Tending with Technology

PERS and home monitoring systems help maintain homecare customers’ independence

By Larry Anderson

June 12, 2013 Home Health

The market for personal emergency response (PERS) and home monitoring systems has something in common with the larger home medical equipment market—the ability to provide better service and care at a lower price. PERS and related systems allow senior citizens and other homecare customers to remain in their home, a factor that could ensure they remain customers for years to come.

Howard Teicher, vice president of new business development for Connect America, says HME and DME providers who have not recently examined the opportunity to sell PERS should take another look. He says the technology is a natural fit and provides a solid opportunity for lucrative cash revenue in times of decreasing reimbursements, and new PERS programs have eliminated costly barriers to enter into the market.

“Some of our dealers do a phenomenal job, but the majority of dealers don’t present the options to their clients,” adds Glenn Maxwell, founder and president of Alert Sentry, another PERS supplier. He says elderly people who fall and get help quickly are more likely to return home after the incident and continue to be homecare customers. Rather than seeing a PERS system as a sign of weakness, customers should see it as a sign of empowerment, Maxwell contends.

Eliminating Barriers

HME/DME suppliers are finding it easier than ever to get into the PERS category. For example, Connect America and Medical Alert offer the “Connect and Protect Partnership Program” for HME/DME providers (www.connectandprotect.com). Supported by full internal support and marketing materials in a free startup kit, the program allows HME providers to quickly and easily benefit from PERS referrals and make incremental revenue on a non-inventory-based model. The program offers an advance of first-year profit when a customer signs up, and continues to pay revenues even after the first year. As long as the customer is retained, the HME/DME provider can share in all of the upside but none of the downside. All customer service, billing and warranties are handled by Connect America, and there is no inventory to carry or minimums and startup fees. The customer’s fee is $29.99 per month for a home-based system, and packages can be custom-tailored for any customer. In addition to the home-based PERS system, Connect America offers a mobile unit with GPS capabilities that can be used anywhere (for $10/month more). “They wear one button anywhere at any time,” says Teicher.

Alert Sentry sells PERS systems almost exclusively through HME/DME dealer programs. The Alert Sentry standard system has a lightweight waterproof help pendant with up to 80 hours of system battery backup and voice communication through the main console. The Alert Sentry Enhanced system also offers two-way communication directly through the pendant. Pushing the button puts users in touch with Alert Sentry operators, who can assess the situation and get help. Alert Sentry offers a “managed PERS” system to each dealer on an individualized program. The provider doesn’t have to handle billing or collections. All programs are flexible, ranging from a simple fee for a referral to larger players who do the monitoring and have recurring revenue streams.

No-risk Revenue

AMCEST Corp. and its division, PERSYS, have been providing PERS systems for 36 years through a network of home healthcare organizations. Fred Rosenfeld, president of AMCEST, says the traditional approach for years in the market was for a supplier to sell PERS equipment and one year of monitoring to a dealer for a set amount, say $200. The dealer would then sell, lease or rent the equipment to a customer for whatever amount he chose and keep the markup. However, the newer approach is the “revenue share” model, in which the dealer can share in the profit without any downside.

For example, AMCEST’s revenue share model allows a dealer to retain half a client’s monthly fee with no economic risk. The PERS provider covers everything from equipment to monitoring to liability coverage. If a dealer charges a customer $35 a month, $17.50 goes back to the dealer. The dealer also gets a $50 “installation/activation fee” back as a “fee for service,” or can choose to waive the fee to lower the barrier of entry. Conveniently, the $35 monthly price for a system (under a revenue-share arrangement) is in line with allowables for PERS in most state Medicaid programs, Rosenfeld says.

New Horizons

Rosenfeld says the changing technology related to PERS includes a new smart phone app that takes the place of a monitoring device. A tap of the thumb on an iPhone provides clear information about who needs help, GPS location data, clear two-way voice communication and even video streaming. The reasonably priced option—about $20 for monitoring and $15 for the technology that drives it—provides a complete mobile PERS system to anyone with a smart phone. “It’s a game changer,” Rosenfeld says.

Another trend is the two-button PERS system, Rosenfeld adds. The pendant’s two buttons are shaped like the yin and yang symbols, with one button (red) set up to contact emergency dispatch and the other button (blue) tied into a nurse/triage company. For the same amount of money, a client could now also ask a medical professional about a health situation to gauge whether they should go to the hospital emergency room or wait until tomorrow to visit their doctor.

Liability is an important issue related to PERS, and should be addressed to make sure the proper contracts, insurance coverage and protocols are in place, says Rosenfeld. For instance, the time required to address a service issue should be specified. Committing to service within 48 hours in a contract could help avoid the possibility of a jury deciding that an hour should be a reasonable timeframe, for example, if an emergency were to happen while the system is down. An advantage of profit sharing systems is that the PERS provider assumes the bulk of the liability exposure and can disclaim liability to the local dealer.

Options Abound

LogicMark provides three options related to the PERS market. The Guardian Alert system provides two-way calls directly to 911 (with no monthly fees), while the Freedom Alert system notifies family or friends before calling 911. LogicMark’s LifeSentry system connects to a trained professional in a call center for 24/7 coverage. The company can provide private labeling for HME/DME dealers.

LogicMark is known for its two-way voice communication directly through the pendant, which is the equivalent of a small cordless phone with a range hundreds of feet from the base station, anywhere in and around the house. The device can share a regular telephone line or be used with a digital voice-over-IP (VOIP) line. Water-resistant devices can be mounted near the shower or on the floor of the bathroom to facilitate communication while bathing.

The customers of any HME/DME provider clearly need this type of product, says Kevin O’Connor, president of LogicMark. “We offer the full range,” he says. “They can sell it as an equipment play, along with shower bars, or they can go the full gamut and sell a recurring revenue business. The product line offers flexibility to meet the needs of any customers.” He says some HME/DMEs are partnering with local security companies, which have existing monitoring stations. The products are also being embraced as a supplement to home healthcare “concierge” services.

A familiar name to HME/DME providers, Philips offers the GoSafe service line, a mobile personal emergency response system including a medical alert system that provides access to help both at home or on the go. In the home, the GoSafe system uses standard PERS service that leverages the dependability of landlines. Outside the home, a cellular system takes over, using multiple processes to locate a customer in case of an emergency. “It’s another product that allows a DME to have a longer relationship with customers, who will eventually need other DME products as well.”

A Philips differentiator is “fall detection auto-alert” that has benefited more than 180,000 subscribers in the three years it has been on the market. The small, lightweight pendant is IPX7-rated waterproof. For home-based cellular systems (when a landline is not present), the home communicator is located in the part of the house with the best cellular signal. As long as the pendant senses the home communicator, it communicates on a proprietary, wireless network; if the pendant leaves range of the home communicator, the pendant’s cellular capability kicks in. In effect, the smart pendant works at home and knows when it leaves and turns to cellular.

Connectivity and Well Being

Emergency panic buttons have a stigma among many senior citizens, who see the devices as a sign of weakness or who don’t want to be a bother to anyone. Pomdevices LLC offers devices that dodge the stigma and promote a greater connection between seniors living independently and their family members or even healthcare providers. Sonamba is a “well-being monitoring system” for seniors living independently, which periodically sends status alerts to caregivers and/or family members. Functions include monitoring of daily activity, personal emergency response, medication and calendar reminders, social communications and games. Pomdevices says Sonambra is packaged as a user-friendly, aesthetically pleasing digital photo frame with a touchscreen interface and built-in cellular connectivity. The device empowers seniors to live life on their own terms. SonambaPro can be used in conjunction with a medical care provider or a medical concierge system. Pomdevices currently sells mostly through clinical and non-clinical homecare agencies, but is seeking to expand into the HME/DME channel.

Telecare and Social Engagement

Independa, Inc. also offers a cloud-based Web application by the name of “Angela”, with a simplified user interface that runs on an off-the-shelf, touchscreen tablet or an LG brand smart TV. The system can interact with activity and environmental sensors and provide access to email, video chats, pictures and a call button. “The system focuses on social engagement, which is one of the big issues for the elderly,” says Kian Saneii, CEO of Independa. For caregivers and family members, Independa provides a “dashboard” view of a loved one’s condition. “It decreases the homecare burden while providing a unique solution to help mom stay independent longer,” says Saneii.