Dr. Michael Ukoha PT, DPT: Without extensive testing I don’t think that it would be something that we can say to our patient with confidence that it’s going to give us a good result in the issue that we’re trying to focus on, like fall prevention and heart rhythm and things like that.
Dr. Jimmy McKay PT, DPT: Welcome to FOXcast physical therapy. A podcast for clinicians made by clinicians. It’s brought to you by FOX Rehabilitation. Find out more at foxrehab.org.
Dr. Jimmy McKay PT, DPT: Interesting different type of episode that we’re doing today. We’re taking a look at a piece of technology, the brand new Apple Watch series 4 that features a built-in EKG monitor and fall-detection technology with a built in option of summoning help if you press a button, or doing it automatically if you remain dormant after detected falls. The question comes up especially for a practice like FOX. Is this piece of technology something that every single older adult should be rushing out their doors to line up at an Apple store and buy for themselves? Now we’re going to bring in two of our clinicians to take opposing sides of the view. And first I’ll introduce Heather Cronin, a physical therapist with FOX in Pennsylvania. Heather thanks for being on the show.
Dr. Heather Cronin PT, DPT, GCS: Thank you for having me.
Dr. Jimmy McKay PT, DPT: And on the other side of the debate-the con side of the debate-Mike Ukoha. Mike is a physical therapist in Maryland. Mike welcome to the program.
Dr. Michael Ukoha PT, DPT: Thank you for having me.
Dr. Heather Cronin PT, DPT, GCS: So Heather your take at the pro point of view. You want all the older adults out there to be wearing the brand new Apple Watch series 4 not because it’s stylish, which it is, but because it could potentially help our older adults. What’s your opening statement for the pro side?
Dr. Heather Cronin PT, DPT, GCS: Not necessarily that every single older adult should have this device. Let’s be serious, I don’t think everybody needs this fall-detection technology. But, I do believe that if your older adult requires fall-detection monitoring, this technology could be very beneficial for our clients. One of the things that is very intriguing to me is the cost that is associated with this. When you think about the cost of an Apple Watch- I think about it for myself and it’s expensive, and I don’t even have one for myself. The up-front cost of this device can actually be a good investment for older adults and save them money in the long term. In addition to the fall-recovery aspect of the Apple Watch, it has other benefits that can help to improve our compliance with exercise and maintain higher levels of activity because that can bring awareness to activity levels on a regular basis throughout the day.
Dr. Jimmy McKay PT, DPT: It’s got some other benefits besides the EKG and the other fall detection, you did bring up price. You want to go into that with a comparable model I think we decided the comparable model was going to be the Philips Life Alert.
Dr. Heather Cronin PT, DPT, GCS: So they believe that they do have plans that that work within your home phone line, or with a cellular line. So I mean with a Philips LIfe Alert, if you want to hook that up to your cellular line, it’s actually more expensive. If our clients are homebound, and they never leave their house with the cheaper model, or you’re using the call-line option- I think it’s like $45/line. But if they wanted to use a cellular line which would afford them the opportunity to have that fall-detection technology out in the community, it’s $65/line for the device plus the activation fees, just to get the services to begin with. So that can cost hundreds of dollars per year. When you think about it from that perspective, it’s a couple of hundred dollars upfront for the Apple Watch vs hundreds of dollars per year for however long you end up needing the device for.
Dr. Jimmy McKay PT, DPT: Yeah when you look at that upfront cost, it really is scary. When you look at a brand new Apple series 4 Watch with cell connectivity at $500, it can look very very scary. But when you divide that over 12 months for a year or longer with that monitoring fee, between the $45 or $60 dollar option it can actually be in fact a cheaper option. All right. Mike what do you think tech or not to tech with the older adults?
I really don’t believe in the Apple Watch Series 4 as a solution right now for the geriatric population. Generally speaking I feel like the Apple Watch is very marketable and has a lot of bells and whistles that you can sell to different populations. But I’m just not sold on it just based on where the healthcare system is in technology in many aspects at this point in time. Heather touched on cost, I wanted to mention in another way, I feel like cost is really the biggest challenge to bring into the healthcare system and making them more reliable option. You guys spoke about the different components and how Life-Alert could be more expensive, potentiall. The other thing to take into consideration is that with the Apple Watch you also have to think about the ability to only work with a cell phone and the cell phone is the iPhone. That’s the only phone that will work in compatibility with this watch. The average iPhone now is costing around$1200. It’s another cost that you’d have to take into consideration when you’re adding that $400 or $500. So you’re looking at $1600-$1700 dollars per patient. If they don’t already have an iPhone I think that can be a big challenge.
Dr. Jimmy McKay PT, DPT: Yes that’s a good point you got to have a cell phone this day and age, but it doesn’t necessarily have to be an iPhone. So you know getting close to that average cost of about $1,000, and it’s just going to go up for the iPhone because they’re starting to do more and more things, that could be one of the detractors. What else can we look at from the debate of “This is a good idea for older adults?”
Dr. Heather Cronin PT, DPT, GCS: I really think that the device provides our clients, we can utilize that device. One my clients right now is wheelchair bound and he has an Apple Watch. He said that the Apple Watch helps him throughout the day by providing him with updates. Such as “you hit your daily goals.” So it can help your client with accountability toward a home-exercise program. Older adults are stepping into the technology world, more than they did in the past. More and more of them are buying the iPad and the iPhone so that they can FaceTime with their grandchildren and their great-grand children.
Dr. Jimmy McKay PT, DPT: One thing that we have an overarching thing with our practice in particular at FOX, is you know our views on ageism. You know we want to make sure these older adults don’t get marginalized because they’re older. So a lot of times you look at an older adult and say well they can’t possibly use an iPhone or iPad. I know for a fact my grandmother in a lot of the older adults that I come into contact with are using this technology on a day to day basis, and they’re using it well. So that could be a reason that these clients are already particularly familiar with the Apple operating system. What do you think about reliability and validity Mike? Does that come into play with this technology in what’s Apple saying it can do?
Dr. Michael Ukoha PT, DPT: Absolutely. I mean I think with our profession and physical therapy we focus so much on what evidence is able to show and dictate in terms of trusting certain special tests and trusting the different things that we use day to day to treat these patients. And I think that with this product something very easy for Apple to market and say that these devices are able to contribute in all these different ways in the healthcare space. But how are these methods tested? You know, were the professional associations involved with this testing- the American Physical Therapy Association or their American Medical Association? Without their involvement and without extensive testing I don’t think that it would be something that we can say to our patient with confidence that it’s going to give us a good result, so in a case that we’re trying to focus on like fall prevention and heart rhythm and things like that.
Dr. Jimmy McKay PT, DPT: We also have to bring in, is the average doctor ready to accept or incorporate this device in for patient care? What do you think about that?
Dr. Michael Ukoha PT, DPT: The average doctor right now. It’s very challenging because these doctors have been practicing for 20 years and they’ve been evolving and they’ve seen the cell phone evolve, they’ve seen other technology evolve, but they don’t necessarily have to incorporate in their everyday practice or their everyday life. The average doctor if you were to talk to them right now, I don’t know if they would really take full account of someone saying that they got some EKG information from an Apple Watch as opposed to getting all testing done. Very specifically for me, you know I experienced something when I was doing my clinical rotation while I was working in ICU and I mentioned to the director of the total hip and total knee unit about a rehabilitation app that you know older adults could use to be better prepared for surgery and also have better outcomes. And I discuss all the different benefits that the app could have for the patient. He didn’t want to deal with the logistics of implementing it. The potential cost and having to adjust with the time. And he said that that was going to be a big challenge if this hospital were to take something like that on. So you know that was a clear example to me about how when you get into the health care space you know you can have a good idea and you can have a good app where you can have a device that doesn’t always translate to a doctor or practice being able to say “I love this product and I accept it and I’m willing to adjust for it.”
Dr. Jimmy McKay PT, DPT: That’s some good points there. Heather some closing thoughts. I mean you opened up saying you don’t think this is right for everybody but overarching theme of this type of technology now making its way into the older adult space. What do you think?
Dr. Heather Cronin PT, DPT, GCS: So I think this is something that we shouldn’t go preconceived notion that this is not going to be a device for an older adult because they’re old and they can’t use it. I think older adults are now much more tech-savvy than we give them credit for. They have the ability to learn new technology. We can see what we’re doing. It can actually be our clients’ lives better and healthier by using this device to help them with fall prevention, and help them with credibility on the level of exercise they’re completing on a daily basis. The opportunities there I think are really intriguing as we move forward in the health-care space with technology.
Dr. Jimmy McKay PT, DPT: I love that. Mike, closing thoughts about this particular technology where we are right now.
Dr. Michael Ukoha PT, DPT: I think it is something definitely worth looking into and I think it’s something that is definitely going to challenge the current landscape of the health care system. But I think that moving forward before we can really incorporate it in a way that’s going to change lives and really make an impact. I think there has to be a much more extensive and thorough process in terms of involving those different parties that I mentioned and really getting down to the details that are going to be the difference in being able to impact our patients the way we want to.
Dr. Jimmy McKay PT, DPT: I agree. Both brought up really really great points. I think we’re taking a lot of looks at the issues. In closing for me, I was most excited about the fact that Apple is at least looking at adding these types of things as features on one of their brand new cutting-edge devices which says they’re thinking about older adults in technology. That’s a great anti-ageism point of view. I think this device would be great in certain situations. I think in a lot of others. It’s not an end all be all but you know what we’re starting for a great great great spot here in 2018. Give this thing 10 years and we could have an even better solution. Mike Ukoha from Maryland with FOX Rehabilitation, and Heather Cronin in Pennsylvania, I appreciate you guys taking some time out to talk about this new innovation with older adults. .
Dr. Jimmy McKay PT, DPT: Thanks for listening to FOXCastPT. It’s brought to you by FOX Rehabilitation. FOX clinicians work hard, love their work, and get the respect they deserve. Sound good? Then you’ll love the autonomy to work in your own style and the support you get to achieve excellence-plus freedom and flexibility to have a personal life. Whether it’s your first day or you’ve been around for a while, your contribution is acknowledged and rewarded. That’s what makes FOX a success. Happy well-trained clinicians make great health care. Are you a fit for FOX? Find out now at foxrehab.org The views and information expressed on this episode are solely of the individuals interviewed and do not represent the opinions or endorsements of FOX Rehabilitation.
