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Rethinking the future of care for older people

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Health Tech World Award winner, Birdie, proposes a new approach to adult social care that empowers carers and maximises the potential of data.

Healthcare costs are soaring.

Approximately 10 per cent of GDP is spent on healthcare, out of which 60 per cent is allocated to elderly care.

The convergence of an ageing baby boomer generation and an increasing prevalence of chronic conditions has created a looming crisis.

Over the next 20 years, the number of frail or dependent elderly people is projected to double, presenting a huge challenge for healthcare systems worldwide.

A workforce shortage is only set to exacerbate the issue, with an estimated 160,000 care workers missing in the UK alone, according to the Resolution Foundation think tank.

This demographic shift requires a re-evaluation of healthcare delivery models to effectively cater to the growing demand for long-term care and support.

One company seeking to bring about this change is Birdie.

Founded in 2017, the London-based start-up has developed a home healthcare technology platform that aims to empower home care professionals to make better decisions, save time and ultimately deliver more personalised care to older adults in the face of this major care crisis.

The company’s vision to transform the way care is delivered was recognised at this year’s Health Tech World Awards, taking home the award for Health Tech Start-Up of the Year.

Birdie believes that home healthcare holds the key to addressing the challenges posed by an increasingly aging population.

“We are obviously facing a significant health care crisis where we have a growing cohort of frail or dependent elderly [and] the numbers are quite daunting,” Max Parmentier, CEO and co-founder of Birdie told Health Tech World.

“What we realised is that the healthcare delivery model is a bit broken and one of the reasons why it’s broken is because the vast majority of people today die because of chronic diseases and long-term conditions.

“We’ve designed an industrialised healthcare system […] based on primary care and secondary care.

“So, if you go to the hospital, you’re going to be treated and cured in an episodic fashion.

“The thing is, for older adults […] that’s not at all the right delivery model because these individuals suffer from conditions that you cannot usually cure but you can live better with.”

A new model for elderly care

The prevailing focus on episodic treatment in primary and secondary care settings is failing to meet the needs of a growing cohort of older adults suffering from chronic diseases and long-term conditions.

But by shifting the focus from acute care settings to personalised care at home, the potential opens for improving outcomes and reducing costs.

Right now, however, the current organisation of home healthcare is riddled with inefficiencies and coordination difficulties, with thousands of private agencies operating in silos. Birdie aims to bridge these gaps with digital tools that enable a more preventative and holistic approach to elderly care.

“This is not only medication but also what you eat, what you drink, what kind of exercise you’re doing,” Parmentier said.

“I think that’s the ticket to solve a lot of issues we face.”

One of the core challenges in home healthcare is coordinating the efforts of multiple caregivers and enabling effective communication among all stakeholders, from carers to patients and their families.

Birdie’s platform encompasses a web application for home care agencies, a mobile app for care workers and another mobile app for families.

The goal is to streamline operations by automating administrative tasks and facilitating real-time information exchange.

                   Max Parmentier

Through the platform, care providers can manage schedules, track medication adherence and communicate updates with their colleagues and patients’ families.

“If you look at how home health care is organised today, it’s essentially a private market with thousands of private home care agencies delivering care in the houses of the patients,” Parmentier said.

“Essentially, you have people who are extraordinarily committed, but quite inefficient in the way they operate.

“They’re doing a lot of stuff on paper, they don’t coordinate, there is a lot of admin work, and so for us, the first step was to empower these guys to become more efficient.”

The concept is simple but its impact could be transformative.

By improving coordination and capitalising on the power of data, Birdie aims to unlock capacity and create a more sustainable system.

This could have far-reaching implications for the care industry, most notably in its potential to allow carers to see more patients in less time.

This additional capacity could be crucial in addressing a growing shortage of care workers and an ever-increasing demand for care.

Unlocking the power of data

Care workers and patients build a close relationship during their time together, but the insights carers get from their daily visits can slip through the net.

For Parmentier, harnessing this data could be a game-changer.

Real-time reporting on mood, pain, medication adherence and potentially vital signs could for early identification of health issues.

The result would be more proactive interventions and reduced hospital admissions, he said.

This concept extends to families who regularly visit their older relatives.

“We’ve widened the ecosystem to other people in the community checking on these old adults,” Parmentier said.

“We actually have a very high-resolution picture of the health and wellbeing of these patients every day, because there are three, four or five visits per day.

“That is very powerful to [support] build[ing] that personalised, preventative journey.”

Parmentier acknowledged that Birdie is at the beginning of this journey but the potential of utilising data to identify early signs of health risks is clear.

“In the future, we [could] be reporting vital signs such as blood pressure or temperature,” Parmentier said.

“That is extraordinarily powerful, to start identifying things early on and shaping that personalised care journey, and to really lower hospital admission and keep patients much healthier for much longer.”

The role of digital in reducing financial burden

The UK government has recently been accused of “halving” its 2021 pledge to invest upwards of £500 million in the social care workforce.

This comes down to a “disconnect” in how healthcare budgets are organised, Parmentier explained.

“Basically, healthcare is where we put the money and social care is where we move the money, to some extent, and that’s a real issue.

“It creates a huge tension and we see that every day.”

These systemic flaws are represented in current statistics, as an estimated 500,000 older people wait for care and a sharp rise is being seen in the number of informal caregivers looking after their elderly relatives.

Meanwhile, traditional solutions, such as care homes, are wrestling with space limitations and resistance from older adults themselves, who prefer to receive care in their own homes to maintain independence.

Parmentier experienced this firsthand with his Grandfather who was reluctant to move into a care home in the final months of his life.

“He didn’t want to go to a care home. He passed away after six months of being admitted to a care home because it wasn’t his happy place.

“We could have kept him at home for sure. I think the solution of home care is the right solution for many older adults.

“Eventually, they will maybe [move] to a nursing home if that’s their choice or that’s the only solution forward, but it shouldn’t be the default option.

“Home healthcare is growing very fast as the way forward because healthcare is failing at serving these people,” Parmentier added.

Birdie claims that its approach offers a more cost-effective solution that aligns with the preferences of older adults and their families.

As healthcare costs continue to rise and future generations face financial constraints that may impact their ability to afford care, digital solutions will inevitably take a more prominent position in social care models.

The potential of digital platforms like Birdie for streamlining systems and empowering frontline staff could hold the key to not only saving lives, but costs as well.

“[Currently], we see healthcare as a very reactive model,” Parmentier said.

“We just wait for a [person] to really deteriorate with their diabetes or hypertension, then we rush them to the hospital, but that’s too late. We could have avoided that.

“And so for me, we need to really integrate this health and social care model.

“Because these guys in the community; the care workers, the community nurses and so on, they are the frontline staff, they are the first healthcare layer to look after these older adults in a much more preventative way.

“Only when the needs arise should we actually get the other healthcare professionals involved and that will lower the cost burden significantly,” he added.

Flying high

Since being founded in 2019, Birdie has received growing attention from funders, raising just under $60 million since its inception.

A 2021 Series A funding round raised $11.5 million followed by an injection of a further $30 million in a Series B funding round last year.

The company’s fundraising success highlights a growing recognition among investors for new innovations that can curb the impact of an ageing population.

“I think everybody recognises the challenges of the future of healthcare,” said Parmentier.

“And everybody recognises today that technology is a massive enabler, starting with more capacity and operational efficiency, but with an avenue towards AI.

“Six or seven years ago, it wasn’t so much the case because […] there was a bit of this doomed approach that healthcare is screwed.

“But today, I think people are understanding that technology is an enabler because there’s been a lot of wins.”

As Birdie continues to attract funding and foster new industry partnerships, the future looks promising for the company’s growth.

And if tomorrow’s adult social care looks anything like Birdie’s vision, the future could also look brighter for older generations.

“I refute the narrative that past 75 years old, [life] is going to be gloomy and dark and sad,” Parmentier said.

“That’s the phase where I want to have the time of my life.”

“It’s a phase of life that could be absolutely enjoyable and where you could actually be extraordinarily fulfilled. The only determining factor here is health.

“Can’t we reverse that narrative and say, ‘These people could actually stay in much better health for much longer?’

“We [can] paint that picture of ageing vibrantly and with confidence.”

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