Seniors are pretty savvy with digital health tools

Not everyone at Invent Health agreed that seniors aren't tech savvy

The way that healthcare is being delivered is changing, with the rise of telehealth services and a generation that is much less inclined to actually go and see a doctor. But that might just be because they don't have to; what about those who actually do need go to the doctor, including seniors? Are they being left behind as the role of the doctor potentially becomes less important than it used to be?

That theme that was prevalent throughout the The Future of Clinics, the latest salon held by Vator and HP, in which a group of entrepreneurs from startups such as Heal, Solv, Crossover Health and Heal got together to discuss the changing way that care is being delivered, and what that means for the future of the doctor's office. 

The panel, moderated by Bambi Francisco Roizen (Founder and CEO, Vator) and Archana Dubey (Global Medical Director, HP), featured Dr. Pat Carroll (Chief Medical Officer, HIMS/HERS), Jenni Vargas (Chief Strategy Officer, One Medical), Yumi Diangi Taylor (founder of TeraPractice at Sutter Health/ Palo Alto Medical Foundation), Karoline Hilu (Chief Strategy Officer, Crossover Health), Justin Zaghi (Chief Medical Director, Heal), Heather Fernandez, (co-founder and CEO, Solv Health) and Mona Chadha (Chief Strategy Officer Bay Area, Dignity Health).

The topic of seniors, and their role in the changing ecosystem, was first brought up by Chadha, in response to questions about whether or not the future of clinics meant that the role of the doctor was no longer necessary. 

Her point was that, for seniors, doctors are still very much needed because they require different kinds of care than young people do. 

"The thing that we will have to keep in mind is also the segmentation of the population. The younger generation really wants to go all digital and then if I want my physical I go to primary care and then I want to go to a clinic. But don’t forget the number of older people that we have and how long those people are living. How do you provide access for them? How do you manage their disease? And then things probably are a good solution where you can offer the right care at the right time and in a way that’s cost effective," she said.

"We are in Silicon Valley and I love technology, and when I try to think about it in the context of Dignity Health it’s a monumental thing to do, so our strategy is to partner. Partner in terms of how to provide better access. How do you provide cheaper access? We had to look into the segmentation of the population. We really try very hard to tell people who to ERs to go to urgent cares, and you will find that there’s this demographic of patients, no matter you do they will turn up in the ER."

Ultimately, said Chadha, "Changing that patient’s behavior is very, very hard. So I want you to keep that in mind as you think about your population."

The topic of seniors and healthcare technology came up again later, with a question from an audience member who asked about seniors not being tech savvy and how the companies on stage think about that.

Carroll responded that thinking that seniors aren't tech savvy is a "mythology."

"I’ll give you a statistic at Walgreens: when you can refill your scripts through your cellphone, 28 percent of the folks who used that were over the age of 65. So, don’t assume that seniors are not tech savvy, they may be a little behind Millennials but they’re catching up very quick," he said. "As we build these tech solutions we should not exclude seniors because they are very interested in tech in healthcare."

Taylor also responded that she didn't believe that seniors and healthtech don't mix, because if there's value for them in it, they will find a way to use it. 

"Once someone who is otherwise not tech savvy, or not that person who normally would be using apps, if there’s value that allows them to have access to care, then what we see is that it’s used," she said.

"We make sure that the technologies that we’re building, we’re not just building for a certain segment of the population. We are building and thinking about other challenges and population, substance abuse support, mental health, so making sure that those chops and capabilities are built in, and those technologies are there when the payment model follows to be able to support that."

Dubey then made the point that technology should be "designed for the extreme user," calling it "the ideal model."

"You have to design everything for the most extreme user and everyone else can fall into that. What you’re saying is an assumption that they will adopt these technologies, but it could be building the right workflows and the right capacities," she said.

Chadha agreed with Carroll that seniors are more tech savvy than given credit for, and noted that "there’s really just a difference in how they want care delivered." For example, for seniors want to visit clinic more than the younger population because "as a senior you’re feeling that every problem you may have may lead to something much more drastic and dramatic."

"They’re savvy enough to use cellphones, they’re savvy enough to be on Facebook. Whereas the younger Millennials might be happy with just having a video call, and content with having their prescription sent over, as senior may say, ‘I really want to be seen,’ and then I want assurance, or a text message, that what I’m taking is right and my problem is not big enough to run. So, we can’t ignore them but the way we deliver care may be a little bit different."

Chadha also pivoted the conversation a bit to talking not only about seniors, but people who are too poor to afford medical care as a population that should be catered to. 

"I came from the for-profit world into non-profit world, but I think this is really the social thing we should really carry as a burden. If you are making profit, you should also figure out how to serve a small set of the population that doesn't have insurance, that doesn’t have the ability to pay a lower amount. I think you can’t ignore that, and if we don’t take that as a social responsibility, then who will?" she said.

"Of course we want the commercial people, that’s what pays the bills, but if we start ignoring it, what will happen to those poor people? So, I think we really need to take more social responsibility and figure out, while 80 percent of your revenue may be coming through urgent cares, others may be commercial, how do you reserve that? It’s really important."

The next question from the audience came from Robin Figueroa of Freed Associates, a healthcare management consulting firm. 

"Even though we’re getting more towards a digital age, I’m not sure the digital age is capturing all that needs to happen to make sure that the patient is staying healthy. There’s a part of it where I go, ‘My mom can’t get into a car. It’s horrible to try to get her to go see her doctor. It takes a lot of effort, both me and my dad, to get her in the car and get see the doctor.' So, I love the fact that we can do the telephone visits and talk with her on the EHR and all, the messaging. But I also go, ‘There’s a lot of medical problems that aren’t being addressed because of that telehealth.’ How would you solve that?" she asked.

After probably half-joking that her mom needs to try Heal, Zaghi noted that "part of it is just using multiple modalities of care."

"So, initially she may need a house call or you might need to take her to any of these clinics, and then the follow up care, I think it’s important it’s with the same provider, or at least the same provider group, so they have that continuity of care," he said. 

Dubey agreed, saying that, telehealth by itself "is not a great solution for somebody with disease management issues and the journey they’re going through with a condition. But it does become a great tool to extend a provider from their offices to a home."

Noting that 30 percent of her visits are done via the phone, she said, her patients "love that I can actually call and go over their lab results and their numbers and everything, and make a decision while they haven’t left their work, even though we are on site."

"For somebody, like your mom’s situation, the plan is created in person, so maybe Heal can do that, and then it’s a follow up with a tele solution. Now they’re more engaged into understanding but tele is not something that’s not changing the outcome. I think it is."

Vargas then brought up a common use case for One Medical, where they will give patients a blood pressure monitor so they can take their own readings and send them via email.

"The old fashioned way is you come in once a week, every other week, and have the doctor take your take blood pressure. The modern primary is you get a blood pressure cuff, and you go home and you take it and, this is very common for seniors, and you send an email and then our system if you do not send your email with two weeks as we asked you to, then we’ll ping you. We’ll reach out and say, ‘We’re waiting for your blood pressure results.’ And we’ll do patient-reported outcomes too," she said.

This type of care is especially helpful for seniors, "who have probably more chronic and more developed diseases."