Showing posts with label Geriatrics. Show all posts
Showing posts with label Geriatrics. Show all posts

Thursday, May 2, 2024

Advising on longevity

The world's population is aging. Between 2019 and 2034, the U.S. population is projected to grow 10.6%, from about 328.2 million to 363 million people.The population under 18 will grow by 5.6%; the population age of 65 and older, by 42.4% — primarily due to the 74.0% growth in size of the population age of 75 and older. As a result, the national prevalence and incidence of diseases that disproportionately affect older Americans will grow rapidly. If we examine this trend together with the expected shortfalls of 17,800 to 48,000 primary care physicians and the all-times high burnout rates for practitioners in 2022, one conclusion is clear - public accessibility to quality medical services will decrease in the upcoming years.

Let's look at another trend - the required number of productive years to reach financial sustainability and when these years start.
  • In the academic year 2020-2021 most of the undergraduate students were aged 25 and older. This is the straightforward data from the U.S. News' Best Colleges rankings, where colleges and universities that are part of the current ranking – all enroll at least some first-year, full-time students. Obviously it wasn't the situation 10 years ago.
  • Across the U.S. the one-year Value Change of a house is +14.9% in 2022 only, but the U.S. real median Average Income Growth is -0.52% in the last 10 years.

It will simply take more years of work for an average American to clear its financial obligations and to start gaining wealth. And you have to stay healthy if you want to be as productive as possible carrying the responsibility for yourself and your family.

Today, across the world, the dominating perception of the concepts of “Longevity” or “Healthy Lifespan Extension” is something that appeals to a very small, niche group of people. Most people feel “Longevity” is something they generally want, but in practice it usually falls far below other, more immediate priorities when it comes to their health.

However, the numbers above tell us a different story. The economic and demographic trends, together with a paradigm shift towards prevention and lifestyle medicine will encourage more and more people to seek professional guidance for a personalized longevity journey, reaching beyond general recommendations provided by public health authorities.

When I refer to a personalized longevity journey, I refer to a proactive, personalized, measurable long-term engagement of a healthy patient or the one that has certain chronic conditions.

Healthcare practitioners could engage their patients in longevity medicine and advise/guide them. Such an engagement establishes an additional line of business, initially provided by the practitioners to the existing pool of patients, given the fact the medical history that can direct the path to a healthspan extension, is already known (even if partially). As reflected in the recent Medscape survey, 37% of physicians in the U.S. have a side gig. Among those having a side gig in 2022, two leading specializations are family medicine and internal medicine. Physicians are looking for ways to make more money and they strongly prefer to do it as medical-related activities.


Longevity advisory


Longevity advisory is a consultative personalized service, in which HCP guides the patient towards the goals of reduction in his/her biological age, towards a slowdown in aging processes and aims to extend the healthy period in human's lifespan— lifetime free of age-related disease. Longevity advisory is a measurable, active, long-term engagement of the HCP and the patient, taking in consideration the clinical and demographical data of the patient, periodic progress, the latest evidence-based recommended practices, available protocols and therapies.

Integrating a longevity advisory into a current practice will lead to the following outcomes:
Revenue growth - consultations.

Medicare. Planned regular longevity consultations and follow-up meetings will create a predictable revenue stream for the practice. As a part of Medicare annual wellness visit (AWV) approach, meaningful usage of healthspan extension recommendations will not only provide important preventive services to the patient but also will close the gaps in quality measures and contribute financial stability to a practice or organization.

If a practitioner works with Medicare patients, he can bill up to $320 per visit using CPT codes 99497 or 99498 for provided advance care planning (ACP). He has to include longevity advice in personalized prevention plans alongside age-appropriate preventive services, recommendations offered by both the U.S. Preventive Services Task Force and the Advisory Committee on Immunization Practices. Practitioners can bill for this service more than once, documenting the change in the patient’s health status and/or wishes about their end-of-life care. These changes can include documented progress in biological age reduction, or Telomere length. There is no limit on the number of times a practitioner can report ACP for a patient. If practice is taking part in Medicare’s Merit-based Incentive Payment System (MIPS), it is recommended to use AWVs to raise the quality scores, which leads to positive Medicare payment adjustments.

Insurers. Many private healthcare insurers provide extended plans for preventive or lifestyle medicine, which is a purely economic decision for healthcare payers for an obvious reason. The variety of these plans is too wide to discuss here, nevertheless healthy longevity services take more and more place in these plans and the demand for professionals to provide this type of consultation is constantly growing.

Private practice. Considering the fact that healthy longevity advisory can and should be provided to healthy patients also, it is performed periodically 2 to 4 times per year and lasts between 30 to 60 minutes, the cost of the consultation for a private patient will not represent a significant financial burden. But the ROI and the value of such consultation for a patient can be equal to several yearly personal incomes, which makes a decision to invest in personal healthspan extension an easy to take.

To conclude the listed above - even by starting providing healthy longevity guidance to an existing pool of patients, primary care practitioners can add several hundred billable hours to his/her practice revenue.


Revenue growth - diagnostics and supplementation.


Healthy lifespan extension planning and execution lays on the six pillars of the lifestyle medicine, but it goes far beyond the general recommendations. Fundamental, evidence-based personalized journey requires a detailed initial assessment of aging biomarkers as a start point. Many of the reliable diagnostic providers, providing home kits and portals for practitioners, have referral or incentive programs for the HCPs to help the provider not only to make the diagnostics more accessible, but also to include him/her in a revenue sharing stream. For example, HealthyLongevity.guide runs a marketplace, where several diagnostic options from vetted providers are available, together with a straight-forward cash back program for theHCPs.

The same applies to supplements. Quality supplements used in accordance with recommended dosage and frequency, become necessary to maintain health and even more critical for improvements. Active longevity approaches and the progress towards advancements in slowing the aging process does involve supplementation. Supplements are well studied, readily available, easy to use, and can improve many conditions. Several reputable suppliers with proven scientific rigor behind their products offer the same revenue share model for the practitioners - incentive or referral program. It depends on the way the program is designed, but if the practitioner is capable of running a small dispensary for the supplementation for his patients, there is an additional persistent revenue stream available. We at HealthyLongevity.guide, alongside the cashback rewards, offer order management and fulfillment services for the supplements for our partners. For example, the practitioner can purchase the supplements for his/her patients, and to ask for the delivery to the patient's address, combining several products from different suppliers in one box, branded to the practice. A typical cashback reward from a combinedpurchase for a single patient - one testing kit ($348), a supplement to support the immune system ($38), and a multivitamin ($14.25) - can get as high as $83. Multiplying is by 35 customers engaged in a longevity journey, with a purchasing frequency of 4 times a year on average, the additional income for a practitioner is over $11,500 yearly.


Revenue growth - market share


From the timing perspective, now it is probably one of the best moments in history to consider the integration of the longevity advisory into the practice. The demand for such services is constantly growing and it is expected to double its size by the year 2027. There is a significant shortage in qualified longevity professionals as of today, but there is a rising interest for such services in public. Simple research in Google Trends will show the 3,800% growth in the popularity of a search term “fight aging” in the US between August 2021 and August 2022. 1.5 million people follow 15 longevity evangelists- MDs and scientists on Twitter. But there are not enough education options available right now - only 14% of the American physicians have been trained in healthy longevity to different extents.

The sooner health and wellness professionals start developing longevity guidance as a specialization, the better they will be prepared in their career path for the future. The sooner the longevity advisory will begin, the bigger pool of customers the physician will be able to gain, simply because of the longevity services differentiation in a certain geography or with certain sub-specialization. And the great news is that you can start with your existing customers base, with generally healthy patients and expand it further via available acquisition vehicles specific to this type of customers seeking professional guidance.


Revenue growth - financial health.


Covid pandemic has particularly been a difficult phase especially, in terms of revenue generation or at least maintaining the revenue generation similar to pre-covid years. As a result, to recover the losses caused by the pandemic, many practices are increasingly looking to improve patient retention and engagement rates as a more effective approach to increase the patient lifetime value (LTV). Active longevity advisory is one of the more effective ways to do so. It is a long-term, 5to 10 years, or even life-time engagement with a patient. The more successful the patients and the practice are in this journey, the longer the engagement lasts. It creates a predictable revenue stream due to the planned nature of the longevity advisory for a particular patient, the follow up diagnostic tests and regular supplementation. Furthermore, it has a good potential to upsell and cross sell, as the coverage for the preventive services will grow in the near future. To summarize - healthspan extension services is one of the most effective ways to increase a patient's LTV and retention along with a contribution to healthy aging.


Personal brand development - differentiation.


The choice to add healthy longevity specialization into your practice now will not only help boost your revenue, but it will put you on the way to a personal brand development and while giving you the opportunityto differentiate yourself in the professional community. As of today, many patients struggle to find guidance in longevity medicine from a professional, and are willing to go the extra mile to find a doctor with experience in this field.

The available opportunities will increase for longevity professionals in the coming years. Opportunities, to speak, tutor, career advancement, consulting for healthcare payers, academia and government, startup industry and more. Specializing in longevity medicine now will help you not only add health to people's lives, but will put you on a clear career path and professional growth.

One last reason why you should start longevity practice now. Diving deep into longevity training and education will allow you to extend the healthspan for the most important person on earth - you. By having access to unbiased education, practical training, and quality products, you will benefit from the latest scientific discoveries and interventions, while reducing your biological age and to add more quality in your personal and professional life. There's no finish line when we talk about healthy lifespan extension. It's a lifestyle that will continue for the rest of your life.


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Thursday, February 9, 2023

AI's impact on the common health conditions affecting seniors

Artificial intelligence is arguably one of the most important technologies being used in healthcare today. I could talk forever about AI's significance in healthcare, from its ability to predict treatment protocols based on various datasets to its automation of administrative tasks. But one of the most powerful impacts of artificial intelligence, which will be the focus of this article, is how it's being used to prevent, detect, and treat some of the most common health conditions affecting elderly patients.

The list of health conditions impacted by AI is pretty extensive. Diabetes, cancer, strokes, and sleep apnea are just a few areas where we're seeing substantial improvements in patient outcomes. In this article, I want to take a look at four other conditions experiencing a similar level of disruption thanks to artificial intelligence: falls, sepsis, cardiovascular issues, and dementia.
Predicting and preventing falls

One in four seniors fall every year in the United States. That means around 36 million falls are reported, resulting in over 32,000 deaths. It may be surprising to hear that falls are actually one of the leading cause of fatal injury in older adults. This is a scary statistic for a condition that can be easily prevented with the right interventions, like artificial intelligence

Researchers at two universities in North Carolina used cameras and virtual reality systems to record 30 different body markers on elderly patients as they walked on a treadmill. Visual cues were introduced that suggested the motion of swaying or falling so that the technology was able to identify if the patient had any balance impairments that were previously undiagnosed. This diagnosis made it possible for facilities and caregivers to know which patient was a fall risk and would need further monitoring.

Skilled nursing facilities and other long-term care centers also have access to AI-enabled technology like UC Berkeley Artificial Intelligence Research Labs' SafelyYou, a company that installs cameras in patient rooms which immediately alert staff the moment a fall is detected. This has been proven to reduce falls by 40 percent and lower emergency room visits by approximately 80 percent.


Demystifying and combating sepsis


Sepsis is commonly undetected or misdiagnosed, especially in older adults, who become more susceptible to sepsis as they age. Sepsis claims one in five lives each year, so early detection is critical in saving lives.

There is still so much mystery surrounding sepsis, which is why it goes undetected. Its earliest symptoms, like confusion and fever, can easily be attributed to other conditions, so technologies like artificial intelligence are powerful tools in getting patients the diagnosis and treatment they need as quickly as possible.

John Hopkins University recently developed a new AI system that has reduced sepsis deaths by around 20 percent. Their Targeted Real-Time Early Warning system combs through a patient's medical notes, clinical records, and lab results to identify if someone is at-risk of developing sepsis. It then recommends treatment protocols depending on the patient, such as starting antibiotic treatment, and keeps all the healthcare staff involved in that patient's care journey informed of what's going on. According to their data, the AI was accurate nearly 40 percent of the time, which is far more advanced than even just a few years ago.


Detecting overlooked cardiovascular diseases


Adults over the age of 65 are more likely to suffer from cardiovascular disease than younger generations, although heart problems are one of the most common conditions affecting the global population and also one of the leading causes of death. For this reason, there's been a major push for using AI to help predict and prevent cardiovascular problems. And a lot of incredible opportunities have come from this.

Physician-scientists at the Smidt Heart Institute have developed an AI tool that helps medical staff identify two major life-threatening heart conditions that often get missed: cardiac amyloidosis and hypertrophic cardiomyopathy. Algorithms can pinpoint diseases that can't be seen by the naked eye and then use that information to inform a diagnosis so treatment can happen immediately. Other researchers from Cedars-Sinai created a tool that can accurately predict which patients will likely experience a heart attack within five years. Additionally, the National Health Service created a tool that detects heart problems within 20 seconds while patients are getting an MRI can.


Helping patients with dementia


Another common condition among the aging population, dementia is a frightening and heartbreaking disease. Changes in your brain can happen over 20 years before any symptoms even appear, which weakens the effects of treatment.

Artificial intelligence can help healthcare employees see signs of cognitive decline that are indistinguishable to the human eye. One AI tool developed by researchers at the Stevens Institute of Technology can diagnose patients with dementia with 95 percent accuracy, which is significant since around 40 to 60 percent of adults who have dementia usually never receive a diagnosis at all. The earlier and more accurately dementia can be predicted, the earlier measures can be taken to improve patient outcomes and quality of life.

The impact of artificial intelligence is vast, but it's clear that one of its biggest benefits is making life-saving care even more tangible in the healthcare sector.


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Tuesday, February 2, 2021

Improve senior patient communication with technology

We know that relationship building is critical to improving patient outcomes, and one of the biggest factors in relationship building is strong communication. According to the National Institute on Aging, effective communication can result in not only more efficient and effective care, but also greater patient satisfaction with their treatment, and this is particularly true when it comes to elderly and aging patients.



While the manner with which physicians communicate with their parents is incredibly important for better outcomes, the means by which they do so also has a big impact on their care. One of the primary ways that provider-patient communication has evolved in recent years – and particularly this year as a result of COVID-19 – is through the rise of technology-driven communications, specifically virtual care and telehealth.

Many may argue that virtual care and telehealth will never fully replace in-person care for seniors, and research shows that is likely true, even after increased adoption as a result of the pandemic. According to a June 2020 survey of adults ages 50-80 by the University of Michigan, over 50 percent of respondents still perceive office visits as providing a higher overall quality of care, and barriers to adoption and accessibility of technology still remain for many seniors. Even if it doesn’t become the primary source of healthcare for seniors in the immediate future, telehealth and outreach through innovative voice automations, and through engagement with care teams between office visits, are providing an opportunity to improve patient communications to meet the needs of this rapidly growing patient population regardless of current care disruptions.


Filling the Gaps in Care


One of the more obvious ways that technology can improve patient communication is by simply making it more accessible. Physicians can only meet in-person with so many patients each day, and on top of that challenge, many seniors face transportation challenges even getting to in-office appointments. Telemedicine in the form of traditional, video-enabled, primary care doctor’s visits certainly alleviates many of those challenges – but it also makes it easier for patients to connect with physicians or support staff in between regular, routine appointments. According to the same University of Michigan poll, 72% of respondents expressed interest in using telehealth for follow-up questions with a doctor they had already seen. Offering telemedicine as an optional and supplemental method of communication between you and your patients helps reduce unnecessary appointments, improve practice efficiency, and open more channels of communication and touchpoints throughout the care journey.


Enlisting Support


Another benefit of virtual communication is its ability to drive better care-plan adoption among patients. For example, one study looked at patients’ understanding of newly-prescribed medications post-hospital discharge and found that while 86% of patients were aware that they’d been prescribed new medications, only 64% could identify the name of the medication and merely 11% could recall being told of potential adverse effects. One of the ways that digital communication can better ensure patient adherence is through increased follow ups—whether by physicians and support staff personally checking on a patient’s status, or by distributing automated call or text messages about medication reminders or lifestyle changes. Increased engagement can also enable providers and patients to bring more stakeholders into the conversation, including family members or caretakers, by enlisting their support in the senior’s care plan adoption.


Real-Time Window


Perhaps one of the most significant advantages to virtual care is the real-time lens that it provides into a patient’s home life and the social determinants that might be at play. Whether it is the clutter that may increase a patient’s likelihood of falling or the isolation that may negatively impact their mental health, the information you can gather by connecting with a patient in their home environment can have an important impact on their care plan adherence and overall health outcomes. In addition, and perhaps most importantly, these real-time insights enable providers to intervene more quickly and collaborate with other members of the patient’s care team to develop solutions before deterioration, or even hospitalization, occurs. With close to 75% of Medicare hospital readmissions being identified as preventable, the real-time insights gained from various aspects of virtual care can play an important role in necessary proactive care management.


Higher Engagement & Satisfaction


Many aspects of virtual care can lead patients to feel more involved in their care and in control of their healthcare journeys. By empowering patients to decide where, when, and how they prefer to engage with their care team, patients are more likely to have a satisfying care experience, which in turn helps to improve care outcomes. Best of all, increased payor reimbursement and revenue sources for telehealth means that practices no longer have to go out on a limb to reap the many benefits of virtual patient communications—a win-win for all stakeholders involved.


References

“Tips for Improving Communication with Older Patients.” National Institute on Aging, U.S. Department of Health and Human Services, www.nia.nih.gov/health/tips-improving-communication-older-patients.
“Telehealth Use Among Older Adults Before and During COVID-19.” National Poll on Healthy Aging, www.healthyagingpoll.org/report/telehealth-use-among-older-adults-and-during-covid-19.
“Functional Health Literacy and Understanding of Medications at Discharge.” Mayo Clinic Proceedings, U.S. National Library of Medicine, pubmed.ncbilm.nih.gov/18452685/.


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