting appropriate and timely information to nursing homes to support care transfers.”

The info-sharing app development project focused on how critical information optimally should be presented and integrated into nursing home workflows. 

“A nursing home admission nurse or admitting physician should not have to sift through a pile of paper or dig through lengthy electronic health records to capture basic pieces of data that we need to know on each admission,” Unroe said.

The app provides “robust” information quickly to support what the research team called a seamless transition of care across settings, regardless of which electronic medical record systems the two facilities use. It addresses residents’ medical needs as well as what supports they might need for activities of daily living, explained co-author Joshua R Vest, PhD, of the Department of Health Policy and Management at Indiana University. 

And the benefits won’t necessarily be limited to patients, Unroe added.

“Costs of staff training are reduced if the time is put into thoughtful, user-centered design, such as the results presented in this study,” she said. “Increasing sophistication of medical record systems and a greater push for interoperability mean it is possible to get widespread solutions in nursing homes into use.”

Unroe now plans to advance the prototype into a fully scaled tool for broad use on computers and handheld devices. The researchers plan to test it in real time with actual transfers to confirm that it will support nursing home nurses “to efficiently and safely admit patients as well as to ensure that there is no disruption in the clinical care plan created by the hospital due to transition to a nursing home,” Regenstrief said in a press release.

Digital health tools — either in the form of apps or other online healthcare services — won’t be useful for older adults unless they are designed to be easy to use and are available at any time of day, a new analysis shows.

The study adds to the growing body of research analyzing what possible barriers or limitations remain for seniors’ using tech tools, even as their use has proliferated since the pandemic. 

The study’s recommendations could benefit senior living and care providers looking to establish increased use of digital communications between residents, caregivers and clinicians.

Although the study includes both clinical consultations and more generic health information under the broad “telehealth” umbrella, the scoping study is aimed squarely at the latter: how older adults can use digital tools to improve their own health outcomes and lead a healthier lifestyle.

“Even though telehealth interventions for preventive and health promotion purposes have the potential to assist older adults in managing and improving their health, studies have shown that their adoption and actual use is low and inconsistent,” the study authors wrote.

The researchers recommend including older adults themselves in co-designing apps and other telehealth tools, to avoid learning after the fact that a tablet or app is too complicated or complex to use. 

The idea that older adults need specialized digital interfaces, either because of physical or cognitive challenges, is not a new concept. Many clinicians themselves have expressed concerns that some telehealth tools are difficult to use, to the point of being dangerous.

One more unique suggestion from the review, however, is for digital tools to include a more social element, such as peer-to-peer interaction on a platform and the ability for family members to interact with their loved ones.

The scoping review on telehealth used data from Australia; whereas the use of telehealth also is down in the United States from its peak during the pandemic, its use in long-term care settings remains high, and Congress is considering permanently extending telehealth options for Medicare beneficiaries.

Hayoung Bae, from Korea University in Seoul, and colleagues conducted a systematic literature review to identify randomized clinical trials evaluating the efficacy of mobile app treatments in adults with moderate-to-severe depression. 

Based on 13 included studies (16 intervention apps with 1,470 participants), the researchers found that the overall pooled effect size of mobile app interventions was 0.50 versus both active and inactive control groups. Significantly lower treatment outcomes were seen with interventions with in-app notifications (standardized mean difference [SMD], 0.45) versus interventions without (SMD, 0.71). App interventions lasting less than eight weeks were associated with a significantly greater effect size (SMD, 0.77) versus interventions delivered for eight weeks or longer (SMD, 0.43).

“In this systematic review and meta-analysis of the efficacy associated with app-based interventions for moderate-to-severe depression, a significant reduction was found in depression severity associated with use of app interventions,” the authors write. “These findings are expected to provide developers and researchers in the rapidly evolving field of mHealth with practical insights into the development, prescription, and implementation of app-based depression interventions.”

Abstract/Full Text

Researchers say they’ve achieved a trifecta on a new app that captures users’ motion data: it’s cheaper than other devices, works faster and requires only the use of a smartphone.

OpenCap, like many new tools, uses artificial intelligence to help interpret video footage of a user’s muscle and joint movements and subsequently generate health diagnostics.

The ability to capture data on movement is very important for older adults, many of whom either have chronic conditions that limit their mobility or have temporary difficulties while rehabbing.

New technology within long-term care that can track residents’ motion or behavior has largely been aimed at predicting and preventing fall emergencies. 

Beyond acute medical concerns, it has become useful for clinicians and caregivers to track older adults’ physical activity to ensure that they are staying healthy. 

Using some kind of analytics on seniors’ physical activity helps fill gaps in clinical diagnoses by doing things such as measuring steps while they are walking down a hallway, another recent study showed. 

OpenCap works 25 times faster than laboratory-setting body or motion analysis techniques, such as sensors, the researchers stated. 

“By democratizing access to human movement analysis, OpenCap can accelerate the incorporation of biomechanical metrics into large-scale research studies, clinical trials and clinical practice,” they said. 

The initial study, which only involved healthy individuals, did not indicate how the speed or quality of data from OpenCap compared with new sensor technology many senior living communities or nursing facilities have installed, although the ability to glean meaningful information from a smartphone app promises to be more scalable and cost-effective than a proprietary sensor system. 

OpenCap’s development was funded by the National Institutes of Health. The study authors also noted that the type of data the app can collect on nuanced muscle and joint movements is more sophisticated than a lot of sensor systems. 

A new app being developed for older adults could help tackle the growing need to make sure technology is helping underserved communities. 

The app, which developers named Ami, is designed for people living with dementia and features touch-screen games in six different languages and dialects. 

A prototype of Ami will be downloaded onto 1,000 IM-OK devices for older adults in Singapore, courtesy of the social service agency Lions Befrienders. 

Not only is Ami designed to cater to speakers of different languages, but the ability to learn or practice multilingualism on the app can also keep seniors’ cognitive skills sharper, said the developers at the Singapore University of Technology and Design.

Older adults with cognitive disabilities showed improvement in their verbal skills when using Ami over the course of a recent six-month study, the developers stated, adding they hope to make the app more broadly available in the near future. 

In the United States, the need for healthcare services and technologies that don’t discriminate against any one group has become part of the national discussion on care for older adults. 

It has been noted over the past year that some new tech, particularly artificial intelligence, has the potential to exacerbate demographic biases if not designed correctly. 

As of 2020, there were 4.7 million Hispanic older adults living in the United States, accounting for approximately 9% of the US senior population overall, according to a report by the federal Administration for Community Living, of which the Administration on Aging is a part.

President Biden cited the need for new healthcare technology to reach underserved communities during a meeting last month with his Presidential Council of Advisors on Science and Technology. 

Much of the discussion at the federal level about reaching rural or underserved communities, however, has focused on telehealth and telemedicine rather than tech aimed at a specific demographic. 

Heart monitoring is a major concern for older adults, and not just because they are at greater risk for cardiovascular disease. Too few older adults seem to be tracking their heart health at all, observers say.

That’s one of the reasons developers of health trackers are continuously trying to design devices to be as unobtrusive as possible. When it comes to heart disease, a small health monitor could have huge implications.

The next iteration of iRhythm’s wearable patch Zio, for example, is less than half the size of previous iterations. It is coupled with an app re-release, making for “an even better patient experience,” the company announced this week. 

Patients who used the Zio technology experienced better health outcomes and received more accurate treatment options, according to data results iRhythm released in May.

The new Zio patch, which is available by prescription only, “weighs less than a pencil” and is made of breathable, waterproof material that can easily adhere to a users’ skin, continuously recording data for up to two weeks, the company stated. 

The MyZio app redesign includes an all-new user interface and new educational and video content, the company added. 

The Zio monitoring service also uses artificial intelligence to enhance data assessments. 

Although the re-release of Zio’s monitoring service is FDA-approved, iRhythm did briefly get into hot water earlier this year for tweaking its algorithms without notifying the agency. The FDA sent a letter of warning to the company, reminding iRhythm and similar companies to be careful when marketing their products. 

Other novel approaches to heart monitoring include a textile patch in development made out of nanomagnets, whereas another firm, Dandelion Health, is conducting a meta-analysis of AI’s ability to interpret electrocardiograms. 

Although some residential tables are designed with tech for older adults, maybe it’s time that seniors had a seat at the tech planning table, one expert suggests.

Technology aimed at older adults could use more input from seniors themselves, argues Clara Berridge, PhD, an associate professor at the University of Washington. 

Berridge led a team in developing an app, “Let’s Talk Tech,” designed to help foster conversations between caregivers, seniors living with dementia and their families, about what technologies they prefer. The tool was highlighted this week in a story on the LeadingAge website.

Berridge also recently addressed topics related to older adults and tech in two journal articles that focus on robots targeted at the senior market. 

Robots have become more prevalent within senior living and care spaces in a variety of capacities, serving as companions to residents, as well as security and emergency aids. 

Despite more technology and tech literacy programs aimed at older adults, those efforts often involve “pushing acceptance” of such tools, regardless of what seniors actually want, and seniors’ feelings about adapting or integrating certain solutions should be “taken more seriously,” Berridge said in an interview posted on UW’s website.

Often, older adults are just used as “passive data points” in both private homes and long-term care, which can be a problem when technology involves invasion of privacy or restricts movement/controls routines, Berridge said.

In a study on older adults and robots, researchers including Berridge found that older seniors showed greater discomfort with the idea of using robot companions, although that discomfort changed during the pandemic’s isolation period, when access to in-person social interaction was limited. Another survey study found that some older adults living with dementia were afraid that their caregivers would deceive them into confusing robot and human interactions.

For related reasons, some robot developers have shied away from promoting their companions as pure replacements for human interaction. The senior living robot ElliQ, for instance, is meant to be more akin to a pet, or something new altogether, ElliQ’s developers told the McKnight’s Tech Daily last month.

The innovation of “smart” technology aimed a older adults includes “smart” cushions that can be used in wheelchairs. 

Patient equipment provider Etac and smart seating solutions company Kalogon have partnered to expand the availability of Etac’s Star cushion product for wheelchair users, the companies announced Monday. 

The cushion works by using air cell technology and machine learning to redistribute pressure. This process helps maintain blood flow in wheelchair users, and it helps with posture and positioning. The technology also involves a smartphone app that lets users control the cushion’s functionality.

Roughly two million older adults in the US need wheelchairs, and at least 70% of nursing home residents spend part of their day in a wheelchair, research shows.

“Kalogon’s air management systems are a game-changer,” Magnus Bjorkqvist, Etac’s senior vice president of wheelchairs and pressure care, said in a statement. “Together we can deliver the latest pressure care solutions on the market.” 

The Kalogon Orbiter cushion was featured at this year’s Consumer Electronics Show in Las Vegas. That cushion is sectioned into different regions, with each able to be set at varying levels of inflation. 

Some wheelchair users in the US stand to benefit from a rule proposed last week by the US Department of Health and Human Services that would help prevent disability-based discrimination, such as being denied admission to a long-term care facility. Beyond just the enhanced comfort angle, new technology aimed at wheelchair users includes apps such as Ahoi, which is designed to help people find wheelchair-friendly locations — places with automatic doors or entry ramps — in their neighborhood.

A new smart lock designed with the safety of those living with dementia in mind is being hailed as a strong example of “the fusion of technology and passion.” 

The technology, which was highlighted in Forbes recently, works by including a removable thumbturn for locking the deadbolt, which prevents someone with cognitive impairment from opening the door and/or wandering around unsupervised. 

The Lockly Dementia Proof tech includes a mobile app that lets a user lock or unlock a door remotely, with access granted via a biometric fingerprint sensor. 

The device is suitable for both at-home use and installation within senior living and care spaces, the company has said. 

For those living at home, being able to monitor and keep their loved ones safe is a major priority for older adults’ family members. But over the past few years, long-term care spaces now have been adopting more “smart” technology systems. Those tools can both prevent emergencies and extend seniors’ stays in communities, McKnight’s Senior Living has reported.

Three out of five residents living with dementia in assisted living are expected to wander at some point during their stay, Alzheimer’s Association data show. In addition, more than half of older adults who elope from such communities end up being seriously injured or dying.

Technology such as monitoring sensors or GPS tracker apps can assist with making sure that residents living with dementia are safe.

Although a smart lock can seem restrictive, older adults and their families want both the physical and emotional security, and many also want to age in place, a Lockly spokesman pointed out in a recent post about the company’s technology.

Even beyond its own devices, technology such as motion sensors, smart lighting and medication management tools can contribute to a “smart” system, at home or in a facility, a Lockly spokesman explained.