Joshua LockeA person can take all the precautions to prevent falls in the home—moving throw rugs, picking up clutter, adding handrails—but falls can still happen. And beyond falls, other emergencies can occur in the home that can make reaching a phone difficult. That’s where personal emergency response systems (PERS) come in. And new technology is helping alleviate the stigma around the devices.

What was once a wearable pendant or bracelet has grown into a wireless wall-mounted system using radar to detect falls. Essence Group is a provider of these systems, which can be customized to fit the needs of an individual. Essence Group provides their solutions through partnerships with home monitoring providers, like Medical Guardian. 

The newest device from Essence Group is MDsense, launched in September 2020. Essence Group Vice President of Sales, Joshua Locke, sat down with us to talk about the technology and what’s coming in the PERS market.

HOMECARE: While fall prevention is important, falls still happen. How does fall monitoring help keep seniors safe?
LOCKE: We have a couple of different fall solutions. We began with a wearable, algorithm-driven, fall detector pendant. It's very small, very lightweight, with long battery life, and replaceable battery. So customers don't have to like throw it away and buy another one. Wearables are the best solution for alerting for falls.  However, there are other options such as voice activation and radar technology. Ultimately, we want to make sure [help is provided] within that golden hour after an emergency happens. There's that 60-minute timeframe that really relates to how well people recover. 

We launched the MDsense, which is using radar technology, because we realized that a lot of folks don't necessarily choose to wear the button. They put it on the door handle or in a junk drawer. So we needed to work with our customers and develop additional safety nets, the latest being our MDsense passive fall detection solution. In addition to this latest technology, a couple of years ago we launched voice activation, another nonwearable option. When developing this we started by thinking about the challenges behind voice activation. It's got to have Wi-Fi and it's all cloud-based—people don't necessarily want cloud-based technology in their home and Wi-Fi complicates the consumer onboarding process. So we started looking at radio frequency, RF technology, having the software on the IoT device, as well as voice-over-RF technology. We developed the firmware that rides on the little “mini me” device. It looks like our control panel, but half the size. And that recognizes a key phrase that we program it to recognize, most commonly “Call 911”.

So, the whole theme of it is layering on IoT to ensure help is available quickly. With MDsense, we said let's still continue down this non-wearable, fall detection route. And so instead of having to press your wearable or say something, it's auto triggering based off of radar technology. The basic description is that it is a passive infrared motion detector; when there's motion in the room, that's when it's triggered and turns on the radar detection. And it does this all passively, meaning you don't have to do anything with it. You don't have to engage with it. It scans about a 20x20 foot room.

It's scanning and is able to decipher whether you're standing, seated, lying down on something, or if you're lying on the floor. It triggers only off of the one that's lying on the floor. It's built to be a simple, because again, our customers—the service provider—needs to be able to have scalability and be self-installable. 

HC: Wall-mounted, radar-based fall technology is growing. How is this superior to wearables?
LOCKE: Because we know that there's a big group that don't want to wear wearables, especially gaudy buttons and stuff like that. So, we need alternative solutions. And we frankly need solutions that are not just individual focused, meaning this are covering the room. It's not only going to cover me if I fall, but it's also going to cover you. 

HC: How do you mitigate privacy concerns?
LOCKE: Well, we're based out of Israel. So we're known for our security and our tech, but it is very secure. There's no video monitoring on it. There's no unique, personal identification with it. It is simply sending an alarm to the control panel via radio frequency. And then the control panel is sending an alarm to the central station and an account number. That's the only part when it's identifiable to the user. 

Regarding audio hacks:
We have RF jamming safety measures built into our technology—people or other tech in the home can jam a frequency, and it does happen occasionally. But we have alerts behind it—the service provider is going to know if the frequency is being jammed and will alert the user to move the device to another room. There are a lot of safety nets put in place behind this technology. And it all comes from our security side. [Essence Group has] been in security for over 25 years. We're the largest manufacturer in Europe and third largest in the world. We manufacture over a million Internet of Things (IoT) devices a month. It has many, many layers of encryption. MDsense [is ultimately] a security product, so the expertise we have from a security side is applied.

HC: How can home health providers partner with a PERS/remote monitoring provider to keep their clients safe?
LOCKE: So, there's several service providers out there. A few examples are LifeStation, Medical Guardian, Guardian Medical Monitoring, LifeFone, Security Central, and many others.  Those happen to be a few of our customers that I know have partner programs but all personal emergency response system (PERS) service providers typically have partner programs. These programs vary and can cater to what the home health company prefers. For example, there are just referral-based partnership. There are leasing models that share in recurring monthly revenue and there are purchase models that increase that monthly revenue because the equipment is purchased. Most partnership programs will also support if the homecare agency wants to keep their brand [on the device]. I have a home health background and have implemented a PERS program at the company I worked for. What was important to us was our brand in the home but the real value came from the monitoring services, reporting, and repeat patients. The company I worked for was a small family run business in Detroit with heavy competition. A PERS program not only set us apart but we were able to retain patients after discharge when another event occurred versus losing them to the big hospital systems. Basically, PERS and homecare services need to work together and if you do it right can grow your business while increasing patient/customer value.

HC: What’s next in-home monitoring and PERS?
LOCKE: So what's really hot now is remote patient monitoring (RPM). Some folks use the term as telehealth, but to us, or to me, telehealth is really between the patient and the physician. What remote patient monitoring is for us is the monitoring and transmitting of vital signs data in the home. The PERS industry is a natural fit for that because the control panel is really a hub. It's a communication hub for data. It's got two-way voice communication, which is a huge factor in remote patient monitoring, but there's also data that comes along with that. So, it's a natural fit. Some of our customers are asking for it. So that's where we're going this year. We're creating a platform. Most of the time, we're probably going to be integrating into an existing repository or electronic medical record.

But basically, it's getting the latest technology in our hub to be able to communicate to Bluetooth peripherals, like thermometers, blood pressure cuffs, weight scales, glucometers, pulse oximeters, those are the top ones. We then work with our partners for use cases of what they need to be able to offer. 

In addition to that, we're developing a mobile personal emergency response systems (mPERS). That's been a hot item for the last five plus years. It's basically a go anywhere, single-button cellphone with two-way voice at the touch of a button, location, and fall detection. We see the U.S. going towards 5G, which to us going to be game-changing.  It helps power remote patient monitoring, provides the data we need to go through that network, access to the FirstNet emergency services network, as well as a smaller cellular module critical to our development of an mPERS product.