A major theme of last fall’s Partners Health Connected Health Symposium in Boston was the need to blend old and new ways of caring for the growing number of elderly Americans who live with multiple chronic diseases.
So often reduced to an either/or discussion — more office visits; more in-home visits; more remote vital sign monitoring — developing new care models, experts at the symposium repeated over and over, must start with a more personable connection with care providers and include socially supportive levels of care. What they were getting at was the need to blend conventional service delivery models with new ones, toward the goal of keeping seniors well, engaged and on track.
care.coach (Millbrae, CA and New York, NY), is a new technology company helping providers create this blend of old and new care modes through the use of pet avatars. Though new, its staff has a history in addressing healthcare needs of elderly patients via "companioning" technology. [GeriJoy was care.coach’s earlier, avatar-based product billed as offering "care and companionship"] The latest iteration takes the connection between elderly patient and pet avatar to a new level.
At start-of-care, conventional care plans are loaded into 24/7-accessible avatars of the patient's choosing — cats, dogs and others. These "pet-like companions" are not toys. They are actually guided by a specially trained "Health Advocate" team. As care.coach CEO Victor Wang explains, "Team members work from home all around the world, and provide a compassionate, psycho-social level of support and personal interaction, 24x7."
Health Advocates, not clinicians
While the specially-trained health advocate team members are not clinicians, Wang explains, they are required by care.coach to complete extensive training and achieve several certifications, often from Partners HealthCare, in the use of a conversational technique known as "motivational interviewing." They also learn from the Alzheimer’s Association to master targeted dementia care for appropriate clients. Health advocates are further guided by care.coach's proprietary software to follow targeted directives, ensuring that patients are properly coached to execute the details of their personalized self-management plans.
Wang adds, "These plans are often very involved, including coaching individual seniors so they can follow their daily care routines and stay on track with medication adherence, exercise routines for fall risk mitigation, and self-management of chronic conditions such as heart failure, COPD, diabetes, hypertension, and others. All the while, their coaching is layered on top of developing a patient's relationship with their chosen avatar."
As an example of how this works, a care.coach website video shows a dog avatar encouraging his assigned patient to bring a sunhat, sunscreen and back-up medications for his upcoming fishing trip. These reminders are followed by well-wishes and suggest development of what the company calls "seamless integration of software-driven health coaching on top of a people-driven social relationship." Supporting a patient's regular routines is another way of customizing care delivery and cementing the one-on-one relationship between patient and avatar.
care.coach typically serves patients ages 50-85+, an age group one would assume is more comfortable with traditional ways of receiving healthcare services and possibly a hard sell for high-tech care delivery. But no, Wang believes. According to patient and researcher views posted on the care.coach web site, participating patients understand that avatars are there to help. For example, at the end of a particularly less-engaged day, the avatar may say, "Remember that you want to get well enough to attend your granddaughter’s graduation from college!"
CEO Wang added that the company is now engaged with hospitals and health plans, participating in clinical research with avatars mounted on inpatient hospital bed rails. "They significantly reduce the rate of falls and delirium by, you guessed it, socially supporting patients and layering on top of that relationship protocols to drive these clinical outcomes."
To those who argue this technology forces a choice between avatars and high-touch nurses and other caregivers, Jennie Chin Hansen, former CEO of the American Geriatric Society and former AARP President replies, "care.coach is pioneering a game-changing innovation for aging and geriatric care that leverages the best of both human and technological capabilities." Clearly, animated avatars driven by remote health advocates aware of each patient's needs supplement but do not replace the work of high-touch, in-person clinicians.
I have been convinced that such technologies should be judged by what keeps patients well, not by what keeps the status quo in place. Aided by evidence of what works, such as that provided on the care.coach web site, I believe we all may finally come around to thinking positively about different kinds of touch.
Audrey Kinsella, MA, MS, is HCTR's telemedicine reporter. She has written on home telehealthcare and new technologies for home care service delivery for 20 years, in 6 books, multiple web sites, and more than 150 published articles. Audrey can be reached at email@example.com or 828-348-5308.
©2016 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan's Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. firstname.lastname@example.org