BOSTON – How are some of the newer technologies and players being harnessed to address the needs of aging populations? That question kicked off a session titled "Revolutionizing the Silver Economy," which took place at the Medtech Conference in Boston on Monday.

While it is known that certain European countries and Japan are seeing a rapidly aging population, Joseph Coughlin, director of the MIT AgeLab, noted that some data suggest that half of children born in the developed economies will live to 100 years or more. In addition, the percentage of the world's population older than 60 years is expected to jump from 12% to 22% between 2000 and 2050. The number of those over 80 also will jump dramatically.

And while much discussion focused on eliminating barriers, such as access to telemedicine in rural, remote and regional areas, Coughlin wanted to know where a new wave of actors and devices may play a role.

"Utility companies now that are providing monitoring services, consumer electronics companies . . . that are slowly starting to turn into health platforms. Where do they fit?"

He highlighted Apple and even Walmart as particular examples, the latter of which just debuted its health center at a store in Georgia. The Walmart Health center will deliver primary care, labs, X-ray and electrocardiograms, counseling, dental, optical, hearing, community health and health insurance education and enrollment.

In framing her answer, Sayaka Tomihara, director, Medical and Assistive Device Industries Ministry of Economy, Trade, and Industry, Japan, discussed a model that companies in her country are involved in to promote health, to include those involved in the utility and appliance sectors.

First and foremost, it is important to align goals related to health. She said that Japan has adopted the social impact bond model. The local governments set goals related to life support and prevention spaces. So, if a utility company, for example, achieves that health care wellness goal, they get paid back in terms of performance.

For his part, Lord David Prior of Brampton, chair of NHS England, focused more on what his organization has done with the digital frontend that is being developed in the U.K., which could reduce physical outpatient appointments by up to 50%, as well as general practitioner deployment by up to 30%. Those numbers can improve as the artificial intelligence gets better.

"I think we are going to be seeing a push away from traditional health-giving quarters, if you like."

Coughlin asked whether that would create a whole different sort of institution that we do not know about yet. "I think it almost certainly will," answered Lord Prior, who pointed to the impact of the digital revolution in banking and retail. "We're just at the beginnings of it in health care."

The relationship between the primary doctor and patient will remain important, Prior noted, due to the sector's conservative nature. Still, he predicted that digital changes will have a fundamental impact on how health care is delivered.

Smart toilets?

Coughlin then highlighted new technologies, such as smart toilets developed by Toto and Matsushita/Panasonic. These products can read body weight, blood pressure and whether a patient took his or her medication. Subsequently, these data can be uploaded to a nutritionist or a call center. Another option is a mirror that can measure changes in face color and capillary action, thereby serving essentially as a checkup each day.

"These things are outside much of what we consider to be the health service, but health now is becoming commercialized." That prompted Coughlin to ask whether there would be a new "class of wellness" that some people would receive, while others do not.

Tomihara noted that Toto is investing in smart toilets, but there is not a good business model yet. So the question is who will pay for this product.

Coughlin went on to note that people now can go into a consumer electronics store and find "prestige devices," which can make sure they stand up straight or monitor their blood pressure. "Where does that business intersect with the business of health?"

Daniel Grant, CEO of MTPConnect in Australia, pointed to the Apple Watch, which some may still view as a toy, but it can become a diagnostic, helping to confirm if a patient has atrial fibrillation. The problem is how to transition a toy to a regulated, diagnostic device.

Turning to the smart toilets: Will they need to be regulated? Also, "how do we put in place the ability to do all of that; to understand what of these new technologies are we really doing?" Grant continued.

Coughlin noted that the U.S. has the FDA to regulate products that are clearly medical devices, but there is no government agency that is promoting, guiding or regulating the "new devices, services and systems being aimed at the longevity economy. It's somewhere between free market and anarchy," he added.

One audience member asked about how individual nations could share what is working in their countries.

"I think one of the fundamental answers to that question is around the protection of intellectual property," replied Lord Prior. "If you've got trust that intellectual property rights will be respected around the world, then you can have an open discussion."

Tomihara added that it is clear what entities regulate devices and pharmaceuticals, but that is not the situation in "lifetech." This leads to lag in cross-governmental discussions. She noted that there is a Well Aging Society Summit coming up next month, to coincide with the G20 Ministerial meeting. It is intended to bring together people from major economies that are engaging in lifetech discussions.

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