Parallax Health Management is a wholly owned subsidiary of Parallax Health Sciences, Inc. (“PARALLAX”) and is part of an overall healthcare strategy of Parallax that includes Roxsan Pharmacy, Inc. a Beverly Hills, CA based Compound and Fertility Specialty Pharmacy licensed in 42 States in the continental US and Parallax Diagnostics, Inc. a Santa Monica, CA based point of care diagnostic business. Parallax Health Management is creating a home health hub to support remote patient monitoring, medication adherence and tele-medicine; regardless of where you live or what language you speak. The product line is registered trademarked and named QOLPOM®.
Parallax Health Management is a technology systems integration company. Through our patented QOLPOM Hub, we provide the industry’s first comprehensive remote patient monitoring system bridging clinical behavioral science with technology and logistics.
In nearly all medical facilities at every level of care medication errors are major concern and source of increasing liability exposure. For the individual in assisted and non-assisted living medication non-adherence is a growing problem. The problem is well known in the medical profession and its ramifications are well documented in regard to patient care and professional liability. The consequences are not only costly but potentially deadly. Yet the problem persists and, in fact, is getting worse as a result of our, in no small part, increasingly aging population. Aging has multiple ramifications medically but in particular more people are being prescribed complex medication regimens for a host of chronic ailments and diseases and more people are being challenged by the natural attributes of aging such as mild cognitive impairments and short-term memory deficits. Unfortunately, when cognitive impairment becomes more than “mild”, or when medication regimens become increasingly complex, full time assistance with instrumental 1st Level Activities of Daily Living(1ADL), including the consumption of medications, becomes essential.
This environment, including the medication non-adherence issue, has been a significant contributor to the rapid growth in senior’s residences and assisted living facilities over the last thirty plus years. Additionally, as residents continue to age, their need for assistance continues to increase. Assistance with 1ADLs are complemented with assistance with 2nd Level Activities of Daily Living (2ADL). Indeed, some facilities “draw the line “ at the differentiation between these two service-levels and require clients to move to higher level care facilities when they require assistance with Activities of Daily Living.
It is worth noting that good medication adherence would certainly delay, if not prevent, the transition from 1ADL to 2ADL assistance.
(1) Instrumental activities of daily living (1ADLs) are the complex skills needed to successfully live independently. These skills include the following: Managing finances, transportation (driving or navigating public transit), shopping and taking medications.
(2) Activities of daily living (2ADL) are routine activities that people do everyday. There are six basic ADLs: eating, bathing, dressing, toileting, transferring (walking) and continence.
The Evolution of Technology, the Internet of Things (IoT), the Internet of Services (IoS), and the QOLPOM Hub
Those clients that are entering assisted living facilities today have been direct contributors to the evolution of technology, in very many cases, as they are representatives of the generation that took our society from the steel age to the silicon age. Just as postal mail has been replaced by email, information is instantaneous and ubiquitous and technology continues to advance at an ever-increasing rate.
The Internet of Things is already a very major trend with smartphones communicating with alarm systems, thermostats, lights and garage doors. But make no mistake. This “trend” is neither a fad nor a blip. The IoT is here to stay and is, in the opinion of some, as important as the Internet itself. IoT is the foundation that enables “Industry 4.0” (the fourth industrial revolution) and is the technology that has given us wearable step-counters, heart rate monitors and a host of emerging connected technologies.
If the Internet of Things allows us to seamlessly connect various instruments, sensors, devices and systems… those things that produce data: “your current weight is 145 pounds” etc., The Internet of Services will amalgamate all of that data and, leverage Cloud based technologies, and will convert that “data” into “information” that we will use to monitor ourselves, our loved ones and, in the case of residences, our clients. This information provided through this monitoring will be absolutely critical to decision making at all levels and will be nothing short of a Medical/Health Decision Support System. In addition, it will make a significant impact on the medication adherence problem for seniors and the chronically ill.
The QOLPOM Hub
QOLPOM® Hub is a personal medication dispensing and remote monitoring solution that ensures seniors and chronic care patients at home (or elsewhere), take the correct medications on time and notifies caregivers and the patient’s healthcare team if they miss a medication dose or have a medical status report that is outside the limits that their healthcare team has deemed as unhealthy or of potential risk. It can capture (through external sensors), monitor and store vitals along with the electronic patient record for better follow-up by doctors and the health care team. It gives users access to digital health care monitoring and potentially medical interventions via telemedicine.
Alerts and notifications include a series of visual, audible and vibration prompts to the senior and email, SMS and Cloud-based recording for caregivers. Thes new generation devices and online monitoring services feature the latest communications and display technologies (android, touch screen tablet, customs apps, multiple interfaces).
QOLPOM® Hub automates the dispensing of packaged medications though a patented process, with these potential benefits:
- reduces the risk of medication non-compliance; and
- prolongs an independent quality of life for the client; and
- provides peace of mind through real time monitoring for the caregiver.
It also bonds clients with their service providers and enables a Patient Care Circle that is unprecedented. In addition, the QOLPOM® Hub features a full set of modern communications technologies specifically targeted for seniors, the chronically ill and the temporary or permanently disabled, that enable both voice and “videoconference” communication directly from the device. These same technologies will enable “virtual doctors visits” that will require no travelling, no time-off-work for a family member to accompany the patient or resultant stress from the “sortie”.
The QOLPOM Care Circle
For the first time, in this new environment of IoT and IoS, any individual’s Patient Care Circle can now include physicians, clinicians, pharmacists, caregivers and family members in a persistently connected, real-time system of support for seniors and the chronically ill. Quality of life is instantly increased and everyone in the Patient Care Circle has accurate and valid information on which they can make life and health decisions for the benefit of the individual at the center of the circle. It is true that what was once independent living becomes, for most people, Inter-dependent Living.
It begins with medication adherence and the ability to remotely capture and monitor medication compliance and a host of other pertinent data in a comprehensive manner.
There are countless tangible benefits to medication adherence including significant reductions in hospitalizations, enhanced quality of life and reductions in the effects of both overmedication and under-medication. The graphic above notes some major problems with non-adherence.
Further, the advent of an intelligent personal medication device, with bio-feedback, allows, for the very first time, the quantitative and qualitative feedback of real-time data to pharmacists, physicians and clinicians that allow medication titration to achieve optimal medication therapy based on the individual patient.
In a medical residence the benefits are equally important. The ability to remotely monitor each client, both from the point of view of their medication compliance and from connected sensors that include everything from vitals monitoring; to fall detection devices; to quality of sleep devices that enable the medical residence to provide a significantly enhanced (and commercially desirable) service to provide for the optimal health conditions for all of their clients. There are obvious benefits to having a client population that requires less staff time providing simple supports. The increased client participation rates, the enhancement of cognitive capabilities, the improvement in overall health, and the more informed family members results in improved care as well staff satisfaction. It should also be noted that the newly minted inter-dependencies that is createdwith the use of the monitoring equipment will likely improve the health and wellness of each individual client which further reduces the support load on staff members.
But all of this depends on the QOLPOM® Hub as the enabler of a host of benefits including Remote Patient Monitoring (“RPM”) and the ability to have patient dashboards.
There is a world-wide interest in “connected health” with major companies such as Philips, Nokia, Apple, IBM, Microsoft and Google all investing heavily in sensors and sensor systems for health care, connectivity and RPM. Traditional telcos like AT&T, Verizon and a host of others are also investing heavily in health care systems and in RPM..
Countless smaller companies around the world are innovating in this sector and are now offering everything from Bluetooth connected toothbrushes and bathroom scales (weight loss or gain is a key indicator of health and disease state) to “wearable’s” that capture everything from body temperature, pulse rates, respiratory rates and blood Pressure monitoring to game-changing technologies such as non-invasive blood glucometers that sample blood sugar level several times per second – continuously – without requiring lancets and the drawing of blood samples. Parallax Health Management’s sister company, Parallax Diagnostics, is in the development stage of acquiring, licensing and developing in-house solutions/products for personalized health monitoring of seniors that will capture a host of vitals. All of these sensor products can be connected to the QOLPOM® Hub so that this bio-feedback information is directly correlated with medication consumption information providing clinicians, pharmacists and physicians with real-time, comprehensive data and information on patient condition.
Medical clinics, on a global scale, are already adopting technologies that allow them to provide better health care to a wider population base.
Government departments of health, in every jurisdiction, are investing as well as they continue to struggle with low budgets, high costs, poor outcomes and population demographics, both from an aging point of view and from a population distribution perspective. One of their major drivers is in serving patients, with quality health care, that are not in urban areas and that do not have ready access to all of the facilities found in the urban environment. Most governments have grant and subsidy programs that offset the costs of technology adoption that lead to better health outcomes.
Insurance companies and HMOs continue to seek the highest quality health care with the highest return on investment by leveraging new technologies to provide better care, to a greater population base, at lower cost.
RPM and dashboards
Remote Patient Monitoring (RPM), even within the walls of a single building, offers countless benefits for the overall health management of clients. RPM is a cost effective means of keeping patients out of more intense levels of care. Correlating vitals with medication history and consumption directly informs health care providers as to the real-time status of a patient, at home or in residence. Anomalies can be reported or alerted to those in need, via the cloud. The result is that patients can stay out of the hospital longer and have a better quality of care.
The average medical residence has some 100 clients. Obviously, some have many more and some have less. It is entirely achievable that the average residence, on a single computer screen, could monitor the medication compliance, the health condition, vital signs and any other sensor data including fall detectors and panic buttons for all of their clients. Indeed, there are hosts of health monitoring platforms that exist and many more that are emerging that offer these dashboard monitoring features and many more. Parallax Health Management offers, in addition, extensive education, support, training, and counseling and motivation services along with the health monitoring.
The primary benefit of RPM is that patients can stay out of more intense levels of care for extended periods of time thus resulting in a better quality of care and of life overall marked by increased independence.
Costs and benefits
It is clear that the personal QOLPOM® Hub robotic, cloud-based, medication dispenser and health monitoring device aggregator is the core of this new environment. But “how much does it cost”. The QOLPOM® Hub can be leased for about $100 per month. Other sensors, devices, alarms and software (described briefly above) would represent additional costs. The cost for each of these is highly variable and is beyond the scope of this exercise as the selection of each is highly variable and dependent on client needs and management desires.
In addition certain point of care diagnostic tests can be performed at home and monitored and have the results analyzed/diagnosed. A doctor is able to make a prognosis without the expense or inconvenience of a doctor’s visit.
- The typical medical residence has 100 clients/residents.
- 40% of them are on a complex regimen of medications and require and/or would benefit from support in taking them.
- Parallax Health Management would charge $85 per month for monitoring, alerts and access to the patient web portal for caregivers and those in the patients Patient Care Circle.
- The built-in cellular connectivity is not required as additional monthly cost may be associated with this type of connection. Ethernet or WiFi can be used.
- The QOLPOM® hub system has a useful lifespan of 5 years (amortization).
- The QOLPOM® hub can be reassigned to a new resident following the departure of the former user.
- Administering medications to clients/patients that require them is currently a manual process that requires an attendant to sort, verify, organize, transport and administer medications to individual patients.
- Attendant labor is $18 per hour ($24 fully loaded incl. vacation, insurances etc.).
- 20 minutes per day per patient are required to distribute and administer medications 4 times per day (a very modest estimate).
- Any manual process is prone to human errors (and corporate risks and responsibilities).
- Patients and patients’ families are willing to pay for enhanced services including health and condition monitoring.
- Residences have the opportunity of charging for enhanced services and superior care
Parallax Health Management VALUE PROPOSITION
Residences can generate new revenue streams
It goes without saying that new business opportunities are enabled by the introduction of technologies, particularly those that ensure a better quality of life for the patient/client and those that allow families to have a better view of the health state and condition of their loved one. The ability to communicate with a loved one by voice or video is particularly attractive. Enhanced RPM provided by the residence is a value-added (and chargeable) service. Providing additional enhanced services are just as valuable and just as chargeable.
Residences can reduce risk
Eliminating the distribution and administration of scheduled medications diminishes the the liabilities associated with this task. Human error is significantly reduced. Corporate risks are significantly lessened with the use of this equipment and it is likely that liability insurance premiums may be reduced as well.
A Win-Win-Win-Win for all Stakeholders
Benefits for Patients
- Better quality of life
- Fewer hospital visits
- Better outcomes
- Reduced travel and health costs
- Increased social interaction with family and friends
Benefits for Patient Families
- Better visibility into the quality of life of the loved one
- Fewer hospital visits – fewer interruptions into their work days
- Better outcomes
- Reduced travel costs
- Increased peace of mind – reduced stress and concern
Benefits for Medical Residences
- Better overall quality of life in the residence
- Reduced risk and liability
- Superior service
- Reduced labor costs
- Increased revenues for enhanced services
- Superior reputation / higher desirability / increased ability to charge for core services
Benefits for Health System Stakeholders
Increasing medication adherence through automation, empowerment and monitoring improves patient outcomes and achieves benefits for all health system stakeholders:
- Government, insurance and other payers reduce spending - patients who are more adherent with medication regimes use fewer health services;
- Healthcare professionals and providers deliver better care more efficiently at lower risk;
- Pharmaceutical companies increase profitability and deliver value beyond the pill;
- Pharmacy retailers ensure repeat orders, increased fulfillment and enhance brand loyalty;
- Physicians have the ability to become proactive, rather than reactive;
- Every one percent improvement in medication adherence results in $2 billion in savings to the U.S. healthcare system and a $4 billion revenue increase to pharmaceuticals;
- Differentiation in the marketplace for early adopters;
- Clearly, as with the introduction of any new technology, there is a significant market differentiator for early adopters; medical residences, assisted living facilities and long term care facilities all exist in a competitive environment in which differentiation + higher desirability = higher profits. Unlike other service businesses, medical residences have the ability to attract clients for the long term.
- Early adoption simply makes good business sense.
The business case is extremely compelling. The evolution of IoT and IoS technologies is clear and will offer significant business opportunities for residences and the health care system in general.
Medication adherence is a cornerstone of significantly improved quality of life and the QOLPOM® Hub is the cornerstone of medication adherence. A unique device, specifically designed for seniors and the chronically ill, the QOLPOM® Hub offer enormous potential for patients, their families, their caregivers and for those residences that choose to offer superior services and a superior health environment for their clients.