Disruptive technology for Preventive Geriatric care
As we grow old our functional abilities decline affecting our lives significantly. Early detection in old age can prevent/preserve functional decline. Yet the existing solutions to this matter aren't proven as effective enough. JDC Israel, Invisi.care and Tel Aviv municipality are examining a unique product, leveraging existing data accumulated by telecom operators into an inexpensive effective large-scale proactive early detection tool. Enabling a new approach to prevention oriented services.
As we grow old our functional abilities decline affecting our lives significantly. Implications of functional decline can severely affect different abilities, quality of life and even lead to death. Early detection in old age can enable preventive interventions to preserve function and prevent decline. Yet the existing solutions for early detection are complicated to implement on a large scale. Unfortunately, too often interventions are only applied after an incident or acute event. Being able to detect a negative trend before it develops into functional decline\acute event sounds futuristic, but with Invisi.care the future is closer than we think.
Invisi.care is an Israeli start up on a mission to reduce age related avoidable pain, suffering, and expenses. Invisi.care excel in a unique approach of transforming existing non-medical data accumulated by telecom operators into an inexpensive, effective, interaction/hardware free and scalable early detection tool for functional deterioration in older adults. invisi.care's novel seamless, remote monitoring technology approach is based on deep behavioral analysis and revolutionary propriety machine learning and artificial intelligence algorithms, which enables it to identify and predict functional deterioration for early intervention. Early detection of this nature can significantly raise effectiveness of prevention-oriented interventions, resulting in maximizing older adults' potential for healthy and successful aging.
This allows invisi.care to be the first to provide an effective transparent 24/7 function monitoring for older adults without any interruptions to their daily life and virtually zero "breaking in" period. The impact on the target market and the industry is enormous - for the first time, an inexpensive population-wide solution is offered that can substantially improve the lives of older adults while reducing the burden for both family caregivers, and health and welfare systems.
Nevertheless, early detection is only half of the solution. The second crucial element are the service/care providers that can reach the older adults and provide the necessary personalized intervention. The public/social sectors are essential key players that can complete the picture and enable achieving the desired outcome for older adults. Yet this is not an easy task, requiring the public and social sector to accept technology data driven approaches and accept a new technological tool into existing work and decision-making procedures.
We recognize three unique advantages of integrating invisi.care's product into the public and social sectors:
-Vanguard insights regarding older adults – enabling better identification of at risk older adults leading to improved planning and allocation of resources to meet real time demand/needs
-Real time personalized early detection – enabling tailor fitted solutions and interventions per older adult to maximize effectiveness. .
-Ongoing measurement – the collection of personalized real time data can also enable better monitoring and evaluation of chosen interventions.
Alongside these advantages, we also mapped three main challenges:
-Implementation of new technology requires a "state of mind" not commonly found in the public and social sector.
-The inherit difference in method of operations between start-ups and public/social sector. Public sector, for valid reasons, is slower to change out of responsibility to its beneficiaries, while startups need to be agile to respond to real time changes in a competitive market.
-Dealing with personalized data raises many concerns regarding privacy. This becomes even more complicated when dealing with developing a new technology - an unstructured process filled with uncertainty.
To address all these challenges we reached out to the different key players in order to understand their concerns and motivations and get them on board with the innovation. Working together, with both public, social and private sectors, we established mechanisms and communication channels to plan the initiative in a responsible and holistic approach. Our joint work resulted in the design of the first stage pilot currently underway taking place in Tel Aviv Municipality. The pilot will include 1000 older adults and has two main objectives:
-Validate the data collected – improving the capabilities of Invisi.care's product
-Evaluate the insights derived from the data – better understand if and how it can be integrated it into work and decision making process.
Looking forward, the pilot's success is a crucial milestone to move this innovation to the next level. Establishing the scope and quality of the data on a large scale will prove its value and potential to decision makers both at the local and federal levels. This innovation, if applied nationwide to all older adults, has the disruptive potential to fundamentally change the way the public and social sectors plan, fund and operate geriatric services.
What Makes Your Project Innovative?
The Invisi.care product is a novel, inexpensive and simple approach to early detection of functional decline in older adults. The product has none of the disadvantages of existing solutions: it is easy to on board, no hardware, requires no behavioral changes from the beneficiary, easy to scale and is based on existing accumulated personalized telecom data.
In the public-social sector early detection and preventive interventions are the ideal. They are cheaper, more effective and prevent more suffering for the older adult. Yet unfortunately, most public services find it very hard to identify functional decline related issues in older adults when they initially appear, let alone detect the functional decline before there is a problem for the individual. Implementing this product will enable revolutionary easy and early detection, making social-public services more efficient both in planning and utilizations of public resources, and the outcomes of interventions for the older adults.
What is the current status of your innovation?
In 2018 a small scale POC was conducted by Invis.care.
In 2019 JDC Israel and the startup company Invisi.care established a partnership to improve early detection of functional decline and prevention oriented services. The main effort in 2019 was the design of a wide scale pilot (1000 participants) with an evaluation research (including the supporting technological and legal infrastructure), engagement and recruitment of key players and stakeholders.
By April 2019 collaborations with key players were formed. A joint steering committee was established and the pilot's design was approved.
In November 2019, Bar Ilan University's ethics committee approved the evaluation research proposal.
By December 2019 work procedures with the different field agents and recruitment platforms was established. The supporting logistical, technological and legal infrastructure was also developed.
In January 2020 recruitment of older adult participants will begin initiating the wide scale pilot.
Collaborations & Partnerships
JDC Israel is leading and funding the initiative with Invisi.care. The Tel Aviv Social Services Administration will grant access to 1000 participants via municipal service platforms.
Telecom operators, following the participants' consent, will provide the required data.
United Hatzalah, an emergency medical service non-profit, will provide participants with social and medical services, and feedback on the system performance.
The University of Bar Ilan will assist the evaluation research.
Users, Stakeholders & Beneficiaries
Participants receive personalized preventive oriented services within the pilot's scope preventing functional decline. Family caregivers will benefit as well.
Invisi.care will use the data from the pilot to improve the products' algorithms and predictive capabilities.
The municipal social services administration and JDC Israel-ESHEL will gain new insights and information about their target population. This will enable to redesign and adapt services to provide better prevention oriented care.
Results, Outcomes & Impacts
The product has undergone a professional technological due diligence and a small-scale 12 months POC trial. In the trial, older adults participating in a program, operated by United Hazalah, joined the product's service after understanding and signing a consent form. Then the system sent out notifications regarding suspicious changes in the participants function patterns. Program volunteers that visit the older adults on a regular basis followed up these notifications. The results showed high rates of true positive notifications (above 95%) and low rates of false negatives (below 1%). Furthermore, desire to sign up by older adults was higher than anticipated (above 50%).
Looking forward, beyond improving the product's accuracy, the desired outcomes focus on public services:
-Accepting unique insights about the functional decline of the older adults served
-Integrating this new data into the decision-making and work processes
-Adapting interventions to be more prevention oriented
Challenges and Failures
JDC Israel is not a technological oriented organization or a VC. Therefore, a collaboration with a startup is outside its comfort zone. With a few champions in management, a comprehensive risk management approach was developed to get the senior management on board.
Bridging the gap between the agility of a startup versus the public sector is a constant challenge. Public sector, for valid reasons, is slower to change out of responsibility to its beneficiaries, while startups need to be fast moving because of funding issues and its competitive market.
Keeping all the key players on the same page moving forward – from agreeing to high-level strategic decisions down to operation level tactics such as legal forms, work processes and allocation of responsibilities. Furthermore, personalized data technology arouses suspicions regarding participants' security and invasion of privacy. Thus, much effort was invested to set safe guards and mechanisms ensuring compliance with GDPR regulations.
Conditions for Success
Participants and their families trust that the product provides a service serving their interest, without endangering or invading their privacy.
The product must provide accurate, high quality vanguard insights regarding older adults' current and future function patterns.
The key players, both at management and field level, must recognize the significant and unique benefits of this product and the insights to improve existing decision-making and work processes. Adopting a novel approach to applying telecom data in public services. Additionally cooperation and open communication between key players is essential to building trust, creating motivation, managing expectations and addressing unexpected issues effectively. Incorporating mechanism for checks and balances, such as ethical committees, are critical to this end.
The pilot's success will enable to secure additional funds required to expand and scale up this innovations to more municipalities on a nationwide level.
Though the product and the innovation are in preliminary stages, there has been much interest in replicating them. The product's and the innovation's easy scalability constitute a great replicating potential which enables quick adoption of this planning and measurement tool by other municipalities and the government level. Furthermore, if proven effective, the product can be adapted to other at-risk target populations such as people with disabilities, children and youth. Another option is consumers purchasing the product's service as a monitoring safety net for themselves or their loved ones.
Factors that would condition replication would include:
-Senior management and field agents (in different levels of government) willing and open to incorporating disruptive technology
-Public resources to fund the innovation and to incorporate it into existing services
-Evaluation based results confirming the products reliability and accuracy.
-Regulation favoring individual's data rights
Despite the stereotype that older adults are less digitally oriented and prefer avoiding new technology, we found that older adults showed profound interest in the product and the demand to on board surpass our expectations. The main appeal was the simplicity of the product that requires no behavioural change, such as wearing hardware or interacting with software, on their part.
When developing new technology and incorporating it in the public services domain much patience is required. Bridging the gap between start-up agility and public sector accountability is crucial, requiring constant maintenance and open communication. The unstructured process of incorporating disruptive technology has many challenges and risks. Moving forward calls for truly brave partnership between social, public and private sectors.
The main concerns regarding incorporation of this product were about the potential invasion of privacy and the affect it would have on services and their accountability. To address these concerns appropriately we constructed a set of safeguards and mechanisms together with our partners. Every advance or issue was coordinated and approved together, keeping all the key partners on board. Nevertheless, there is always risk involved when pushing forward innovative initiatives.
To address privacy issues we adhered to the strict GDPR European regulations. Furthermore, it was our priority to make sure that the older adults understood the meaning and implications of their consent.
To address the issue of accountability, it was important to emphasize that this product will not replace existing services or procedures. Rather it is a new tool with significant potential to upgrade effectiveness and that integrating it would be a methodical procedure.
Developing novel disruptive technology and incorporating it into public\social spheres is a very complex and risky endeavor. Invisi.care's product has the potential to be a game changer and to transform geriatric health/social care systems. Improving both effectiveness of services, minimizing suffering and enabling all of us to age significantly better. And this is just the tip of the iceberg.
The public sector has the opportunity and the responsibility to advance this endeavor, make sure it stays on the ethical tracks, and make sure this technology will affect and reach those who need it most.
I really believe this innovation is an example how the public, social and private sectors join forces, leveraging each other, to create a better tomorrow for everyone.