By Jack Cumming

In an earlier article, I introduced a therapeutic app, https://www.talktoash.com, which seems to be unusually well conceived and executed, though still in development. The founders view it as “AI for mental health,” but its natural conversational approach can lend it to many other human relationship situations.

Cost and Inconvenience of Office Visits

We know anecdotally that the time and transportation challenges of frequent physician office visits are a major component of the aging experience in the United States. This is an area in which the senior living industry might engineer a social breakthrough. The result could be a paradigm for how to bring American healthcare expenditures in line with other countries and to improve the care for our oldest citizens.

In this article, we take a dive into that office visit conundrum to see what can be done about it. Today’s office visit culture doesn’t work well for anyone. Doctors don’t like the feeling of being rushed. Consumers, called “patients” by the medical culture, like the rushed feeling even less. Moreover, doctors who are highly trained can get jaded with a procession of routine medical complaints. Often, the outcome is a prescription that might have been handled by a clinical pharmacologist.

The Geriatric Challenge

The visit dynamic becomes particularly daunting with advancing old age. My friend, who is well over 100-years-old has a “concierge” doctor for whom she pays a handsome surcharge. Although she is mentally as sharp as an 85-year-old, she is physically frail. Her meals and more are delivered to her in her living unit. Still, she has to be bundled into a wheelchair and taken to her concierge doctor, who doesn’t make home calls.

An aspect of senior living that is seldom spoken of is the constant challenge to transport frail and failing older residents to their many medical appointments. Transportation has become a major, neglected part of the prevailing medical office visit culture. Primary care physicians don’t even follow their patients to hospitals. Instead, they rely on “hospitalists” to pick up the care at the hospital door.

An Emergent Opportunity

The senior living industry has a clear opportunity to improve the system. Some senior living enterprises are already doing so with PACE (Program of All-Inclusive Care for the Elderly) undertakings like that at St. Paul’s San Diego. Others, like Juniper Communities, offer geriatrically tailored Medicare Advantage services on campus.

Recent telehealth and artificial intelligence advancements make on-site services like this practical virtually everywhere. That has the potential to greatly improve geriatric medicine and to reduce the cost of health care in the process. The primary barriers are special interest pushbacks, regulatory equivocation, and political posturing. Despite these barriers, improved geriatric medicine delivered onsite in senior living communities is becoming increasingly feasible.

A Better Medical Visit

That brings us back to our conversational app, https://www.talktoash.com. Imagine if, instead of just limiting the app to therapy, it were developed to emulate the conversation you have with a physician during one of those inconvenient medical office visits.

  1. AI-enhanced telehealth can be trained to be more probative than most physicians.
  2. AI-enhanced telehealth can be on hand casually, whenever a medical concern arises, for instance, a sudden sharp chest pain that passes as quickly as it struck.
  3. AI-enhanced telehealth can analyze far more quickly than even the most highly trained physicians can.
  4. AI-enhanced telehealth can allow a reduced number of physicians to better maintain the health of a much larger number of “patients.”
  5. AI-enhanced telehealth can bring the specialized knowledge of physician specialists directly into the context of the initial conversation with a worried consumer.

Thus, a simple application of emerging technology can improve convenience, lower cost, and bring the effectiveness of routine healthcare within the reach of all socioeconomic strata. Senior living has a huge advantage since there are also on-hand staff who can facilitate remote telemedicine, for example, by using a lens device to allow a distant physician to examine retinal health. But this article just touches the surface of a major opportunity.

This is part of a series considering how AI, robotics, and technology in general can take senior living from laggard to leader.