Around 2017, a cardiothoracic surgery nurse at New York Presbyterian Hospital in New York City noticed that an inordinate number of patients who underwent surgery experienced a notably high number of adverse health outcomes.
The reasons behind these outcomes were initially unclear, and they would be potentially hard to glean unless someone was monitoring that patient around the clock. But the nurse implemented a novel solution to the problem: “Augmented intelligence.”
Senior living operators have a similar problem with residents and health outcomes, according to Maplewood Senior Living Chief Clinical Officer Brian Geyser. And Geyser believes that if senior living and cardiothoracic surgery have the same problem, they also can share a solution.
For Westport, Connecticut-based Maplewood, that solution takes the form of “Augi,” a portmanteau of the words “augmented” and “intelligence.” Maplewood worked with Inspiren, Inc., to adapt the Augi for the memory care setting. Insprirn, which is headed up by Michael Wang, the former clinical nurse from NYC, had previously only deployed Augi in hospital-type settings.
“When I met Michael Wang, his company Inspiren had not pivoted to any other vertical in health care,” Geyser told Senior Housing News. “I told them we need this in senior living. And they heard me loud and clear.”
Maplewood piloted Augi as a way to reduce falls among senior living residents and implemented it at the company’s Inspir community in New York City. In March, Maplewood and Inspiren wrapped up a six-month pilot that found Augi had a meaningful impact on resident falls, and therefore outcomes.
Maplewood’s path to tech implementation is meaningful, as it is one that other senior living operators are also traversing in 2023. A recent NIC survey showed that operators are overwhelmingly implementing tech this year in areas ranging from human resources and staffing to marketing and finance.
Still, while the allure of some new senior living tech rises, the allure of others — like robotics — is fading somewhat, leading to new and interesting ways to use that tech from Maplewood and other operators including Vitality Senior Living.
The allure of augmented care
At the heart of Maplewood’s use of Augi is that it acts as another set of eyes on a resident.
The system uses a wall-mounted sensor to “see” residents and their surroundings to track resident and staff behavior and detect patterns in sleep, mobility and activity. Using that information, Augi can also sense when a resident fall is likely to happen and notify staff before it does.
Inspiren and Maplewood worked together to outfit the Augi platform for senior living. Maplewood chose its community in Manhattan for its proximity to Inspiren’s headquarters in Brooklyn. In all, Maplewood added the platform to 33 memory care units. The residents selected for the pilot were those who were the most vulnerable and had the most history of falls, according to Geyser.
Maplewood and Inspiren in March found that using the tech resulted in 400 fall “saves” at Inspir Carnegie Hill.
During the pilot, a “save” referred to events where a Maplewood worker prevented a fall after Augi alerted that a resident was in a high-danger situation. During the entire 160-pilot, only two falls were recorded and, in both cases, Maplewood had a worker in the patient’s room in 30 seconds or less, according to Geyser.
that a fall was prevented because the Augi alerted staff, and staff responded
As a former nurse practitioner, Geyser immediately saw the utility of using something like Augi in senior living.
“Any one of those 400 incidents could have been a catastrophic incident,” Geyser said. “So that tells us that this is working really well. And it’s worth the money.”
The money Maplewood saves is through preventing serious injury or death, “because we know for certain that we’ve been able to prevent adverse events,” said Geyser.
The other way in which the system helps is with staff efficiency. By leaning on the help of Augi, memory care staff understands how care-intensive each resident truly is, which helps with triage and setting staffing levels.
“It allows our staff to be more effective and efficient which makes them happier,” Geyser said. “They love this system. They’ve told us time and time again that at this point it’s basically an indispensable part of their job.”
The ongoing pilot will add Augi’s “vision” to an additional 30 units at Inspir, with grant funding from nearby Hunter College to research the efficacy of the system. Maplewood plans to roll out Augi at its 84-unit Stony Hill memory care community in Connecticut.
Health care providers like memory care operators have two ways to finance Augi. The first option is to buy the hardware and pay a monthly fee for the services. The second option is a full subscription model with a higher monthly fee, but no upfront cost, according to Geyser.
Augi is similar to other existing senior living tech platforms, including SafelyYou, the use of which in recent years have led to similar outcomes among memory care residents at other communities.
Indeed, Maplewood is working on a separate pilot with SafelyYou in the coming months in select communities and plans to compare the service to Augi’s. Other operators, including Brentwood Tennessee-based Vitality Living, are also using SafelyYou in their operations.
Some operators have gone big on tech that keeps residents connected. Atria Senior Living, for example, uses a “discovery and matching” app in its communities that has helped residents connect with one another in the past year.
“Consumer-facing technology changes at a fast pace,” said Atria Chief Technology Officer Chris Nail. “Our focus is to deliver innovative tech at an enterprise level that is designed with the end user in mind: our residents and our staff.”
Robot debate continues
The rise of robots in senior living is well-documented and nothing new in senior living. In 2023, they can be seen flitting around communities as cleaners or servers but handling relatively simple tasks. As in years past, robotics still has a long way to go before it is the largest line item in senior living tech budgets.
For senior living operators and their capital partners, figuring out which technological innovations will actually help and which are simply cool toys is an important step.
“There are a lot of cool things out there and you can get sucked in,” Lori Alford, COO of Avanti Senior Living told SHN.
Alford, a 25-year veteran of the industry believes that the key to choosing which new gadgets and software hinges primarily on one thing: Who’s paying for it?
“I’m not sure capital partners want to. I’m not sure an operator wants to. And I’m not sure a family member wants to,” Alford said.
As the allure of some tech fades and reality sets in for some operators, others are holding on to the notion that certain kinds of well-worn tech, such as robots, still have a place in senior living despite their potentially limited use cases.
When Vitality Senior Living CEO Chris Guay and his wife ventured into Takumi Hibachi Shushi in Franklin, a wealthy suburb of Nashville, they were surprised to see a robot server take their order. Not only did the robot correctly deliver his edamame, but Guay realized that because the robot handled the back-and-forth part of waiting tables, the human server was freed up to spend more face time with diners and could cover a larger area.
Gauy, a skeptic against the idea of robotics in senior living until “a couple of years ago,” is on board with robot servers, though not the Servi bots from Bear Robotics seen in so many communities these days. Instead, Vitality is looking into using robot servers from OrionStar Robotics.
Maplewood and Transforming Age are two other senior living operators leaning on robotics to fill gaps and improve operations. But in some cases, the appeal of using that tech has faded.
“We have Temi Robots in every single one of our buildings – we purchased them during the pandemic,” Geyser told SHN. “They were useful at that time.”
Fast-forward to 2023 and Maplewood is still figuring out what to do with its stock of robots, which aren’t serving the same function they used to. But that has led to some novel uses in time since. For example, Maplewood is using its Temi bots as a touchpoint for residents at its luxury high-rise Inspire Carnegie Hill community
According to Geyser, Temi robots wander two of the building’s floors and ask residents if they need anything when they see them.
“If the resident says ‘yes’, the robot will call the concierge and the concierge will come up on the screen so the resident can see them and interact with them,” Geyser said.
Maplewood also is working with Temi’s manufacturer and Cleveland Clinic health care providers to turn the latest generation of robots into surrogate geriatricians.
“This particular robot will be outfitted with medical peripherals like a stethoscope and pulse oximeter and so forth,” Geyser said.
The robot – already being piloted at one of Maplewood’s Ohio communities – can take vital signs, listen to the patient’s chest for a heartbeat and pneumonia as well as perform cognitive tests using a touchscreen interface.
Geyser added that the physician who is working with Maplewood is expected to execute the first clinical visit using the robot before summer.
“I’m the kind of person who wanted this to be happening 10 years ago,” Geyser said. ”Things are going a lot slower than I would like, but that’s why I’m in this role trying to constantly push forward into the future.”
But while the Temi robots have been well-received Geyser — like many other operators — still has questions about their feasibility.
“Is it scalable? Is it something the residents really need and want?” he said. “It’s one of those things – just because we can do it doesn’t mean that we should.”