Raising Tech

Amber Bardon

Welcome to Raising Tech, a podcast about all things, technology and senior living. I’m your host, Amber Bardon. And today our topic is all things smart home. To facilitate this discussion we have Keith Stewart from K4Connect with us. Welcome Keith.

Keith Stewart

Hi, Amber.

Amber Bardon

Keith, can you tell our listeners about K4Connect and your role there.

Keith Stewart

Sure. Well again, my name is Keith Stewart and I’m the Chief Growth officer at K4Connect. I’m responsible for sales, marketing, and business development. I’ve been at K4Connect for about three years. But formally I was running worldwide sales for the IBM Watson Internet of Things division and broadly speaking, my entire career has been focused on technology disrupting different industries. And I think this industry in the last couple years in particular, but has really been on a big evolution and smart home has been a big part of what’s been driving a lot of the change. K4Connect is a mission driven health tech company integrating the best in technology to serve and empower older adults and those living with disabilities. So we’re really here providing powerful enterprise and analytical tools to drive efficiencies, better outcomes, new services for operators, providers, and payers.

Amber Bardon

Thanks for that background. I’m really excited to talk about this topic today. I think smart homes are a buzzword. You hear a lot, but maybe people don’t always understand what exactly does that mean or what does that involve? So we’re really excited to dive into this topic today. To start off with, can you give us a little bit of insight into the marketplace trends? What does it look like in the marketplace and what is the appetite for smart homes that you see from your perspective?

Keith Stewart 2:02

I mean, broadly speaking, whenever we’ve talked about IOT, you can see some really eye-popping numbers. Just the amount of things now that are being connected to the internet. This proliferation is happening that by 2020, there were more devices connected to the internet than people. When you start mapping out that progression line, you’ll see by 2050, it’s just gonna be unbelievable the amount of things that are connected to the internet. You then overlay the older adult demographic. There’s a lot of supportive tailwinds that are happening there. More and more of the average older adult has been using smart phones for 10 plus years. They not only have email addresses, but they have high expectations on using technology. Those two trends combined are really driving a lot of this change.

Keith Stewart 02:59

And then you’ve got all sorts of devices that are just, again, proliferating. Whether it be things around the environment, lighting and thermostats and general things like blinds and fans and switches, all the way through to facilities types of things. Is your oven on, for too long? Maybe it needs to be turned off or energy surge protection or moisture and leak detection. Obviously we are seeing so much, happening in the wellness categories around just tracking your, your pulse or your heart rate, the number of steps, how well you’re sleeping, oxygen levels. And really the big next big frontier is medicine and medicine dispensing and all of those things as it pertains to telehealth. So very exciting. And it’s all happening now.

Amber Bardon

And that’s a great point. A lot of people use terms like smart homes and telehealth, and they kind of toss those around and there is, there is a difference, but they are related to each other.

Keith Stewart

Absolutely.

Amber Bardon

Let’s talk a little bit more about the application of smart home technology in the senior living space. Can you walk me through, what would it look like for a day in the life of a fully equipped, smart home senior in a community?

Keith Stwart =

Well, let’s just start with waking up. And so I might wake up, I might look at my tablet, or ask my Alexa for what’s for breakfast or just start my day before I even get out of bed. But then when I do get out of bed, I potentially, you know, it might still be dark. So I might have a lit path to it at the bathroom. I don’t want to have a hundred percent lighting on me like a spotlight, but I want enough to where I can see as I’m walking into the bathroom. And that might be turned on through a responsive environment, through motion being detected or what have you. But once I get up then I want to know that the coffee is getting started. So that could again be triggered by motion or timed from, some sort of scene that you’ve set.

Keith Stewart 05:08

I might also walk into the kitchen and see that my morning medicine has been dispensed. But after that, I might then think, okay, “well, I’m gonna go, go for a walk.” I can start seeing that my steps are being counted, my heart rate being monitored or any other health metrics that I care about are being tracked. I might then have forgotten to turn off the coffee pot, or I might have forgotten to close the garage door or lock the door. And I’ll have peace of mind to know that if I did do any of those things, the devices themselves are smart enough, or there’s a routine that’s actually going to make sure that those are close. The other fringe benefit here might be that, you know, when you’ve left your thermostat just adjusts to go into energy savings mode.

Keith Stewart 05:56

But ultimately through the day, my activities are starting, are being tracked. My behavioral data is being understood and I’m starting to trigger scenarios based on what I’m doing in real time, but also I’m adding to, and working with my trends data. At some point I’ll return home, it could be in the afternoon or already into the evening. There might be any number of different scenes around your lighting, your temperature, or the music that you’re creating, just for driving a mood. All the while my environment is responding to me, that environment is learning over time, based on that behavior.

Amber Bardon

That sounds like a really amazing experience for communities to offer to their residents. One thing I’m, I’m sure that our listeners are thinking about as they’re listening to the description of this is what is the reimbursement model for this type of technology? I’m curious to know if you could talk about how is this structured in a community, and then alternatively, is this available just outside of a traditional community in someone’s home?

Keith Stewart

Okay, well, let’s take that one step at a time. In terms of reimbursement, I’m not really seeing much in the way of that. What I am seeing though is through different programs like the American Rescue Act and the Cares Act, there is funding that’s being allocated specifically focusing on infrastructure. There are definitely ways that you can get started and find budget for these things with some, you know, local or federal assistance with that. And then the other thing that we often talk about is just if you’re an operator and you’re trying to differentiate, if you’re looking at the sales and marketing side, this is a major differentiation. And really could boost levels just on the virtue of having this where a potentially a competitor down the street might not have that.

Keith Stewart 8:07

The other thing, we all know about the staff challenges that we’re facing, and that growing challenge. You can think about the staff efficiency gains that you can get through the use of data. And, just understanding through the scenario that I talked about before. If you start to see certain trends that are troubling, it might drive behavior on how you’re providing care. And so there, there’s certainly opportunities for staff efficiency and really driving focus where you need that focus. Another element that you could think about is, through the proactive management of lights and your temperature controls. There’s an opportunity for energy savings. Again, these are things that you would think about if you’re building a business case and, you know, some sort of return on investment and payback model. And then a big one really is just the, the very concept of risk reduction and cost avoidance.

Keith Stewart

If you take the scenario through leak and or fire detection, if you’re turning the oven off or you’re proactively going in and finding water leaks through moisture detection, you’re very likely preventing very large, expensive, maybe even catastrophic damage. And then again, I was telling you about that lit path to go to the bathroom. If motion is what’s triggering that, you might have scenarios where you’re doing, situational awareness, much like that staff efficiency game. If somebody went into the restroom in the middle of the night and you didn’t see motion coming back out you might be able to rapidly respond and come in and potentially find somebody who’s in the bathroom a lot sooner than you would’ve otherwise. There are all sorts of opportunities to drive very compelling business cases when you’re starting to think about that growing list and types of sensors that are available. Very much on the business cut case side of things is very helpful.

Amber Bardon

When you talk about the monitoring, that actually brings up a question that I frequently get asked by our clients about the whole concept of smart home technology. One of the things that I’ve heard people say that they see as a potential risk or liability with this type of technology is who is checking that monitoring. And if something is detected through monitoring like a fall or a refrigerator sensor or something like that, does that actually put the community more at risk because they didn’t catch it soon enough for the monitoring should have told them. And I’m curious, from your perspective, what is your answer to that and who is actually doing this monitoring?

Keith Stewart 10:57

Well ultimately we’re not actually taking any responsibility away from anybody who would already be caring about that. What we’re doing is providing better information for that person to be able to do what they’re already supposed to be doing. Kind of an adjacent part, everything that you’re talking about is this concept of security and privacy. I think a lot of people like the idea that, they’ve got a digital safety net, they just don’t wanna feel monitored. And so they don’t want cameras in the bathroom or anyone watching them, but if it’s pure data and it’s contextualized by time and things like that, then you’re really looking at it as triggering use cases. In the case of, from 6:00 AM to 9:00 AM I’d like to know that there’s motion in the room, because that way I know that they’re up and about, and that report can be sent to somebody who’s responsible for tracking morning check-in. I would turn your point around the other way.

Keith Stewart 12:06

A lot of people are using very manual error-prone techniques for doing morning check-in such as, scanning the breakfast room just to make sure that they can visually verify that everyone’s there;  very prone to human error. You would look at other scenarios where it’s things like dialing a phone number in the morning, or pressing a button in the hallway, not really a natural behavior that people would think to do every morning, and so oftentimes they forget to do it. And if you’re just really having that extra data to help you drive action, I would argue that it’s, it’s a lot safer than the other techniques are probably more prone to failure. Now, the other part of that being the security and privacy, of course. This is contextual data based on timing; just light went on, light, went off, that’s not really a privacy or security risk, but when you start building out that model over time, and you start to get that behavior data with the context, you can anonymize that and secure it and just make sure that it’s not in any way giving any HIPAA related information away.

Amber Bardon

Keith, can you tell us what market segments are you seeing the most adoption of this type of technology in?

Keith Stewart 13:32

I think primarily when we were talking about the early adopters, we were really seeing kind of the higher end communities that were really embracing this. Oftentimes it would be the nonprofit providers that had a little bit more money, were focused more on differentiation and recruitment. But you’re really seeing a lot of the for-profit moving into this space. They do look at OPEX probably more than they do at CapEx. And they’re justifying these as either part of budgeted for new builds or differentiation and recruitment. You’re really starting to see the trend go more and more to mid-market just purely on the basis of the of business cases are starting to add up. The cost of the sensors are getting less. Wifi is becoming much more prominent and just the fact that we’ve got such a challenge with staffing,you really need that digital safety net and, and that little extra support.

Amber Bardon 14:34

And I’m assuming you can and implement this just in part of a building or in certain units, it doesn’t have to be a whole community implementation.

Keith Stewart 14:43

Sure. Yeah. I mean, we’re, we’re really seeing people drive this in a lot of different ways. The amenity element of this, the smart home is certainly something that you can do on a room-by-room basis. It might be upgraded during a room turn, if it’s a retrofit. It might be an opt-in scenario based on, you offer it as a amenity upgrade and a resident might choose to go ahead and add the that on. So fro that side of it, the smart home amenity piece definitely on a room turn. If you’re trying to drive core business practices like automating your morning check-in you would really want to try to standardize that across an acuity setting or like a hallway or something like that. So that you’re not trying to mix and match based on who has smart home capabilities versus who doesn’t.

Keith Stewart

And we’ve even seen scenarios where they’ve put in the basics where they’ve got an edge device, like a control box, and maybe some motion sensors where they’re able to do things like morning check-in and trend analysis in the room, but they’re not really investing into the rest of smart home by adding smart fans and blinds and thermostats and all the other things that you could potentially go for. But there’s really a lot of different possibilities there. And something that we’re very accustomed to having conversations and driving based on need and budget.

Amber Bardon 16:12

Yeah. That’s good to know, because I have a feeling for a community who is just starting down this path, it may feel a little bit daunting or overwhelming with so much that’s out there and available. So given that, can you tell us where would a community start if they’re interested in implementing smart home technology, what should they know? What are the key factors they should consider and how should they go about planning?

Keith Stewart 16:34

Well, honestly, just for the point that you just raised, there are so many options and, my number one advice that I give to anyone is just get started. This is the type of thing that will continue to run away from you if you just wait. Each year everything’s getting faster. There’s more device that are coming out all the time. Just get started. Just start to try it and have your own experiences with it. I would also say that you want to work with partners that have experienced in the space. There are so many different strategies that you can take, and certainly there are some better than others. I would also say don’t try to do everything in the first go. The famous adage that Rome wasn’t built in a day really applies here.

Keith Stewart 17:55

It’s about just kind of tiptoeing in, getting some use cases going, understanding it. But when you get started, you need to have a longer term time horizon for what you’re thinking about. So I’m starting today, I want to  get going, but I want to think about where do I want to be in two years and in five years. And that’s not to say that anyone’s going to be able to predict what technology will look like in five years, it’s just knowing that technology is gonna keep evolving, so get started now and think about that five year plan. The one thing that you know, is that you probably are gonna need very good internet. You’re going to need enterprise, wifi, and you need to have a strategy that can scale. You need to have a, you that is extensible and, you know, just know that it’s gonna grow with you over time.

Amber Bardon 18:13

That was one of the points I was going to bring up is I know from working with K4 on some projects and other systems that having that WIFI that’s really comprehensive is really a key base of anything that you want to do around smart home technology or other artificial intelligence type telehealth systems. What else would you say are the key findings that you’ve had as takeaways from your implementations that make an implementation really successful?

Keith Stewart 18:42

Sure. Well, I mean, great point spot on can’t under underline that point enough. Very good WIFI is always at the the root of all of this. But when you think about this, this is business transformation. And like anything with business transformation, you certainly need a champion for that program, so somebody in that community needs to really wake up in the morning and feel ownership of that. They need to be part of that transformation. But equally you need the residents on side as well. So if you think about the concept of a resident champion. I could go to the residents all day every day and just tell them how great this is, and they’ll listen to me, but they’ll certainly be a healthy measure of skepticism in that. But if their peers are starting to adopt it, if they’re the ones talking about it, you start to build a little bit of that, keeping up with the Joneses, and there’s more trust. There’s more believability. They see themselves and their peers in the hallways, and maybe go over to their room and see that when they get up the lights come on or they’re adjusting the thermostat with their voice. It just starts to grow in and of itself. And then the other thing is you need to expect that this is going to  continue to grow. And so whatever strategy you have just think about that continuous improvement element of that.

Amber Bardon

This is so much great information. I am so excited to we’re here to share this with us today. Is there anything else that our listeners should know?

Keith Stewart 20:16

Yeah. I mean, I think it’s all within the points that I was just saying, but, there’s really no way that any of us could understand what the next big thing will be. The advice that I would give to anybody is whatever solution you pursue, whatever area that you try to get started on, think about your strategy with ease of integrating and ease of extending that solution. The other thing that we always say is that the Internet’s not a passing fad, the Internet’s here to stay. What’s happening with the internet internet is just about making that investment and good WIFI. And then ultimately it’s about just getting started. You need to get started. And where you begin is really up to you because you’re going to be that much further on in a year than you would’ve otherwise.

Amber Bardon

Thank you so much for your time today, Keith, and for coming on the show.

Keith Stewart

Absolutely. It’s my pleasure. And look forward to being on again at some point

Amber Bardon

Listeners, thank you for tuning in to this month’s Raising Tech episode, and we will see you next month with more fresh technology insights. Thank you for listening.

Amber Bardon

Welcome to Raising Tech, a podcast about all things technology and senior living. I'm your host, Amber Bardon. Today we have two guests with us, Anthony Columbatto from John Knox Village and Deepak Gaddipati from Virtusense. Welcome to the show.

Deepak and Anthony

Thank you. Thanks Amber. Thanks for having us.

Amber Bardon

Deepak, let's start with you. Deepak is the founder of Virtusense, which is a company you may have heard of. Virtusense has created a revolutionary falls prevention technology that uses artificial intelligence and innovative sensors. Tell us more about your founding story and how virtue sense came to be, Deepak.

Deepak Gaddipati

Yeah, so my background is in mission vision and artificial intelligence. So 15, 16 years back, I developed the first airport security scanner, that you you go lift your hands and looks for explosives. So we practically put in every airport across the globe and I took a break, wanted to do something different in life. When I was 26, I moved to New York city. So while I was there, I got a call from DOE to develop some technology. So I ended up working with the US Army for about six years. And while I was doing that, my grandmother who was 68 years old, she fel and broke her hip, and died as a result of a fall within 10 days from the day she fell. So that's what got me into trying to figure out what can we do to prevent falls. And that was my calling and I started Virtusense in 2013. 

Amber Bardon 01:43

Anthony. Can you tell the listeners about yourself as well and about John Knox village?

Anthony Columbatto

Certainly I'm the Vice President of Health Services here at John Knox Village. We're located in Lee’s Summit Missouri, which is about 20 minutes outside of Kansas City. We are the second largest single site life plan community in the country. And so we provide services from a range of independent living, assisted memory care, skilled. We have our own home health agency, hospice agency and our own ambulance service that we provide for residents both on campus and within our broader community.

Amber Bardon

Anthony and Deepak. Can you tell me the story of how you came to work together and how did you meet?

Deepak Gaddipati 02:25

So it is really interesting, right, Anthony? I mean, I didn't give, I'll give you a little bit of overview about Virtusense products, because I just said about why we started, so you can put the context together. We provide, we are the number one fall prevention solution in the world today. We take care of our 1.2 million seniors just in the US. We are in about 4,000 post-acute care sites. We are in about 40 health systems across the country and rapidly expanding our footprint. This was almost five years plus back, when we were just getting into the market. There is an insurance company called Caring Communities Insurance that actually is a captive insurance for quite a few not-for-profits. And John Knox village was one of the members. And at that time we we got connected with Caring Communities through a affiliation with Ziegler, and they were looking at our technology from fall prevention because 70% of the claims that happen in senior living industry are fall related. Anthony, you wanna take the story from there?

Anthony Columbatto

Yeah. So I mean, from our perspective, we've been trying to navigate the world of fall prevention for a very long time and our industry has not been able to move the needle a single bit. And so as we started to do all these different interventions and we did, we introduced new call lights and we did pressure pads and a variety of other things. And it didn't work. We at John Knox Village, we've always felt like we were trying to be on the cutting edge of new technology, new interventions to improve the lives of our residents. And so Jim Caldwell, the CEO of Caring Communities came to us and said, “hey, I’ve become familiar with this technology that I think is right up your alley.” And so Deepak came out to do a presentation. I think it was in 2017. And I think within 30 minutes we were all sold that this was the company we were going to partner with to actually prevent bad outcomes for our residents.

Deepak Gaddipati 04:43

It was really a very funny story. I was pitching and Jim Caldwell, and then obviously CEO at Caring Communities was with  JKV with Anthony and me, and he said, “hey, I'm willing to pay for this technology.” It was the balance, the assessment system back then, the first one. And and I still remember Rodney and Anthony said, “no, no,” it has enough ROI that we can buy it on our own. So it was very interesting when when they really saw a clear ROI for the residents and as well as my financial standpoint. And I, after that, I mean we deployed a VST balance and assessment system that in under 90 seconds figures out, who's at risk for falls based on balance, gate and function deficits. And it designs a care plan customized for each resident and tracks to see who's getting better and who's not, and it's starts de-risking the seniors. 

Deepak Gaddipati 05:43

The seniors. So that was our first engagement with John Knox Village. And right after that, I mean, the relationship went to the next gear. So during the presentation, I mentioned that we were developing a technology that is in room based that also is focused on preventing falls in skilled nursing and memory care. We said, I mean, we are here or a couple of years out in developing that. And we were focusing a little bit on the hospital side. So Anthony being Anthony, a man who is a very innovative leader, he said, “hey, can we get this in senior living? I, I need this like tomorrow.” I mean, he kept pushing us and we finally, even the same time we were testing us in hospitals, we had it like two years from the roadmap to get into senior living, but Anthony put quite a bit of pressure, they said, “I really need it. I really need it.” So we just got it in into JKV.

Anthony Columbatto 

I think if I remember correctly, I had it on my calendar to call you every three months until you would commit to me when we would be able to have it installed, because it was that exciting.

Amber Bardon 07:00

I love that persistence. Anthony, you said a few minutes ago that you, there hasn't really been any company that's been able to move the needle on falls technology. Tell me a little bit about what Virtusense actually does. So what does it actually look like from a resident's perspective or from a caregiver perspective and what are the benefits?

Anthony Columbatto 07:17

As Deepak mentioned there's two different applications that we're using right now. So let me, let me talk a little bit about VS, I'm gonna go backwards and talk about VST alert first which is the in room sensor that will notify our staff. If a resident is starting the process of getting out bed. We, through Deepak’s research and some of our own, we know it takes on average about a minute from the time that a resident starts the process to get out of bed till the time that they're actually out of bed. And a minute may not seem like a long time in the real world, but in our world, that's a lot of time for us to really get in there and help. As Deepak mentioned with the story of his grandmother, we societally do not know if someone's a fall risk until after they've had a fall, and that's really backwards if you think about that.

Anthony Columbatto 08:10

And there should be some ways for us to understand, you know, what puts someone into that high risk, medium risk, low risk category. We installed 11 sensors onto our rehab unit that was our highest area of fall prevalence and our highest area of claims that we had. And so we picked 11 rooms to do this pilot program with Virtusense over a six month period. And in that six month period, we saw almost an 80% reduction in falls from the previous year, which is substantial. And so I think, and Deepak would admit, we were the first, we were the guinea pigs. We helped them work through a lot of challenges, but it was, and is a really good partnership and learning opportunity. At the end of the day, we were able to prevent falls and, and that is something that we were not able to do on our own.

Amber Bardon 

Where do the sensors, are they on the residents? Are they in the rooms or how does that part work?

Deepak Gaddipati 09:12

The, yeah, let me explain how the technology works, Sam. So the in room technology uses a technology called LIDAR. This is basically what you see in your autonomous cars that figures out in 3D (CUT) what Google does on the autonomous cars or Ford’s autonomous driving cars, so it figures out in 3D, (CUT) where is the bed? Where is the chair? Where is the IV pole? Where is the patient? Where is the hand wash station? So it knows the surroundings. And there are AI chips built in on the system itself that take all this data 30 times a second, it captures all this data. We use two and a half millions such hours of data, trying to figure out what do people do before they get up from the bed?  And before they get up from the chair. because traditionally all you know is after. There are a bunch of things that tell you they have fallen or they have already gotten up from the bed, so it's too late. So using this AI, today we know 30 to 65 seconds before they get up that they're going to get up, with very few false alarms

. 

So as a result, when the system talks back with the resident in the room in a bunch of different languages, so it says, please don't get up, someone will help you. And at the same time alerts the nurses and the CNAs and techs on their phones or endpoint devices and in the central console and the nursing station. All this happens simultaneously that extra time of asking them to wait in their room, gives you an extra minute or two. So as a result, most, a lot of times when clinicians walk in the residents or seniors are still in their bed or in their chair and they're waiting.

Deepak Gaddipati 10:53

So that's how we are preventing significant amount of falls. And it's, you don't need, it's a super lightweight system. It's like that small. It just fits in your hand and it goes on the wall. And the most important thing to note is it's not a camera. It works both in night and dark. It uses like how do you think of a radar in submarines that uses Doppler and ultrasound and all that, this uses just light. It’s completely privacy centric. You don't know if it's a male or a female or a skin tone, nothing. And even all that data is only just processed and discarded. So we don't keep any of that.

Amber Bardon 11:32

That one minute response time seems like a short time window. How do you present this to caregivers in terms of being constantly aware and looking for these alerts to come in and what is your - what is the response like to alerts?

Anthony Columbatto 11:46

Our strategy was really to focus on the nurses. We know at any given time throughout the day, a CNA could be tied up in a room with a resident and that could prevent them from leaving that person in a vulnerable position to help another one. Our communication strategy was aside from the fact that, you have the opportunity to prevent a fall when a nurse has a fall on her shift, there's a lot of work that goes into that. Even for a non-injury fall. They have about three hours worth of paperwork to complete. They have to notify a family member. They have to notify the physician. They have to do 72 hours worth of neuro checks on the patient. In our mind it was okay, you have this device on you, you see the alert, it is worth dropping whatever you are doing to go help this resident, A, to prevent a fall, which is most importantly, but B all the after effects that, that come after the fall. And, and I think that was the, the key to get a lot of buy-in.

Amber Bardon 

What is the resident and family response to this? What are their thoughts on this platform? And do you encounter any resistance to this type of technology?

Anthony Columbatto 12:55

We have not encountered resistance. I remember the first time we deployed it, we had a daughter that we were informing about the sensor and what it could do. And I remember that the daughter ended up in tears because she said, “I can't even at home, get my mom to stop falling. And for the first time I have home hope,” and I'll never forget that story. We have them sign a, a waiver, just letting them know that there is a sensor in the room that we are going to be working with a a software vendor to monitor and to send alerts and things like that. I've yet to get anyone that did not want to sign the waiver that did not understand what we were doing. I think everyone has been very supportive.

Amber Bardon 

Deepak, can you talk a little bit about the growth of VirtuSense? How many communities are you in? How many residents are you serving today in the senior living industry?

Deepak Gaddipati 10:53

The bulk of our installations are in senior living. I mean so we had exponential growth in 2020, 2021, and so when we were working with Anthony, probably we were in about about a hundred, 200 communities. And so what happened after that is the assessment product VST balance got a very, very wided option because of the outcomes. So we started, so if you think about it, everything today in falls is reactive and everyone reacts after a fall happens, whether it's in a nursing home room or even in an AL or IL, everything is reaction based after you fall. So when we identify these deficits ahead of time, all of a sudden physical therapy, contract rehab providers, a lot of them got us into, they bought thousands of systems from us and put them in these communities where they were reducing falls significantly.

Deepak Gaddipati 

They were able to generate new revenue streams by identifying MED B residents. As a result of that, we expanded to almost about 4,000 facilities with the VST balance product. And on the VST alert side, we've been growing very consistently. We are in few thousands of beds in postacute side. And the same VST balance actually is also used now in primary care. It is used during annual wellness visits by primary care physicians, so quite a few health groups. Anthony, I don't know about you, but at least in central, we have quite a few health systems rolling this out, across all primary care in Chicagoland and quite a few places. Yeah.

Amber Bardon 

That's amazing growth. Congratulations.

Deepak Gaddipati 

Thank you.

Amber Bardon 15:32

Can you walk me through when you're having these initial conversations with a community, what are some of the benefits that you highlight? How do you talk about the ROI and the cost model and what are some of the other key things you think that community should know?

Deepak Gaddipati 15:46

Yeah. Obviously depending on what kind of community the ROI is different. For example, if you're looking at a just let's start with skilled, because that's where the toughest place where a lot of falls happen, right? So to give you a perspective, as I said before, 70% of the claims that happen in skilled nursing are fall related. So if you keep that in perspective, the industry numbers are average across the country. An average, hundred bed skilled community has about 1.3 settlements in a given year. I'm sorry, 1.5 settlements in a given year, and the average settlement costs is about $250,000. So if you think about it, they're spending about $375,000 a thousand dollars a year, and 70% of those claims are false. So when we did this study with Caring Communities Insurance, and what it came down to is we were actually eliminating the complete, we were reducing the claims by 70%.

Deepak Gaddipati  

This is almost, if you think about it, it's about a quarter million plus savings in a year, that's the first thing, The second thing is now your quality ratings, your star ratings go up. I mean, we've seen this in quite a few communities. I mean we actually did a case study in a different community where we reduced falls with injuries by 96% within a quarter of implementing this. And the nurse to patient ratio is something off late. We are seeing a big jump because we are going to be enabling pressure ulcers. We are already doing this in few hospitals now. So as a beta program, Anthony, so what it's gonna do is, I mean, if patients don't turn a bed, it's going to talk back with them and say, “please turn to your right side, or please turn to your left side.”

Deepak Gaddipati 17:41

And if they're not compliant, then it alerts the nurse. So as a result, we will be reducing about 70 to 80% of pressure ulcers that happen in any clinical setting. When you are doing all this in a highly automated fashion where your nurse doesn't have, or CNA doesn't have to go in every 30 minutes or an hour and check on the residents because we are checking them every 30 times a second. That really helps you provide care for more people with less resources. We are seeing this in both hospitals and post acute care. So these are some of the three big benefits, right? I mean, reducing costs, the liability legal costs. Enabling more, I mean, actually there is, if you are a using a physical therapy provider to use our balance system, then what happens is you also generate new med B therapy revenue, and you almost have a five to six ROI on that system right away.

Deepak Gaddipati 18:40

So that's why a lot of contract rehab providers use our technology today, right? So between all this and then day one, when we go and flip the switches, we actually, it's a ROI positive thing. It's immediate new revenue, cost avoidance, as well as quality metric improvement. And quite a few communities use this as a marketing differentiator like John Knox Village. When you want to put in your, let's say your mother who is 78 or 80 years old and visit three or four communities, everyone says the same thing. I mean, plus or minus 10% change in pricing. But you can say, put them through a quick assessment when they walk in, and show your mom is a high risk, and this is the technology we're going to use. This is how we're going to take care of them. And if they don't get better, then we put these sensors in their room to make sure we take care of them without falling. It’s a very simple decision for a family member to make.

Amber Bardon 19:36

Anthony, can you talk a little bit about how you implemented the program at John Knox? What are the things that you think were the keys to success and what are maybe some things you wish you would've known or lessons learned that you could share?

Anthony Columbatto 19:49

Well, yeah. And I said, I was going to go backwards and talk about VST alert first. I'll stick with that. That, that was a program that, I think we knew going into that,being the first, you have all the benefits of being the first community to have that you have all the pitfalls as well, right? Because we're all learning things together. I think I don't really have anything that I would've done differently with that implementation. Virtusense and the team were out here routinely on the phone with us as we worked through and learned together, and so that was a really good relationship. I'm a personal believer that, you know, we're not a customer, we're in this together. And we have always been treated like a partner which has been fantastic. 

Anthony Columbatto 

On the VST balance side, the reason I went backwards is even though that was on our campus first, it actually took longer to get that integrated into the culture. And that I think more so is, we didn't really understand the long term ramifications of using a product like that. And so very recently we've started to use that product more routinely. And as Deepak has said, we have seen a incredible increase in the amount of referrals for outpatient therapy that the group that is doing the VST balance and the outpatient therapy group are now meeting on a weekly basis to find out who did their VST balance system and who would benefit from therapy? We've told our residents that our goal is to have them do the VST balance every six months or so, because it will track them over the course of their lifetime.

Anthony Columbatto 21:26

It'll show if their gate speed has slowed down or their time get up and go is different, or their balance has just changed as they've aged. And it was funny. We're now starting to walk around campus and we'll hear, “well, hey, you’ve got to go get your balance test done. And so the residents are finally starting to embrace it because they want the same thing that we want, which is for them to age and place as long as possible, and to receive healthcare where they want to receive healthcare, as opposed to being forced to move through the system.

Amber Bardon 

What do you see are the real possibilities to take this technology to the next level in the next couple of years? What do you envision how Virtusense will look in the next three, five years in terms of outcomes in new products in, and tell me what you're most excited about.

Anthony Columbatto 22:10

I think historically senior living has been so far behind other interest industries from a technological standpoint that we're now starting to see a lot of companies flood the industry with a lot of different solutions. For us, we’ve had to carefully pick and choose because you can't do everything right? And so we've had to be very strategic with our partners. I think what I'm looking for is to partner with organizations that can continue to automate some systems and some processes for us and really to augment our workforce because we've all experienced tremendous workforce challenges, even pre pandemic, they're getting worse I feel like almost every day. And so we have to figure out like other industries have how to utilize technology to help us augment care, deliver care, whatever system that is, because that is going to be where the future is. That's where we're very excited to continue to partner with a very forward thinking organization, like Virtuesense so that we can continue to kind of look through that crack crystal ball together to predict what the future's gonna look like and how we can create a different future for seniors and a better one.

Deepak Gaddipati 23:25

So just to add on to that, Amber exactly what Anthony was telling. So when we started our collaboration relationship with JKV, Dan Rexroth, who is the CEO of John Knox village, Anthony and Rodney. They were the three pillars who saw what we were doing and where we are going with it. Right. I mean, it's not just the falls I mean, it was about the pressure ulcers and and it's about enabling care. So what happened during the pandemic is, it’s becoming very hard to get hold of specialty physicians to really help residents in a nursing home. And on top of that, you don't have enough staff to actually care for these residents. What we are doing now is, and we are already doing this in the hospital side where we are enabling telehealth. What we mean by that is, when a resident has, for example symptoms that are not getting better from a physical standpoint or pain standpoint, we can bring in a physiatrist onto the system within a matter of 24 hours.

Deepak Gaddipati 

So like that. And they can schedule a call and they come in and they provide care. And there is no cost to the facility, and physicians will bill directly through telehealth and they'll take care of the patient. And in most cases, there's not a lot of cost to the patient either because they're all covered to insurance site. We are not only just provide being predictive. We are being the ecosystem that connects and deliver care pretty quick. So Anthony, one more thing, there is a new partnership we formulated through which you can designate one room where we’ll put our hospital grade VST one inside the nursing home. And if you have any patient that has a stroke, within 90 seconds, you switch the system on you will get a stroke neurologist to evaluate the patient. So today if you think about it, you drive the patient to the ED and the ED it's about 20 minutes, 

Deepak Gaddipati 25:31

And then there is a stroke neurologist that needs to see them. The point is not all EDs have stroke neurologists. There is a huge shortage. So the company we are working with, they actually partnered with us on the ED side in the hospitals. And then we said, why should we wait another 20 minutes to make the call? Why can't we do this in the nursing home itself, or in senior living where all they need is and access to a nurse? So if we can get access to a nurse, they can do initial triage rather than waiting and putting them at a 70% mortality risk. Can we reduce that to 10 to 20% by identifying, by intervening ahead of time? These are new care delivery, enabling mechanisms through telehealth that we are doing. And additionally, we also did decent amount of work with Anthony and his team on vital monitoring.

Deepak Gaddipati 26:25

So we have FDA approved patches. These are like stickers that go on the chest that automatically measure all the vitals like heart rate, respiration rate, pulse, core body temp, PCG, and blood pressure. And the AI automatically looks at deterioration and would alert the nurses if the patient is deteriorating. So you don't have to wait to get vitals every eight hours, or 12 hours. COVID cases, you have to get vitals every two hours. So you don't have to use PPE or the mask. The system was automatically doing all this for you. And now we are working with Anthony to get it more into, independent living. A wearable that goes on your arm that can monitor these vitals pretty much real time. Like once every 15 minutes, it's like a small iPod. If you remember the iPod nanos that go on your shoulder it's exactly of that size. So there is quite a bit of innovation coming in healthcare and especially to be, our focus is to be proactive, right? We just don't want to tell after something happens, because there's already people who know what to do when a person has heart attack or respiratory failure. We want to find these out ahead of time. We want to find sepsis ahead of time. We want to find pressure ulcers before they happen, falls before they happen. So that's the pathway for Virtusense

Amber Bardon 

That sounds really exciting. I'm excited to see what comes next. Anthony and Deepak, is there anything else you want our listeners to know?

Anthony Columbatto 27:54

I think as dark as the last two years have been for our industry, I really do believe that we are headed for a very bright spot, and I think we've talked pre pandemic even about how this next generation of seniors, they're going to want to age differently. They're going to want alternative choices. And so now fresh off the pandemic, I think we're at a point where we are going to have some very significant offerings for them, and we're going to meet the consumers where they meet and want to be met, which is exciting for both parties.

Deepak Gaddipati 28:31

So just to wrap up on that, Amber, I think, I mean, I can't echo more. The last two years have been really, really tough on healthcare. But senior living, you had the toughest problems and least amount of dollars on the other side, which made it even worse. And typically healthcare is not only just senior living. In general healthcare, we have always been very a reactive society and always we threw people at problems. And this is the first time in the history where we don't have people to throw at problems. So this is where the key for, I don’t want to use the word, autonomous care, but to the level that we want to be predictive and augment the capabilities of clinicians on the floor, you can't expect them to run around and do everything and do all these original 20 things, and it causes burnout, stress and all these things.

And you need to take, senior living communities will have to make some technological investments like core base. You need to have a very minimal working WIFI for any of these technologies to work, right? So those are some of the investments they need to make on the infrastructure side. On top, they need to pick technology partners that can truly transform care for them and make some bets. You’ve got to move. You can't just drag, wait for miracles to happen. Because I mean, if anything that got thought in the last two years, unless you act, you'll be in a tough spot,

Amber Bardon

Great summary and wrap up. I love it. Thank you so much for joining me today. Deepak and Anthony. Thanks

Anthony and Deepak

Thanks for having us.

Amber Bardon

And listeners. Thank you for tuning in to this month's Raising Tech episode and we will see you next month with more technology insights. Thank you for listening.

Amber Bardon

Welcome to Raising Tech, a podcast about all things technology and senior living. I'm your host, Amber Bardon and today I'm joined by two guests from Pi Architects, Greg Hunteman, and Sam Swinbank. Greg and Sam, we've had a lot of conversations about our topic today, which is technology innovation and new construction and I feel like each time we get on a call, we could just keep discussing topic for hours. It's really interesting. And there's so much opportunity in this market right now. But before we get started, could you go ahead and introduce yourselves to our audience and tell us a little bit about yourself and about Pie? 

Greg Hunteman

Yeah. Thank you Amber it’s  great to be here we really appreciate the opportunity. I'm Greg Hunteman. I'm President of Pie architects. Our company focuses on all types of senior living. Active adult all the way down to hospice and nursing. So a little bit of everything. CCRCs and repositioning renovations. We've really been blessed to have a variety of clients that have actually allowed us to kind of add services. So we do the architecture, the interiors, the landscape, the planning, and recently the past couple years have added low voltage to improve the services that we provide.

Sam Swinbank

And good to talk with you, Amber. I'm Sam Swinbank, Director of Engineering at Pie Architects. I'm licensed as a professional engineer to practice electrical and low voltage engineering.

Amber Bardon 

Thanks for the introduction and that background about Pie to start with, let's talk about some number in terms of how much growth and new business is being developed right now with new construction. Can you give us some context about the opportunities that are out there?

Greg Hunteman 01:53

Yeah, it's really picked up. It was a little slow through COVID. You know, the banks were a little slower, but really in a weird way,  the IT kind of did not really pause. The desire to connect with people remotely, really amped up the marketability whether they're trying to continue to fill up or maintain occupancy in existing building or the blue sky side of it. So really amping that up as it's harder for families to get into the communities on the marketing side. So in a weird way, the IT didn't quite take the hit that I would say the new construction and significant repositionings have taken it. So really in the past, say two, three months, we've really seen a lot of positive movement on the new projects that have kicked off numerous projects in several states where we're really starting to really think through how we're doing because the cost of construction ha has grown so much and the cost of land and staff and everything that really we're having really start thinking even deeper about, what we're doing, how we'reproviding the services to the residents, the construction costs.

Greg Hunteman 02:53

How do we, how do we try to mitigate that a little bit, but in a weird way, it is kind of the new norm. So I think people are starting to realize, “hey, you know, things, aren't gonna go down a whole lot,” inflation is obviously kind of here. So what can we do to, you know, provide the greatest success in the new communities that we're doing and control the costs both in the operations and the staffing and the new development in construction.

Amber Bardon 

So it sounds like what you’re saying is we're really seeing an explosion of need in housing services in the marketplace today. And what people are looking for now is very different than in the last 20 years or so. Greg and Sam, what are you seeing as the top needs in new buildings That's different than in the past.

Greg Hunteman 03:40

Really it's the social integration. People are realizing through COVID that the wellness of the residents is critical and being isolated and not integrated, and really I think that's what I think brings most of the residents to the communities and now to their houses. They really need that socialization, the integration with other folks. Numerous studies are starting to show that the lifestyle, the social engagement that people have is just as critical as the genetics. And that's something relatively new I'd say from that standpoint. And really it improves their satisfaction. It improves them inviting their families and friends into the communities, so I think that's super critical in how we're doing it and that engagement can be done in so many different ways. It can be done in the kind of video engagement that we do with signage. It can be done as applications. We're doing a lot more working with apps and how they integrate with residents. The biggest challenge is more of an active adult independent living community that is low staffing, but they want to feel like they have a higher touch, but then the privacy aspects of being in their unit. So it continues to evolve. The residents are just wanting a lot more than they used to. So a lot more expectations.

Amber Bardon 

So we're seeing a lot of innovation, a lot of news systems, a lot more focus on the resident experience, especially when it comes to technology. However, there still are core systems that are expected and need to be installed and maintained as part of these projects, things like emergency response, door access, et cetera. And from my experience, it feels like there's not been a lot of innovation in those areas and in those types of systems, and that can feel really frustrating. For example, you're building this beautiful new building, and then you're putting a nurse call wall unit that looks like it's from 1970, it's plastic, it's yellow. The pendants are still just unappealing. What are your thoughts on why hasn't this technology evolved more or to look like a Fitbit or an Apple watch, or why hasn't the design of that technology kept pace with innovation in other areas?

Greg Hunetman

So I think the biggest challenge is we've seen lots of devices kind of come through the system where they're really cool. They look really interesting, but I think the problem is that the devices improve so quickly, whereas the technology and the integration of that technology, that evolves so quickly as well. So right now, I think we're going to get to the point where I think they're just gonna start using the Apple watches. They're going to start using the different devices that we're using in every day life and can try to do more interconnectivity with it. We're involved with Ziegler's linkage group, which is kind of interesting. They're doing a lot more of kind of investing in the different companies that they see are going to provide those future devices, the future just technologies, whether it be software or hardware to folks. And it's been fun to be a part of that, to see it very early in its advancement. K4 was one of the big ones that they kind of were able to look at to Care Merge as well.

Greg Hunteman

So it's been fun to be a part of that. And then through that, they've also brought in a lot of futurists, I guess you could say that are really anticipating where we're going. The challenge is going to be creating just a very good backbone in the community. Sam has got some great things that he's done with residents so that he can develop this backbone that's not just for today's technology and interfaces, but what can we do that is going to give them that 10 year longevity, we know at some point it's gonna have to be improved, but how do we do that?

Amber Bardon 07:18 

Sam, from your engineering perspective, what do you see are the biggest areas of opportunity when it comes to innovation in technology and new construction?

Sam Swinbank 07:27

One of the big new opportunities is that technology has finally evolved to the point where it can increase resident wellness and resident satisfaction without requiring more touch from staff. Software platforms that we discuss on our regular calls like K4Connect and Care Merge, and Caspar are using artificial intelligence and knitting together ‘internet of things’ devices like relatively new smart switches that have integral motion sensing for instance, to create reporting on whether a resident is moving about an apartment normally, and whether they've fallen. If a resident and a family opt in an adult child at their own home, can discreetly check in with the software platform to see how their parents are doing, including how they slept last night, all without additional staffing. To me, that feels like a significant new opportunity.

Greg Hunteman 08:16

Yeah. And then the good thing I think about that is that they're not waking the resident in the evenings when they check on them. So I think there's other upsides to this that maybe aren't completely understood or intended that they found.

Amber Bardon 08:28 

Do you think that the market is in a place now where potential future residents are actually actively looking for this type of technology to be in place when they're selecting, where they're going to move into, or how are you seeing those trends in the marketplace?

Sam Swinbank 08:42

That’s the interesting thing. We have some clients that look at providing it for everybody, and it's just kind of in the base cost. We have other clients that are looking at it as more of a value add, they kind of separate the costs out for the people that maybe see the opportunities there, or maybe they don't think they need it initially, but then they start seeing their friends use it. Especially as there's more risk of fall and stuff like that. I think that as we have the evolution, as more communities are providing this that there's gonna be more of a I guess requirements maybe the right word to, a request and an integration of it. Ironically, it helps staffing. It helps so many other ways that they're, they're running the communities to be efficient. I think it's gonna be here to stay. There's a whole robot thing, which is a whole nother integration here, which we're gonna see. How do you do the charging points for the robots? How do they navigate the communities? They have cleaning robots now. There's gonna be a time when everybody has a robot friend. I know it sounds silly, but it'll be fun to watch and see what happens.

Amber Bardon 09:48

It's really interesting, exciting to think that in the future, not too far off, that people may be basing their decision on where they're going to move into based on these technology features that are available in the communities. It's pretty exciting that that's gonna be our new reality. Talking about all these new and innovating ideas is really exciting, but let's just take a step back for a moment and talk about what are some of the basic considerations you need to have when it comes to including technology in your  design. Our company, Parasol Alliance has done multiple projects where we worked very closely with our clients on new construction or renovation. And we've actually come up with a checklist to walk them through multiple decision points and areas to think about when we're brought into a new project. One thing that we often see is just a lack of a comprehensive attack plan on who is managing what part of the project in relation to technology, especially around things like low voltage network design and business requirements, and we've added this step of gathering client requirements up ahead of time.

Amber Bardon 10:48

So that we're all working off of the same page. There's no assumptions made. Or if there are assumptions that we're testing those, or we're finding anything that's been missed. Based on our past project experiences and some lessons learned, some of the things that we like our clients to think about ahead of time are things like security decisions. These are things that we want people to think about before we even get to the actual type of system we're going to use, or the counts, the number of cameras. For example, do you want and have cameras in the buildings or just on external doors? Do you want to have them in staff areas in resident areas? Those types of answers to those questions is going to all feed into the overall technology design. Wifi is another area that we see a lot of assumptions made that may not line up with the client expectations.

Amber Bardon 11:36

All of the technology we're talking about today really relies on having a really robust wall to wall wifi coverage. But often that step in the design can get missed or be an afterthought, or again, maybe there's some assumptions made without actually having a real heat map design that will provide and guarantee that wall to wall coverage. Another example is thinking of things like, do you want to have smart homes like Sam was talking about with the smart switches? And if you do, you can bring in a company like K4 to help with the actual electric electrical design up front to make sure that the design is optimized for those types of systems. 

Another thing to think about if you have existing buildings, are you planning to extend those systems or is this an opportunity to possibly select new systems and then retrofit those back into your other buildings? Greg and Sam, where do you see technology playing the most valuable role in these types of projects, And what do you think is the optimal timeframe for technology to be involved in projects?

Greg Hunteman

Yeah, we really want to start from day one. I mean, when we start planning and programming the building, we really want to think through everything. We want to figure out how we have the connectivity, not just of the building spaces but of the technology and how it flows through a building. When you come in, how do you feel, how are you connected to it? Are you seeing the digital signage like we talked to? Does the staff have what they need in order to greet you and understand you? Are there ways that they know who's gonna come to the community, if it's a new prospective resident and they know, “Hey, Ms. Green, great to see you excited that you're, you know, touring our community. I think you'll really enjoy such and such..” Because there's a prep and they know that green loves gardening. So they can work through that. There's different ways that can integrate that. But then as they work into the community, you can sell the smart home technology. You can sell the socialization, the clubs, and the way to connect to everything.

Amber Bardon 

So it sounds like your advice is to get technology involved as soon as possible, which I agree with. As we all know, to go back and try to add technology after the fact is always going to be more expensive. So the design phase or the initial phase is really the best time to get technology involved. Sam, what would you say that communities should know or consider when it comes to technology before starting their planning? 

Sam Swinbank 13:52

These days with increased adoption of technology. It's important to think about what we informally call the backbone, the data backbone of the building. How is data going to move around from computer room to computer room, to wireless access points, and through a robust wifi network to get to the resident? It's important to think in the early stages of planning, how you're going to accommodate a wide data backbone for these buildings with increased technology.

Greg Hunteman 14:22

And then when you're looking at that, we have the interconnectivity, everybody thinks of the inside of the building, but how are we going to do the connectivity on the outside the building? How are we going to  allow the residents to enjoy the exterior spaces? Right. It used to be that we'd be stuck in our room with our computer connected to the wall. Now we can take our device anywhere. We can go be in the pub and enjoying a drink with friends, or we can sit on our favorite veranda for a little bit more quiet space. So I think that's important. There's other ways that people are looking at kind of monitoring residents so that they're not stuck at the door, but maybe there's a little bit more of a mesh where they can actually go outside and enjoy the front of a building or some other areas a little bit more to provide a little bit more of the preferences, let's not try to control people so much. So what can we do to give them greater flexibility? 

Amber Bardon 15:14:

Greg and Sam let's tie this all together. Walk me through how you envision this technology experience to be in a new building. Let's say we have no limit on our budget. We've got all the options that's built into the building. What would this experience actually be like for a resident?

Greg Hunteman 

Well, I guess you kind of want it to be as personalized as possible, right? So from the moment a resident, a prospective resident walks in the door, we talked about how they could be engaged, but from the resident perspective, as they wake up, what kind of music do they like to listen to? How do they like to be greeted? How do they let the staff know that they are there as technology just, let them know, “hey, they got up, how well do they sleep?” You have the wellness devices that are kicking into say, “Hey, Ms. Green's doing great today.” Or “I sense, there's something off in her balance, maybe we need to give her X this type of food or whatever. So how do we get all of the different services that we already provide and really amplify and improve the integration to the resident lifestyle?

Greg Hunteman 16:10

Then once they leave how is Alexa reminding them of the different activities that  there are today? Or  how do you integrate in a way that they're friends, they're not just a device that's kind of stagnant? The TV's actually displaying it as well? How does the TV system integrate with the overall I guess lifestyle integration, might be a way of putting it. How do they do that once they get to the hallway? What kind of artwork are they seeing? Is the artwork actually changing? Is there a gallery they can go to when they go to the cafe and  have breakfasts with their friends? What kind of music's playing? What are they seeing on the TVs and the walls? Is there different rooms that actually play towards different types of experiences people want. Do people want more of a pub environment, a cafe environment?

Greg Hunteman 17:04 

We're doing a lot more conservator where it's an outdoor environment that's actually inside and controlled.  How do they do that and then still have access to their devices? Through the day, do they integrate the lighting that actually changes the temperature where that actually helps with their sleep pattern? So that's been proven new very well in memory care communities. It can be a little expensive, but the newer technologies are getting better at how they do that. And so now your body's just going through the natural cycle a little bit better if they're not able to go outside and get that 20 minutes of sun, which really helps kind of work with their biological clock. So how do you do that? So that there's a more seamless, comfortable day cycle, I guess you could say, but then not the sameness of everything. How do we do it so it's actually broken up?

Greg Huteman 17:54

Because I think what we find in these communities is that they're just, nobody wants to go to the same place every day. I know in a house to a certain extent you do, but when you go outside of your house, you want a variety of options. It sounds silly, but you may actually want to go to the same place every day, but you want to know that you could have gone to a different place, if that makes any sense. And then obviously with the seasons, how do you integrate that? So I think just kind of a seamless cycle where it feels a little bit more catered, but then in a weird way, not to perfect. That's where they were, that's where the matrix went wrong. Right? So that's what you're trying to figure out is how do you get that balance? And each person's going to be different. I mean that’s what's going to make it so challenging. 

Amber Bardon 

Sam, what are your thoughts?

Sam Swinkbank 18:41

Baby boomers, the silver tsunami, they're heading our way towards senior living. And they're largely not in the product yet. And baby boomers are largely adopting technology. They have a smartphone and many baby boomers have at least one wearable whether it's a Fitbit or an Apple watch, or even an Ora ring. And so baby boomers are accustomed to technology and  they're going to expect it in this next senior living environment, hopefully in a way that mimics their nice homes, where they're coming from. Inside an apartment smart home devices, like an Amazon Alexa paired with a smart thermostat, smart light bulbs, and even smart blinds will give this feature resident more control of their home independently.

Amber Bardon 19:25

That all sounds really exciting. This has been a really fascinating discussion. This is one of my favorite topics. Is there anything else you would like our listeners to know or you think they should know?

Greg Hunteman 

Well, I think the biggest opportunity we have in senior living is how we integrate wellness. I know it's kind of weird to maybe bring that directly into the technology side, but I think that's the biggest thing. I mean, people are wanting to move into our communities because they're going live longer and better. And so how do we do that? How do we prove that out? And so this really has an opportunity to directly connect them on the social side, letting the staff bring things to them. There's really fun ways where you can do different activities and compete, kind of virtual competitions that you have. Where it's challenging people on health mind challenges. There's so many different things you can do. So I think as we start these projects and we talk about the building programming, we talk about the IT programming.

Greg Hunteman 20:29 

We also want to talk about the branding, how they integrate wellness, how they market it, how we really integrate it. Because with all these things, if we don't have a champion that's encouraging it and integrating it into the community, then it's not gonna get used. I want to maximize the opportunity and the usefulness of what we provide there so that it's done in a way that makes sense. We have the people in the communities that are really promoting it. We have the people that understand it. So training's really big. And sometimes training might just be the way to use it the most efficiently. How can they use it to make it easier and better so that if we can give the staff more and what they're doing, and then also give them more time to spend with the residents is kind of a win-win. Because the staff here they're really doing it cuz they love the residents and they love what they're doing primarily. Because there's a lot of choices they have. 

Amber Bardon

Sam, any additional thoughts you wanna add before we wrap up today?

Sam Swinbank

Our advice having seen this many times would be to plan for our robust data backbone. You can in a way, futureproof your building by allowing large amounts of data to move throughout. Our other key point of advice would be to bring your IT and low voltage teams into projects as early as possible. And let your architects know if we can help.

Amber Bardon 21:41

Thank you so much for listening today. Thank you, Greg and Sam for being on the podcast today, really enjoyed our conversation and be sure to tune in next month for new topics.

Rachel

Hello, and welcome back to Raising Tech. I’m Rachel Lugge with Parisol Alliance, where we help senior living providers maximize their use of technology through strategic planning and full service IT support. In today’s episode, we are going to explore an important aspect of resident engagement, specifically assistive technology, and even more specifically wireless hearing solutions to help combat untreated hearing loss. And to help us explore and better understand why this topic is so important for the senior living field, I am joined by our friend Matt Reiner, co-founder of Eversound. Matt, thank you so much for being on the show today and helping us better understand the importance of assistive hearing technology.

Matt

Thanks so much for having me, Rachel it’s an honor, and a privilege

Lugge

I’m really looking forward to this conversation. So I’m thinking, why don’t we just like dive in and start with Matt. Maybe you can tell us just a little bit about yourself and about ever sound and kind of your journey in, in starting the company.

Matt

Absolutely. So a little bit about myself is I have no idea what I’m doing. I just keep showing up and trying to learn fast, fail fast, and try and improve the quality of life for older adults. With Eversound, we are dedicated to a improving this quality of life, and we kind of walked into it in a in a very strange and kind of amazing way where my co-founder Jake and I had started another company that was doing things in a special events space, helping people throw silent disco events around the country. Jake was still in college at the time. It was kind of an undergrad project that he put together and asked me to come help start it so he could still focus on class and pass which I think we all wanna accomplish while we’re in school.

Matt

But as we were like doing this company and kind of running it successfully year over year, we started seeing a few things happen right around the same time where we started receiving phone calls from senior living communities, basically asking for help. What they were experiencing was that hearing, especially in group program, so think resident council meetings, worship services, BINGO, I know we can’t forget about BINGO. They started calling and asking for help because what they would say is like everyone’s hearing was at different levels when it came to these group programs and they needed a wireless headphones system designed for groups with individual volume control, which was pretty much the system we were using on the silent disco side. And then right around this time I saw what my grandmother was going through.

Matt 03:06

She happened to be 93, lived in a senior living community and frankly her quality of life wasn’t good. She would just isolate herself to a room, blast her television or listen to romantic fantasy novels through her own headphones system. And I would try to better understand why she wouldn’t go out. It all stemmed from this idea of like, “I can’t hear what’s going on, so why should I even bother?” And then right around the same time too, Jake and I were kind of thinking like, “huh, I wonder if there’s an opportunity here to help more are people and kind of expand the business.?” And we probably walked into every senior living community in upstate New York, where we were based at the time in Ithaca, New York. And some of these early demos would just leave your jaw on the ground. You would see staff crying, you’d have residents coming up and thanking you. You would see people thought to be nonverbal, start singing along with music and really set us on this, this crash course over the last five or six years to where we’re now impacting over 1100 communities in all 50 states and seeing measurably improved quality of life enhancements.

Rachel

Oh my gosh. That’s an incredible, what an incredible journey. So what what year was this? When everything, when you started on this journey?

Matt

So on all of our LinkedIns, we’ve got different start dates, but it was about 2015 or 2016 since ideation and then started creating a product that was more tailored for an older adult user in a senior living community.

Rachel:

Oh that’s impressive. That’s incredible. And then to be at in 1100 communities to date. Wow. What would you say is the biggest pain point that you see in communities? I mean I’m just kind of envisioning like you’re in the former company and you’re getting calls from senior living communities. They’re asking you for help. So, so what specifically was the pain point that, that the community is needed help with?

Matt

Yes. So I think the pain point can be best described and pun intended as a “silent epidemic” in senior living communities today. And it all stems around this idea of hearing loss. So when we were starting Eversound, we started looking into more of the data behind it, coming from people way smarter than us. What they were basically saying was that 80% of people over the age of 85 have some sort of hearing loss, but what the hearing aid adoption looks like, it’s about one in five that could benefit from a hearing aid are actually using one on a consistent basis. You know, price, quality, accessibility, you know, the stigma around it is why we see this gap of about 60 to 65% of people that have some sort of hearing loss that aren’t being proactive in finding solutions to help them.

Matt 06:08

It’s pretty amazing when you think about it and you look at the data around some of the comorbidities associated with hearing loss, and I know correlation and causation, we definitely have to think about the differences between that, but hearing loss has been tied to an increased risk in falls, an increased risk of developing dementia. If have moderate or severe hearing loss, you’re three to five times more likely to develop dementia, which is kind of blows my mind whenever I see that. But hearing loss is also tied to of course, isolation. I think it’s definitely a hot topic in senior living communities today. If someone can’t hear they’re more likely to isolate themselves in and hearing loss has even been tied to increased risk of mortality, which is kind of wild, how one sense can really impact everything. And it’s really everything between the ears. So the brain that’s being engaged and stimulated when someone’s hearing might be a little bit better.

Rachel

Wow. That just some of those statistics are staggering, to know that that’s, that’s probably one of the biggest factors for engagement overall is the sense of how as somebody’s able to hear and understand and process what’s happening in their environment. That’s incredible. Can you tell us a little bit more about how you partner with communities and maybe like some of the key outcomes that highlight the impact of your solution?

Matt

Yeah, absolutely. I think when we partner with communities, what we try to identify in the frontrun end is what are some of their key business objectives right now? You know, is it driving occupancy? Is it helping with engaging? Is it helping with the resident experience? Maybe family visits look a little bit different right now, beause every sound could definitely be used to really enhance any level of communication. Right? I think some people just kind of get stuck in their brain that this is just a solution for BINGO, which it definitely can help with BINGO. We’ve heard stories of people winning for the first time in years where, hey, I’ll always support that, but this is really a tool that’s being used across the care spectrum and wherever communication is used. Those PT or OT appointments, those tours to give them more experiential, or someone might come in who might be a little bit hard of hearing.

Matt

We’re also finding that people are, are using it as a tool to, I think wheret he best kind of case study that we’ve done, and every group we work with has gathered their own data or kind of wanting to test the efficacy of this new technology. But one group that really stands out is the Front Porch Center for Innovation and Wellbeing. Based in California who do an amazing job in terms of really vetting tech. And they did a 12 month case study with over 600 residents that showed ever sound improved engagement by 76%, improved understanding of the event by 76%, improved mood in those living with dementia by 64%. And then they had some other positive indicators that ever sound was actually helping. And we’ve had other communities do other studies, right? Whre they’re kind of making sure that this technology piece works.

Matt

We’ve also seen increased attendance again, increased engagement. And when you kind of get to the simple idea, right, the inability to hear is detrimental to how we experience the world around us. And if we can give a tool that can help for a community to really experience that and a tool that’s tailor made for an older adult user and tailor made for a senior living community. So it doesn’t need wifi, doesn’t need cellular reception, can be used anywhere, just a click of a button plug and play. That’s where we really start to see this positive experience of residents lives being better because they can actually hear what’s going on around them.

Rachel

That’s amazing. I love the research aspect and the partnership with those institutes that I can imagine just how powerful that is and you sharing your story and the impact with communities. So can you, I’m just curious, can you tell us a little bit more about like how the technology works?

Matt 10:10

Absolutely.The way that it works it’s similar to Bluetooth, but it’s actually called DECT so digitally enhanced cordless technology. You can actually think about it as like an old cordless phone, but the way that it works is that there’s a transmitter or the base unit and whatever you plug into that AV systems, computers, laptops, iPods, microphones, you can plug in directly in AV systems, so if you have microphones are using, whatever’s plugged in that transmitter would then broadcast to all the headphones simultaneously. In each headphone you can turn it up or turn it down helps to block out some of that background, ambient noise that might be too much. But it’s really just amplifying what people should be listening to at a level comfortable to them. And then the range you’re looking anywhere like 250 to 300 feet in all directions, so about the size of a football field. And then you can have up to 120 headphones to one transmitter. So it’s not just like a one to one, but it’s a one to many. And that’s where we start to see people doing it. Because, maybe Ruth Anne might need it a little bit higher than Betsy, because like they all want to hear the same thing, but they have different hearing profiles of, of what makes sense for them.

Rachel

You mentioned that the solution can be used pretty much across the continuum and in a variety of settings. How are communities most frequently using technology? Yeah. How are they incorporating it into their programming?

Matt 11:41

Yeah. So I would say it’s pretty much been incorporated to help with things that they’re already doing today. Right? The nice thing about Eversound, it enhances things that are already happening. So wherever there’s been a situation of using communication, right? Which is pretty much every and any program that’s happening today, we see Eversound as kind of being as a tool to enhance that. And then we’ve also got like an online database of grabbing go programs that people can use to really set them up for success that way. So our whole goal here to improve the resident engagement and make the activity professional’s life that much easier, helping to curate all this content for them and that they can maximize their time being spent with the residents and not going and finding YouTube playlist or some of the other stuff that might be out there.

Rachel

What are you hearing from the communities when, after the program’s been implemented? Thetechnology is in use. I can imagine this is a bit of a game changer for the life enrichment team.

Matt

One of the most positive compliments that we’ve gotten is people don’t have to lose their voices anymore. Because usually right, if you’re talking about BINGO or doing something, you’re having to elevate your voice. And especially now in a world where we’re still practicing physical distancing, but need to stay socially connected. So we start to hear things like that. We actually have heard compliments that they’re getting more residents out to their program than ever beforen because people can actually hear what’s going on. And then I it’s like almost every other day we hear a story that would just bring like tears to your eyes because they saw a loved one or a resident that they thought were disengaged due to reason one, but then realize that they just couldn’t hear what was going on and then they start to see these, we call them our Ever moments. They start to see their Ever moments you know, front and center within their own community. And that’ just feel good moments all across the board.

Rachel

No, that’s absolutely. That’s incredible. Can you tell us, I’m just curious too about your team. If a community is looking to partner with Eversound, what are the steps and who might they be working with to get the program launched?

Matt

Absolutely. Myself or Eversound would not be where we are today without the team behind it. We’ve got about, I think just over 30 people full time working with us today and really what that looks like, of course we’ve got the, the community advisors or our sales team that are really working with the community to identify what problems are going on, what packages might make sense for them. And then kind of once we get through that, we hand them off to our community success team, which are really there to help the communities feel comfortable and confident with Eversound. What we’ve learned is that with technology adoption, especially in senior living, there needs to be that coach or that, that extra help there to really help with utilizing help with retraining help. If there’s someone that might leave a community and a new person comes in. So our community success team is the most like amazing people that I think that I’ve ever met. A lot of them are former program directors themselves, and they’re really there to make sure that the communities are able to fully utilize the technology and making sure that it is improving that quality of life for their residents.

Rachel

That’s fantastic. We touched on our ROI. I mean, there’s a lot of it, there’s a lot of return here for communities and impact. Engagement goes up, quality of life goes up, isolation goes down, there’s the team even workforce, you know, this is impacting workforce, this is impacting a high value ads for the life enrichment team. What a tool. Can you give maybe a few guiding print of advice that you might offer a provider who is looking to enhance their resident experience through technology, what they should consider?

Matt

Absolutely. So I think one of the things that I’ve seen, you know, we’re definitely still, I would consider a young startup, but as these reports are coming out about the aging demographics, right, and you start to see more and more of these tech companies and these startups popping up into this space where I think a lot of ’em are really cool in concept, but I think I’ve heard horror stories of communities start working with companies that are startups that end upnhaving a three month runwayand  aren’t around for the long haul. I always like it when we have new partnerships or even current partnerships that are asking us about our what’s our one year, our three year, our five year, 10 year plans, just to make sure that they’re, they’re investing in a company that’s gonna be around for the long haul and not just gonna be there for a year or so where you invest invested all this time and money.

Matt

And then that solution is no longer available, which is just definitely something. So I guess the advice would be to a provider is just press those newer companies. Even the older companies, are they going to be around, are you investing your time and energy with the right company? I would say another just piece of advice is looking for solutions or companies where they’re actually working or talking at least because I think you’re finding more and more companies coming out, popping up that are pretty much designing their solutions in a silo. Which every time I talk to a community or provider, I think of my friend Scott Smith with Five Star basically said collaborate to automate, so us as vendor companies need to be having those conversations and really aligning with what that looks like and making sure that we’re creating a solution to make life easier within the communities and, and not doing that.

Matt 17:26

So I guess the advice to a provider would basically say, ask them who their partnerships are, who are they friendly with? Who are they talking with? What other technology solutions you already have and making sure that it aligns and helps with that and just doesn’t become a deterrent and makes it that much more difficult to operate. And then I think third, and this really comes from my conversation with Amber and I completely agree is that these providers need to identify their tech strategy and their tech roadmap, and then find technology vendors to help make their vision come true. There’s been so many times where, I’ll talk to somebody and try and ask about what their vision or their strategy looks like for their technology. And they’re pretty much asking us to dictate that for them, Where we can do that, but granted they and their leadership team have the best knowledge of what their community looks like. Of course I want them to work with Eversound, I definitely see the benefit there, but I think providers need to take a step back and really look at what innovation means to them, not just give the innovation, the title to someone, because it’s part of your key values, but just making sure that you’re embracing that and coming up with your own strategy and then finding technology providers to help you make that vision come alive.

Rachel

I mean, that’s fantastic advice and in line with what we see as well, for sure. Especially on the strategy piece. We’ve been beating that drum now for six years and it’s just really interesting that the more we have these conversations with providers, the more we find that everybody is aligned in that need. Yes, we need to understand what the end goal what’s the vision and then who are the right partners in helping us get there? And make sure we have that comprehensive strategy in mind along the way. So, okay. So you mentioned your one year, year, three year five, your plan anything you want to share in regards to what’s on the horizon for Eversound?

Matt

Yeah, so I think with Eversound, our mission is to improve quality of life, right? And whatever we can kind of figure out or product suite that we can create towards that, I do see us, not to distill too much information, but moving to a more all encompassing healthcare solutions provider and really trying to become the company that destigmatizes hearing loss because I think hearing loss is still unfortunately stigmatized. We’ve talked about the data and I mean, everyone wears some form of of glasses of some sort, myself, I can’t drive at night without my glasses or it’s illegal. But I think trying to be a company that helps to destigmatize hearing loss, bring forward some good information and good products around that. Because I think what you’ll find is the communities that are prioritizing finding solutions for their residents to help with the more all encompassing census will be communities that continue to stand out in the communities that have higher census because they’re looking for the whole person and really finding solutions like that.

Rachel

You started out this conversation by saying, “I don’t really know what I’m doing. I dunno anything I’m just kind of like have a lot of passion and move forward.” You have a mission, you have a passion that is moving, but you’re incredibly bright in how you’ve gone about building this concept and launching it into the field and injecting this into senior living. So thank you for that. Matt, as we close up, what I hope you know, we have one question we generally close each conversation with what excites you about the future of technology and senior living?

Matt

Yeah. So I think what really excites me is, I think senior living communities up in until recently, especially like before the pandemic, it was a really micro approach, right? So everything that’s happening within the community, what BINGO game are  we running? What outside entertainer is coming in to deliver an experience? But where I think technology and what I’m really excited about is how does that open up the world, right? How does that not just open up the doors to the community, but to the overall world where, people might go take a trip to a virtual trip to Australia, a virtual trip to Paris, and giving people the experiences to really do that. Because I think the point of going into senior living in addition to the care is to continue to have these social experiences. And if we can give communities the tools to really just broaden their horizons and make it that it’s not just what’s happening within that community they’ve got a penpal across the country in Germany. Like I just think it opens up a lot of opportunities for, for social engagement. That’s not just the happy hour that’s happening within a community today.

Rachel

Excellent. I love that. I love that vision. And I agree with you. I think that’s, that’s so exciting. There’s so many possibilities on the horizon and I look forward to, I think we’re gonna see just rapid, rapid movement towards that future as well. It’s, it’s now gonna be accelerated based on what’s happened in the last, just within the last two years, I think we’ve had a lot of destruction.

Matt

One of the things I’ve heard, one of the silver linings coming out of it that I heard from some of our partners was that technology was a nice to have. And then during the pandemic, it became a need to have, and it was a silver lining that it definitely saw tech adoption really skyrocket, and we just hope that it can continue because I think there’s, there’s definitely a lot of great companies out there doing really amazing things and continuing to partner with each other and work hand in hand and side by side to deliver these solutions. I think will set us up as an industry for the better.

Rachel

I couldn’t agree more. Matt, thank you so much for being on Raising Tech and having this important conversation, helping us better understanding.

Matt

Amazing. Well, thank you so much for the opportunity and keep up the amazing work Rachel with Parasol Alliance.

Rachel

Thank you. All right. We’ll see everybody next time.

Amber

Welcome to Raising Tech, the podcast dedicated to transforming technology culture in senior living. I’m your host, Amber Bardon. Today we’re discussing a hot topic that has really come into focus with the COVID pandemic; telehealth. We have with us, Dave Darr and Josh Hofmeyer from Avel eCare. David and Josh welcome, and thank you so much for being here. Would you like to do a brief introduction of yourselves?

David Darr

Sure. Thanks, Amber. We’re really happy to be part of your podcast and we appreciate the efforts Raising Tech podcast is doing to help promote and help educate the, your listeners. So my name is Dave Darr. I’m the national director of sales and client relations for Avel eCare. I’ve been in the hospital and healthcare industry for about 20 years. The last 15 I’ve dedicated to our senior population, both in the hospice world and in telehealth. I’ve been with Avel now for just under six years and have really enjoyed reaching out to the communities throughout the United States to help bring healthcare directly to their residents.

Josh Hofmeyer

Thanks Dave. Thanks Amber. I’m Josh Hoffmeyer. I’m the senior care officer for Avel eCare, and I’ve been here for about seven years now helping to provide telehealth services to seniors in a variety of settings that we partner with. Prior to coming here, I spent several years out in the field as a licensed nursing home administrator and health services executive helping to manage skilled nursing facilities, assisted living, independent living, home health and hospice. And so I truly have a passion for seniors and making sure that they have the quality of care that they need and certainly deserve, but then also helping to support all of the clinicians and local caregivers who are taking care of those seniors at the same time.

Amber

Telehealth is such an interesting topic because it’s been around for a while, but it hasn’t really gained a lot of traction or there hasn’t been a huge widespread use of telehealth up until COVID hit, which obviously really accelerated the adoption of telehealth. With this being somewhat of a more newly in use field with the pandemic, to start with, could you share some terms and a little bit of an overview of what telehealth is in the marketplace today?

David Darr

Certainly. Telehealth is a very broad term and it’s used sometimes interchangeably with telemedicine as well, and so you can hear both of those or virtual care. It can really be a true wide variety of things. Anything from a phone call between a clinician and a patient on the other end, to sometimes they do things via text messages or emails, and as robust as a video system that has peripherals such as a stethoscope or otoscope that allows the clinician to truly dial in and see what’s going on. There’s also aspects of remote patient monitoring technology and different data perspectives and systems and softwares that you can look at and work with to really get in there and telehealth or telemedicine, whatever term you want to use to provide that patient care. And with COVID you’re right. Things certainly have been growing and expanding. And so things have become a little bit more sophisticated lately. There’s more companies diving into this type of work there there’s more physicians diving into this. And patients and their families are becoming more comfortable with it as well, which allows for this to truly keep growing into the potential that it could have.

Amber

Could you give us a little bit more of a deep dive into some of the specific terms such as, such as, is there a difference between telehealth and telemedicine, virtual care E consult, Store and Forward? Could you describe a little bit more detail around some of those concepts for our listeners?

Josh Hofmeyer

Absolutely. So telehealth typically is more of that potential like text messaging back and forth, or it might be emails. It’s a back and forth to really see what what’s going on with the health person, of people monitoring what’s going on. Remote patient monitoring would fall under that category as well. Telemedicine is the practice of actually providing medical services through some type of technology. And so that’s where you get the direct interactions of provider to patient in things along those lines. Virtual care is very similar to that. Making sure that you’re providing care to your patient virtually. Store and Forward is a phrase used for taking a episode of care that might be going on. The best example to probably use would be a skin condition or a wound concern where the patient can take pictures of it, upload them into a software platform, send those to their provider, and then their provider, at some point in the near future, after receiving those, can take a look at them when they have their time. So it’s not an immediate interaction between the patient and provider and that’s where that name ‘store and forward’ comes from. And then that provider takes a look at that can figure out what they want to do and gets back to the patient on what the next terms might be. There’s a lot of terminology out there I would say when it comes to this type of care. Especially as it grows and expands, that terminology just continues to get added to. And so the list keeps growing and growing.

Amber

I’m really curious to hear your observations of the trends in the increased use of telehealth, where have you seen this really take off and grow in the senior living industry? And what do you think is driving that adoption?

David Darr

Great question. Yes. The last 18 months with COVID has definitely helped boost and identify telehealth as as a solution to supporting our local communities, especially our elderly population. So it’s really in the spotlight right now. We’ve seen over the last year additional telehealth platforms coming onto the market, greater adaptation from the traditional brick and mortar hospital organizations, clinics, and primary care physicians. So they’re all doing some type of telehealth right now, and that’s really been spurred on since the pandemic began. As far as the communities that are involved you know, skilled nursing facilities were kind of always at the forefront of it. Assisted living, memory cares are really taking the forefront of telehealth along with home health and hospice situations. But what it comes down to, prior to the pandemic telehealth was really geared towards those rural communities where they didn’t have access to care where you could kind of zoom in and take care of those residents without having them travel a distance. Telehealth today is just as prevalent in the urban areas. So access to care doesn’t matter where you live, whether you’re in the big city or in the country, access to care is out there and providing the support to the staff and getting those quality outcomes is what it’s all about. So what’s boiled down to in the last year, Amber is that if, no matter where you’re at in the United States, if you want telehealth, you have the ability to get it in your community.

Amber

That’s really great insight. What have you seen helps a community get set up for success in using telehealth?

David Darr (08:08):

Yep. Another great question. So it’s really about having a plan, setting up a timeline for what you need. Telehealth, isn’t something you go to the store and you buy and you take out the box and you roll it out in your community. You really have to have that timeline. In some buildings, it could take up to a year to plan it. There’s a lot of things that go on behind the scenes. On the clinical side, you have to identify what your benchmarks are, what your goals are for the program. What are the reasons why you want telehealth in the building? Get those benchmarks down and then track that as the program goes on. Of course the big concerns out there we don’t have the IT connectivity, you know, telehealth technology doesn’t work in our building.

David Darr

Things have really progressed a lot over the years. And that in most cases, if it’s a wireless virtual tool that you have, if your cell phone works in a building, you’re going to be able to have telehealth in that building as well. On the front side of it, it’s all about staff engagement, letting your staff know and understand what the goals are. Not only with the residents and the primary care physicians, but with your telehealth partner. And then also what we found is that provider buy-in is important. Those local providers, these are their patients, their residents, they wanna make sure that we’re filling in the gaps appropriately. And with what we’ve seen over the last 18 months with COVID at least we’re seeing that the buy-in on providers are really seeing more of a collaboration than competition when it comes to taking care of their patients.

Amber

What we’ve seen with this increase in telehealth is that if it’s used effectively, it can result in reductions in ER visits and reduce readmissions, which causes more unnecessary COVID exposure. It can also empower the frontline staff and improve the resident and family experience. But I can imagine that this still seems very overwhelming and maybe a little bit far off for some communities, even though these solutions are already available and ready to be implemented. Can you share some insight into specifically what the options are that a community or a home care agency may be looking at as available and what would be some of the differences between these?

Josh Hofmeyer

Yeah, absolutely. Amber, that’s a great question. A lot of people need to realize that as Dave was mentioning, it’s important to plan and figure out what your needs are and are you ready? And, and once you know what those needs are, then you can start what I would say, shopping for what services are going to help support those needs and what technology then goes along to help support those services. So I always encourage people to first figure out what those needs are. And then look at the services that are out there. Telehealth companies provide anything from 24/7 urgent care clinical support access, to after hours support, to specialized programs, such as behavioral health or wound care, or something along those lines. And then when you know what that’s going to be and what services you’re going to go after, you can then start figuring out what technology needs to go along with those services.

Josh Hofmeyer

And so in today’s world as most people well know, there’s a lot of technology out there and you could really spend a lot of time looking at that technology and trying to figure out what you need. And so trying to shop around and figure out the, the right solution is important. Do you need video capabilities for what you’re gonna be doing? Most of the timet the answer to that is ‘yes.’ It’s much easier for a provider to do telemedicine services when they have those video capabilities and they can see the patient that they’re looking at. Then there’s also the questions around, do we need any remote patient monitoring equipment? Or do we want peripherals that connect through the video equipment so that we can maybe use the stethoscope to listen to heart and lung sounds, or use an otoscope if we need to look into someone’s throat or into their ears if they’re having issues?

So that’s some of the examples of what’s out there. It’s a wide variety of services and a wide variety of technology that truly help support those services.

David Darr

And I’ll just add to that, Amber, you know, when we visit with communities around the country, the goal is to really fill in that gap of service. So telehealth isn’t really going to replace any services that they have. It’s really going to compliment what they have in their building or further support them. As far as specialty services, that could include the behavioral health. It could include wound care. It could include social work, care transitions in those advanced care planning. You don’t have to have a big need in a building, but sometimes those, you take care of those smaller needs and then you can kind of grow into a larger, more comprehensive telehealth program.

Amber

Do you have any insights that you can share with our listeners around the reimbursement for telehealth and how that has changed with COVID?

Josh Hofmeyer

Yeah, so prior to COVID. First of all, let me say that the reimbursement is payer specific. And so you need to know the payers that you’re working with and what their rules and regulations around  the reimbursement for telehealth are. One of the biggest ones, of course in the industry that we work in with seniors is Medicare and Medicaid, and knowing what the CMS rules are and what the state Medicaid rules are when it comes to billing. And prior to COVID, whether it was the CMS payer sources of Medicare and Medicaid, or it was other insurance companies, Medicare replacement plans, those types of things. It was rather limited on the reimbursement options for billing through those payers for telehealth services. You had to be in a rural designated location. It could not be urban. You had to be in a qualifying originating site, such as a skilled nursing facility or a clinic.

Josh Hofmeyer

It could not be a person’s home or an assisted living or other settings such as those. You could only have an encounter with certain CPT codes billed once every 30 days or so, depending on what it was. And so when COVID happened and the public health emergency came out, they really started to look at how can we keep these people from that unneeded exposure, as you referenced earlier Amber in our conversation,  and having to health and telemedicine capabilities was key to that plan. So they opened the doors and eliminated a lot of those restrictions on the payer side. And so you saw CMS coming out with allowing any location to truly be an originating site. You saw those 30 day qualifications, or if it was a billing code for one third, 14 days, those things go away and they were able to more freely use telehealth and have more frequent visits as needed. A lot of the other private payers and different things too started opening their doors a little bit.

Josh Hofmeyer

And now we’re still in the pandemic. There’s still a long road ahead with COVID, but as we start to hopefully turn the corner, everyone’s starting to say, well what now? What are these payers gonna do? What is CMS gonna do? And actually just in the last few days, CMS did release a new final rule for Medicare and Medicaid for 2022. And they’re saying that their telehealth billing changes are going to stay in, in effect until December of 2023, because it takes legislative action to truly change these rules and regulations. But with this public health emergency they can push out what they’re doing to allow time for research, to be done and see what the impact the telehealth actually have been the last couple of years with these lifted restrictions. So it’s a complex world. Certainly something that you have to do your homework on, talk with the experts, get a really good understanding of it so that you know, what the reimbursement’s going to look like based off of what we just talked about with the services you select and the type of technology that you’re considering.

Amber

I imagine that all this information is a little bit overwhelming to any listeners who may not have started down this telehealth journey yet. To put things in perspective. Could you share a specific story or case study about a client, maybe share a little bit about where they were before telehealth, how they actually went about implementation and then some of the outcomes?

David Darr

Sure. We’ve been rolling out a lot of buildings over the last 18 months.  Just for reference here at a value care, we provide kind of the soup to nuts. We do everything for the telehealth. We’ve got physicians, a full geriatric team of nurses, pharmacists, social workers, behavioral health specialists, wound care specialists, so we can handle pretty much anything. So just depending on what that specific community needs is kind of how we set up that program. We did a lot of go lives, adding new services to new buildings virtually of course we just rolled out a small assisted living building in Alaska. We’re in the middle of South Dakota, all of our clinicians are located here. And so we really had an opportunity to reach out and help anyone anywhere.

David Dar

So just this morning, Josh and I were in the clinical hub doing standup, finding out what’s going on. And we had a phone call at 3:00 AM last night from a universal care worker that had just started working there two weeks ago, so she hadn’t been quite fully trained on what the telehealth capabilities were in the building. And so she called in not really paniced, but the nurse said call in and, and Avel can kind of help out. Well our nurse picked up the phone right away, kind of found out what was going on. She was able to give her a quick tutorial on our cart review all the peripherals, kind of explain what our role is and, and helping out. And within a few minutes we had that resident up on video and we were able to do a video consult and ask some questions and look into their EMR to find out what was going on with them and address the issue right away.

David Darr

So in that area there, like most parts in the United States staffing concerns are a big deal. Not having to send a resident out because of a small issue is a big deal. And we were able to kind of help out in a big way. It was a small situation up there, but in the end, it turned out to be a pretty big deal for that building. We just found out that the clinical concerns that we had were address right away and we’re moving on and we’re waiting for the next call from them.

Josh Hofmeyer

It certainly can be overwhelming though, as you said. And I think that’s why it’s important when you’re looking to pick a partner for your telehealth that you find a team that has done this work before, can help you walk through this implementation, is there to help train your clinicians because you do have that staff turnover at times, and you need to know that they’re gonna have a reliable source that they can, that they can go to.

Josh Hofmeyer (19:30):

And the example Dave shared is just one of hundreds that happen each and every day with the work that we’re doing here at a Avel. And I would also just throw out there as people think about, “well, what would we use telehealth for?” Besides Dave’s example, we get calls on a variety of different things, anything from acute changes in condition, like what was going on at this resident in Alaska last night, to falls and needing to do an assessment to make sure there’s no injury, medication questions and issues, behavioral health, skin concerns, exacerbation of some of the comorbidities that they might be dealing with such as congestive heart failure, or COPD, or diabetes. So the list goes on and on, but I just wanted to share some examples. So people also had an idea of the types of things that you can truly handle from a telehealth perspective.

Amber

That’s really great insight. I think that’ll be really helpful to our listeners. And it’s also really exciting. I think the widespread adoption of telehealth is one of possibly the silver linings of the COVID pandemic. One last question I have for both of you, what excites you the most about the future of technology in senior living?

David Darr (20:45):

Well, I’ll start with that. I think the title of this podcast today says it all, Telehealth is Here to Stay. I mean, at aVel we’ve been doing this for well over 25 years, and there’d be times that we were wondering, “do people get it? Do they really understand what telehealth is all about?” And it is here to stay and part of that on the technology side, at least Amber, with how it is we take telehealth anywhere. The use of the peripherals is wonderful. I mean with our system, we have a stethoscope. We can listen to the heart, the lungs, the stomach, the bowels, you name it, the dermcam, the otoscope, tongue depressors, blood pressure. I mean, it’s as if you’re there having a full assessment with that patient, but there’s a lot of things going on now.

David Dar

We have access to a multi call. So if we’re doing a social work encounter, we can bring in family members from other parts of the country to sit in on that call. So that’s a wonderful thing. But they’re adding EKG machines, scales. So this is going to go from the stiff world to the assisted living world, to home health and hospice down the road. So it’s going to be available to almost anyone for any reason at all. So that’s, that’s probably the most exciting part about it is that this technology is helping sell the service and show up front and close just how well we can help.

Josh Hofmeyer

Yeah. And I would just add on what excites me besides everything that Dave just shared is the true impact that it has on access and quality of care and making sure that patients are getting that quality of care that they need, and that it’s a accessible when they need it versus having to wait. And as we see workforce shortages and more and more providers retiring or changing careers, that access becomes harder and harder. And telehealth is one way that we can broaden that perspective and have support there for more and more people. It could be for the residents that we’re serving through Avel, it could be for our families. It could be for any of us that are doing this podcast today. At some point, you’re gonna need that access and need that service, and it might be telehealth that helps you get it in a timely fashion.

Amber

Dave and Josh from Avel eCare. Thank you so much for joining us today on today’s episode of Raising Tech, really appreciate all the insight and knowledge you shared with our listeners. And thanks for joining us today listeners.

Amber

Welcome to Raising Tech, a podcast about all things technology and senior living. I'm your host, Amber Bardon, CEO of Parasol Alliance. Today, we have a very special guest, Jack York, co-founder of iN2L, an engagement company for older adults and senior living communities. Jack, thank you so much for joining us today. You've been in this industry for quite a while, and I would really love to hear your story and how you got started in this field, and how that led you to co-found iN2L. Can we start with having you share your story with our listeners?

Jack

Oh, you are right, a long while. I call myself the Jimmy Stewart of agent and technology companies, but most people don't know who Jimmy Stewart is, so I need a different analogy. I spent my early career in the Silicon Valley world working for a large semiconductor company called Siliconix, and then Vishay and people think I'm a technology guy, I was a total sales and marketing guy. And when I was moving in on 40, a friend of mine, Leslie Sweeney, who's one of the co-founders of the company, she had the idea to donate some computers to a local assisted living community in Long Beach, in Southern California. And never thinking of it as a business, I had money and no time and she had time and no money. So we donated some computers and it was just, it was fascinating to see what happened. It was very small, you know, this is 1998, right as the computing world was starting. So it was way ahead of the curve in terms of the technology impact in older adults. But it really struck a chord with me. And then it's a long story that I won't go into all the details, but about six months after that my mom died and I was turning 40 and it just, yeah, I just wanted to do something that I felt better about. And so my nickname has always been, “Ready, Fire, Aim.” So my brother and I and Leslie jumped off a cliff, and started the company without having any idea of what we were getting into.

Amber

I am curious about the name. How did you come up with the name of the company?

Jack

Yeah, so we kind of go by iN2L now, it’s abbreviation, but it was, “It’s Never Too Late.” And it was funny, cause it looks like we were trying to be clever with the number two, It's Never Too Late. And it was just a matter of trying to find a URL in 1999 that we could use. We were trying to be, It's Never “T-O-O” Late “T-O,” all these things. We couldn't find it, but it was with that number that we got it. But, and I like it when people ask the question, because it was my brother. My brother unfortunately died about four years after we started the company, and the name was all him, and it was really just trying to convey a context of don't put limitations of aging into doing something that's new and different, and that's really, that's what it was, what it was, what it was kind of all about.

Amber

Can you describe how that initial donation of computers led to the creation of the software and what exactly it is, and that it does?

Jack

Yeah. Well, I think, I mean, you know, in a 22 year retrospect, I think it was beneficial, frankly, that I didn't have any experience in senior living, cause I didn't look at it through, you know, ‘well, we do things this way because that's why we do things.’ And so, like I said, I had no idea about the industry. I had no idea about what we were kind of getting into. But as I talked to people and as I observed, you'd go into a community and you'd see people that were there were full of life and vibrancy, in their seventies, eighties, nineties. And when you looked at the activity programming, you know, incredibly well-meaning people, but they were being treated like 10 year olds. It's teachers and welders and lawyers and doctors and, you know, whatever they were in their life. But you’d walk into an activity room and they’re like, you know, let's throw a beach ball around. And things that just made no sense to me. And so I think it just was a lot of, you know, there's gotta be a more dignified way to do this, but still let people enjoy where they are; wherever they are physically or cognitively. So one of the things really, to answer your question about the product, one of the things that was really interesting for me in this industry, relative to what I came from, I came from this, like I said, this whole Silicon Valley world where a Compaq, wasn't going to tell a Dell, wasn't going to tell an Apple what they're doing. Everything was so closed that it was fascinating for me, how open senior living providers were. And so you'd ask them for advice, and you'd ask them for this, you want to try this and would we try that? And people, so many people, opened their arms up to what we were doing, to my brother and I, and it was such a cool industry in that context. And so we just started trying to figure out, you know, I look at our early systems, it's kind of like, I'm almost embarrassed. It was, at that time, it was state of the art, but it felt like touch screen was a relevant thing to do, but to do touch screen in the early nineties, early two-thousands, you had to have a docking, a laptop go into a docking station, and then the wires all connect out of it. It looked like, you know,it wound up looking like something out of an old Twilight Zone episode, what the systems were. But it was what we've, really, what we've done from the beginning, and haven't changed, is try to just become a content company, and no matter where people are physically or cognitively, you want to be connected to things that are meaningful to you. Whether it's your music, or your spirituality, or your family, or games you want to play, or newspapers you want to read. And so what we've tried to do is just curate content and then make it just readily accessible, both in a group context for an activity director or a therapist, but also from an individual standpoint. You know, my parents have been gone forever, but my dad, if I was helping build a profile for my dad, and that's kind of how our software works is that each person has their own experience, I know that my dad would have The Wall Street Journal, the rosary, the Nebraska Cornhuskers, and I know exactly the music he would like. And again it has nothing to do with how old we are, we all just want to be relevant. And that's what we try to do with our technology is make it relevant for that individual person. 

Amber

Is the software used primarily in the skilled setting? 

Jack

Yeah. You know, I mean, it can be used in any setting. I think I am kind of equal parts so proud, and equal parts frustrated. But a lot of times we've kind of been pigeonholed into a memory care context, the dementia context. And I think a lot of that is, it's so hard to find meaningful programming for people living with dementia, especially mid to late stage, and we've really excelled at that. But the ability, the content that we have on our system is we pride ourselves on the fact that it really does span the horizon cognitively. And you want to kind of balance the content with ‘where is that person,’ and you don't want to make it demeaning, and you also don't want to make it too difficult. So a lot of the games and some of the interactive content we have in the system is curated for different levels of cognition. So someone that is more independent, and they want to go to Paris, they're going to have a different experience than a person far down the cognitive path that wants to go to Paris, where that would be a little bit more visual and audio, as opposed to a quiz about The Louvre or things like that.

Amber

Your product is the original resident engagement application, and resident engagement applications are such a buzzword now. And it's something we hear so much about is a must have for communities and a competitive edge, and I'm curious to get your perspective on how you've seen technology in this space change during the time you've been in the industry.

Jack

It's funny you say that because everybody has their own definition of engagement, and people turn on a vacuum cleaner and go, ‘oh, this is an engagement: vacuum cleaners.’ I mean, it's like an adjective that goes in front of everything. So I mean, I think our definition of engagement is just what makes a person enthused and captive, and want to be connected and want to be relevant. So, you know, to be honest, I feel it's kind of funny because, I don't mean this to sound self-serving, but I do personally get a lot of compliments as to how ahead of the curve we were, and innovative we were, and to me it was just like such common sense, you know. What would my mom or dad want? Just make it. It's such a simple concept that you're just trying to let people get what's relevant for them, make it age appropriate, make it relevant, make it non demeaning. There's an art to doing all of that, but the concept itself is just very simple. To be honest, I think the reason we survived and have thrived when so many people haven't is, I, and I'm such an aberration compared to other startups, it’s funny, it is the funniest thing for me, Amber, when I go to say this to like people starting a company and they asked for my advice, cause it's just like the biggest buzz kill you could tell a 20 something is, cause what I did is when I was like 25, 26, I knew I would want to do something later. I didn't know what that would be. So I just started diligently saving money and saving money and saving money and investing that money and saving money. By the time I was 40, I had enough money to start a company. And then the spark came to me through the donation of the computer, but I didn't have to, for the first six, seven years in the company, I didn't have to spend one minute looking for money. And if I would have had to do that.. It took me eight years to get a paycheck, it took the company 10 years to turn a profit. Any normal investor would have shut us down. And I think that that's the big difference to me in my old life to this new life. My old life of technology in the Silicon Valley is, customers would make quick decisions with no loyalty. In the world of senior living, at least the experience I've had, has been people take forever to make a decision. But if you do a good job, the loyalty is unbelievable. And I think that's what, you know, we've gone through some transactions and have done some things over the last few years, but it was from a position of strength, not a position of gravelly for money. Now, I did. Eight years into it, I ran out of money and I had to go through the 'grovel for money’ stage. And so I've kind of lived all that different stuff, but I just think that, I dunno, long way to answer to your question. I love to see different companies popping up. I love to see how engagement does matter to people now. COVID so accelerated that, it's a great thing. And so I love the fact that what we're doing now is not a novelty. It's much more mainstream, which is great.

Amber

I attended Leading Age National in Indianapolis a few years ago, and I attended a presentation where there was several physicians talking about how they had done a case study, where they had removed psychotropic medications in a memory care unit and replaced it with your product and were able to show clinical results of using the software that were equal to the medication. Which I find really fascinating, and I talk about that a lot as an example of how technology can be used in this industry. I'm curious if you have any stories you can share or impacts that you can share with our listeners of something like that or something similar.

Jack

Yeah, no, what's funny is, the whole research thing is hilarious, I'm such a hypocrite. I'll open myself up to hypocrisy. Because the first 10 to 12 years of the company, you know, I was so dismissive of research, and I do still kind of feel this way, is that, I think a lot of times lack of research becomes just an excuse to not do something that you know you should do. Cause like where's the research that a Ruth’s Chris steak is a lot better than a McDonald's hamburger. Do you need to research to say that someone putting a puzzle together, if it's a picture of their grandson, they're going to be more engaged than if it's something shoved down their throat. So anyway, but then what I finally kind of started realizing is that research does matter, and outcomes do matter. And so, we were fortunate to be a part of several projects. I mean, I'll kind of answer it broadly and then specifically. Broadly, we had the good fortune to be a part of several case studies, several research projects, and we have Dr. Lydia Nguyen, who works for iN2L now, we have a PhD on our staff. She's phenomenal, and it's really cool to be able to take what we've seen anecdotally over the years and turn it into research. For me personally, I still get more juice out of an email from a daughter saying, mom was so depressed all the time, and now she's doing this or that on our system, whether it's a game or just virtual chat kind of feature. I just, I love going into communities and just seeing people doing things and hearing their stories and all that kind of stuff. So it's nice to be able to have kind of a mix of the big, broad picture outcomes of what we do mixed. You know, at the end of the day, it's just a whole bunch of individual interactions that it's really cool that you know that they do make a difference. 

Amber

What was the tipping point for iN2L?

Jack

From a technology standpoint, I was like a kid in a candy store when HP came out with their touch smart, that all of a sudden integrated the touch screen into a relatively compact PC, so that was a technology transformation. We did a major project with Brookdale. In the first 10 years of the company, it was so frustrating because we'd have all these non-profits, that I loved to death, we love the leading age world, but they would go get grants to buy our systems and the for-profit world, I just didn't get it. Cause, you know, you'd read their mission statements, ‘we put the residents first’ and ‘we do this’ and ‘we do that,’ and they wouldn't buy our product. And then we had kind of two things happen fairly close to each other. A company called, well they've changed their name. They used to be Pinion Management in Colorado, and then Brookdale. I mean, those two for-profit entities bought into iN2L, they just budgeted it and bought it. And all of a sudden, it really flipped the switch that, you know what, the families are starting to demand this kind of thing, and then we were able to kind of really be able to have a product that was worth people budgeting and buying. And then also, so much stuff is incremental, but just such cool people along the way, and so many people that have worked for the company. I was a pretty mediocre CEO, but I was passionate. And I think people, I always felt like people would run through walls, for the company. And so that's hard to make it a one-time transformational thing. But I always feel like, I don't know, the analogy I use is that I was good at getting customers to want to date iN2L, but then our team behind us made us want to marry us. And that was just the way we treated customers and we still keep that philosophy to this day. You know as you get bigger, it's harder to do all the same stuff we used to do, but it's kind of fun to kind of put that puzzle together.

Amber

Are you able to share how many communities are using iN2L?

Jack

Oh, sure. Yeah. We're tipping in on 4,000.

Amber

Wow. That's pretty impressive.

Jack

Yeah, no, it was fun for me personally. I remember this tangibly, when all of a sudden I'd hear customers' names that I wasn't involved in. It's like, wow, that's cool. I don't know who they are. I guess we're bigger now.

Amber

Are you able to share what the future holds for iN2L?

Jack

Yeah well, we were acquired by a phenomenal, a massive private equity company called The Vista Equity Partners, and that's always a transformation for the company, because you want to hold on to the culture of what's made you who you are, but they provide a gravitas and a resource space that we've never had before. So I think that our direction is really to keep doing what we're doing in the context of engagement, but just keep making it bigger and better. Start to tip toe into the at-home world. Not so much that we would directly market to the consumers, for now anyway, but to partner with entities that are providing technology, partner with the AAA world, agencies on aging, we have projects going along those lines. And also look at other integrations that take our engagement, and then add some of the more practical applications. We don't need to be that company, but you want it to be that the engagement just seamlessly fits into the whole ecosystem of the clinical side of things. And so there's lots of conversations going on along those lines that are exciting to be a part of.

Amber

I think the technology world in this industry is really exciting. I think there's so many opportunities and so many new things happening. What do you see as the future of technology in senior living?

Jack

From a broad standpoint, I think that engagement, which, as you said, has different definitions, but I think engagement now has a seat at the table of all of the other applications. And so it's ludicrous to have to buy different devices, different products, that do different things. So I think that there's just going to be over the next, you know, this has been said for a long time, but I do think over the next couple of years, there will be some synergies and companies coming together to do some of that. So, I just think a lot more integration along those lines. I mean, what do you think? You're a thousand times smarter than I am. How would you answer that question?

Amber

I don't know about a thousand times smarter. I think that there is definitely a big application in the home market. Like you said earlier there's an opportunity to bring more technology and more engagement and connection to people in their homes. We see technology becoming almost like a utility at communities, where it's expected that this technology will be there and be available, and not just be available, but be supported. And I think that one of the things we're seeing is communities just struggle with how to pay for that. You know, what's the ROI on that? But it is becoming something that just, it has to be there both for the families and the residents, and the staff.

Jack

Yeah. And the other thing I was going to say is for me personally, I am becoming obsessed with the stories of the residents that aren't told. And I think you knew a little bit about the 60/20 tour that I did a couple of years ago, where I turned 60 and the company turned 20, and I went all over the country in a van. We were doing carpool karaoke, and we had all kinds of cameras in the van. And you know, I'd spent 20 years going into senior living communities and, you know, you'd see the residents and you say hi to the residents, and there's always those guys on the outside that are like in their wheelchairs, usually smoking that are like the outside Walmart greeters from the senior limited standpoint. But really the reason I was going into a community was to sell iN2L to an administrator, and ED, an activity director, or a therapist, whatever it may be. But the 60/20 tour was the first time that I really engaged with the elders, and the stories they had to tell, and people living with dementia when they'd get out of their kind of confined environment and be their person. So I'm still kind of getting it put together. I don't want to talk too much about it until I get it put together. When you, Cheryl and I are together at our next cocktail event, I'll tell you more and more about it, but I'm really putting something together that's going to be going all over the country, it'll still have an iN2L flavor to it, but it's really, my own way. This sounds hokey, but it's real to me that I just feel like this whole industry, this whole profession has given so much to me, and it's because of the residents. And to be able to kind of highlight their stories and help change the perception of, you know what? There's cool people inside the walls of these communities, and it's kind of becoming the next chapter of my life a little bit.

Amber

That's really fascinating. I really love that that's your focus, and that is what you're obsessed with.

Jack

Especially on the dementia side, it was just fascinating. So, I would take people around for a ride for like 45 minutes, and don't worry anybody, any listeners, there was always staff and people that were with me, but a lot of times the staff would so negatively frame the person. They might do this, or don't ask this, or be careful about this behavior. And, you know, I probably took a hundred people living with dementia on trips, nothing bad ever happened. It was just joyful. And I think that it was so opening for me, the stereotypes that I had after 20 years of doing this. And so I think that I have a platform, a little bit now, to run with, and to try to kind of help change that perception a little bit. I'll look for your help, and also the Bridge the Gap folks that I do want to publicly say that Sara does all the work, that as pretty as Josh and Lucas are, it's really Sara doing all the work.

Amber

Sara is fantastic. Well, Jack York from iN2L, thank you so much for joining us today. We appreciate your time and sharing your story with our listeners.

Jack

The work you're doing is fascinating. I think there's things that we could talk offline about company-wise, but I love meeting people, doing creative things for the right reasons. And that's you Amber, that’s cool stuff.

Amber

Thank you for joining us today on this month's episode of Raising Tech, and special thanks to Jack York. Tune in next month for new episodes on Raising Tech, a podcast about all things technology in senior living. Thank you for listening.