Surveillance Swoops Into Health Care to Protect Senior Citizens
One company offers radar beam for in-home monitoring of vital signs,
activities of daily living and falls; another collects data from motion,
temperature, door, chair, bed, pill box sensors, caller ID information
to catch telephone scams
2013 - In an inconspicuous control room at the Sioux Falls, S.D.,
headquarters of the Evangelical Lutheran Good Samaritan Society, nurses
keep round-the-clock watch on motion and humidity sensors in the living
rooms, bedrooms and bathrooms of elderly men and women in five states.
The seniors - a handful in their own homes and the rest in assisted
living facilities owned by Good Samaritan - are part of one of the most
comprehensive remote health monitoring efforts anywhere.
Using sophisticated sensors, computerized pattern recognition and human
responders, Good Samaritan hopes to show it can detect and head off
health threats to the elderly and thereby accomplish two important
goals. The first is saving money on medical costs. The second is helping
seniors feel secure enough to "age in place" at home or avoid moving
from assisted living to a skilled nursing facility.
Whether this costly technology will ultimately prove clinically or
economically effective remains uncertain. So, too, is whether a benign
health care purpose can help overcome the unsettling "Big Brother"
overtones for some potential users. What is clear, however, is that
health care is joining a national trend toward greater surveillance of
For example, more than 70 U.S. cities now use
sensors to pick up the sound of gunfire and alert authorities even
before 9-1-1 is dialed. Auto insurers are
hooking up sensors
to a car's computer system to monitor driving habits and, with the
driver's permission, calculate premiums accordingly.
Even some farmers are
equipping cow collars
with monitors allowing automated milking systems to track the cow's milk
production, amount of feed eaten and even how long it chews its cud. If
the system detects a problem, it can call the farmer on his phone.
What benefits bovines might also help humans, albeit with appropriate
modifications. Good Samaritan is the nation's largest nonprofit provider
of senior services, operating more than 240 facilities in 24 states.
Working with the University of Minnesota, the system recruited 1,600
seniors in North Dakota, South Dakota, Minnesota, Nebraska and Iowa to
test the impact on cost, quality of care and senior independence of a
comprehensive set of monitoring tools.
With an $8.1 million grant from the Leona M. and Harry B. Helmsley
Charitable Trust, the LivingWell@Home study began collecting data at 40
of its assisted living facilities in January 2011, and will stop at the
end of June 2013.
LivingWell@Home comprises three technologies. First, sensors from
are distributed throughout the living space. (The company stresses that
no cameras or microphones are involved.) When a senior is sleeping a
motion sensor records how often he or she moves in bed. Showering,
toileting and other activities of daily living are also analyzed by
WellAware algorithms and scrutinized by nurses for changes that might
signal health problems.
The second piece is a medical alert button from
that includes an auto-alert function designed to detect a fall and call
for help even if the user is incapacitated. Lastly, remote monitoring is
provided by the
telehealth unit of Honeywell
through a clock radio-sized console in each apartment. It turns on each
morning and prompts seniors to strap on a special blood pressure cuff,
step on a special scale and transmit that and other information back to
the monitors in Sioux Falls.
Jacci Nickell, who is Good Samaritan's vice president of development and
operation delivery systems, emphasizes that the technology is just a
tool. "Unless you gather, integrate and interpret that data in a
meaningful way to the client and to their formal and informal
caregivers, a sensor hanging on a wall isn't going to help anyone," she
says. "It's what you do with that data, and how you optimize wellbeing."
Good Samaritan isn't waiting for the study results to be finalized to
roll out the LivingWell@Home service, in which the system has a
financial stake, as an option in all its assisted living facilities.
It's also putting parts of the technology into some skilled nursing
facilities and even into seniors' own homes.
The organization's website tells the story of an elderly woman who
agreed to have the sensors installed in the South Dakota farmhouse where
she lived alone. Not long afterwards, the sensors detected a change in
her toileting that prompted a call from a nurse. In response, the woman
sought out her doctor, who discovered a bladder infection. "Maybe it was
God talking to me," says 83-year-old Carol Tipton in a
seemingly near tears.
"We think the use of the technology can reduce the need for physical
visits and will save expense and time," Nickell says. Still, the
high-tech security blanket doesn't come cheap. The technology costs $500
to $750 per month per person at home and about $175 a month for
residents in Good Samaritan assisted living facilities that already have
a personal emergency response button service. By comparison, notes Mary
Cain, managing director of consulting firm HC3, conventional disease
management costs well under $100 per month per patient.
"It's a very small percent of the population that's going to benefit
from [the Good Samaritan] level of monitoring," Cain says. "How many
will you monitor, and who is paying?"
similar cautionary note comes from a spokeswoman for United Healthcare,
the nation's largest health plan. United already covers devices such as
those used to detect abnormal heart rhythms or measure blood sugar. But
"health insurers typically rely on guidance from the clinical community
in making coverage decisions," says the spokeswoman, and with sensors
and similar technology "it's too early to do so at this time."
Privacy also remains a concern. Some critics may detect overtones of a
1983 song by The Police that warns, "Every breath you take, every move
you make, we'll be watching you." As Christine Sublett, a health privacy
and security consultant, put it: "Individuals should have the right to
know exactly what information is being transmitted and that appropriate
controls are in place."
Good Samaritan says it takes appropriate precautions, but the research
study may not provide a rigorous test of protection against hackers. Nor
has Good Samaritan or its vendors yet encountered
patients demanding their own data
feed, as has happened to makers of defibrillator monitors and similar
Still, other companies are jumping into this market. For instance,
offers a radar beam to provide in-home monitoring of vital signs,
activities of daily living and falls. The company suggests its equipment
be placed inconspicuously behind a picture frame. And
offers to collect data from motion, temperature, door, chair and bed
sensors, in addition to pill box sensors for monitoring medication use
and caller ID information to keep an eye out for telephone scams.
Choices are also proliferating for consumers willing to pay out of
pocket for detailed quantification of their diet, exercise and sleep
patterns. In just one example,
sells wearable sensors said to gather 5,000 data points a minute on skin
temperature, heat flux and galvanic skin response. The company says its
aim is to provide users with a personalized assessment of health issues
such as stress, fatigue and depression.
Evangelical Lutheran Good Samaritan Society
Michael L. Millenson is a Highland Park, Illinois-based consultant, a
visiting scholar at the Kellogg School of Management and the author of
Demanding Medical Excellence: Doctors and Accountability in the
information is reprinted from
kaiserhealthnews.org with permission from the Henry J.
Kaiser Family Foundation. You can view the entire Kaiser
Daily Health Policy Report, search the archives and sign up
for email delivery. © Henry J. Kaiser Family Foundation. All
• Nursing Home Abuse,
• Medical Malpractice -
• Experienced Legal Help
Janicek Law attorneys are working every day to help senior citizens and others harmed by failure of care in nursing homes and the healthcare system.
you or a loved one have suffered due to the neglect or inadequate care of others, call us today. We offer the skill and knowledge gained in more than twenty years of success.
Free Consultation - Call toll free 1-877-795-3425