Transcript Sample Presentation Title - Center for Technology and Aging

Tele Home Care: Current Trends and
Emerging Opportunities
David Lindeman, PhD
Director, Center for Technology and Aging
Co-Director, Center for Innovation and Technology in
Public Health
Aging Means Business
Gerontological Society of America
November 22, 2010
© 2010, Center for Technology and Aging
The Early Adopter Experience:
Veterans Health Administration
– VHA Community Care/
Health Technology:
$1,600/pt/yr
Age Distribution of all CCHT Patients
– vs. Home-based primary
care: $13,121/pt/yr,
– vs. Nursing home care:
$77,745/pt/yr
– 43,430 patients enrolled
– “Systems Approach”
© 2010, Center for Technology and Aging
 Today’s Environment: Mobile, HIT, Telehealth
 Technologies that address Chronic Disease and
Maintain Independence
 Examples from Diffusion Grants Program:
 Medication Optimization
 Remote Patient Monitoring
 Care Transitions
 Emerging Trends and Future Opportunities
© 2010, Center for Technology and Aging
Mobile Technologies
 57% of Americans age 65 and older have a cell phone
 More than 80 percent of U.S. physicians will have
smartphones by 2012--up from 64 percent in 2009
 4.6 billion mobile subscribers end of 2009
© 2010, Center for Technology and Aging
Health Information Technology
 US putting $19 Billion into HIT
 Spending on HIT rapidly increasing by 2012
 80 percent of physicians and 58 percent of non-users plan
to implement Electronic Health Record programs
 72 percent of hospitals increasing HIT implementation
© 2010, Center for Technology and Aging
Broadband and Telehealth
 American Reinvestment and Recovery Act of 2009
$7 Billion
 Broadband Expansion
 Distance Learning and Telemedicine Expansion
 e-visits and 24x7x365 nurse call centers in every state
 2008: over 200 telehealth networks connecting 2000
institutions
© 2010, Center for Technology and Aging
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Technology Trends: Maintaining
the Independence of Older Adults
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Medication Optimization
Remote Patient Monitoring
Assistive Technologies
Remote Training and Supervision
Cognitive Fitness and Assessment
Social Networking
mHealth Technologies
See the Center for Technology and Aging’s
Briefing Paper for more information at:
www.techandaging.org/briefingpaper.pdf
© 2010, Center for Technology and Aging
Medication Optimization
Medication Optimization
– Medication reconciliation, dispensing, adherence,
and monitoring.
– Medication use is ubiquitous among older adults,
with 90% of older adults using one or more
prescription medications per week.
– New England Healthcare Institute:
$290 billion in healthcare savings
© 2010, Center for Technology and Aging
Remote Patient Monitoring
– Remote collection of patient information using
a device: physiological, emotional, location
– RPM benefits:
• support patient self-management
• early diagnosis
• reduce ED and hospital services
• shift responsibilities to non-clinical providers
• improve care coordination
• built in patient education programs
• improve patient and provider satisfaction
© 2010, Center for Technology and Aging
Center for Technology and Aging:
Diffusion Grants Program
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Improve efficiency of care delivery
Improve health and independence
Reduce the cost and burden of care
Improve chronic disease self-management
Improve rate of diffusion, adoption, and scaling
© 2010, Center for Technology and Aging
MedOp Diffusion Grants Program
Veterans Administration of Central CA
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Home self-management and medication adherence
Veterans that are home-based with Congestive Heart Failure
Remotely located internists and allied health professionals
5 central California rural and medically underserved counties
The Health Buddy® system plus weight scale, blood
pressure monitor, assessment algorithms and clinician alerts
– Telehealth coupled with care coordination (RCT)
Health Buddy
© 2010, Center for Technology and Aging
MedOp Diffusion Grants Program
Connecticut Pharmacists Foundation
– Culturally and linguistically appropriate Medication
Therapy Management (MTM) services
– Community health workers and remotely located
pharmacists serving Cambodian-American older adults
– Long Beach, CA and Connecticut
– Use of videoconferencing, Electronic Health Records, and
spoken format technology to deliver MTM services
© 2010, Center for Technology and Aging
RPM Diffusion Grants Program
California Association Health Services at Home
– CAHSAH - 556 members / 850 offices that are direct providers
of health and supportive services and products in the home
– Use of the Intel Health Guide to monitor patients with CHF
– Outcomes: Reduce hospital/ED visits; improve patient
activation, QOL & satisfaction (RCT)
– Medi-Cal adoption of/reimbursement for RPM technologies
© 2010, Center for Technology and Aging
© 2010 Center for Technology and Aging
Tech4Impact Diffusion Grants Program
Technologies for Improving
Post Acute Care Transitions
– Collaboration with Administration on Aging (AoA) and Centers
for Medicare & Medicaid Services (CMS) - $68 million
– Use of remote technologies to enable care transition models
– Evidence-based programs: Coleman, Naylor, Counsell, etc.
– Outcomes: Reduce avoidable hospital admissions/ED visits;
improve patient health outcomes; reduce costs
– Five states through their Aging and Disability Resource Center
© 2010, Center for Technology and Aging
© 2010 Center for Technology and Aging
Barriers to Diffusion
Barriers to Technology Diffusion/Scaling
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Limited experience of many providers with technology
Poor preparation for adopting such technologies
Lack of financial models document Return on Investment
Limited awareness by patients/clients
Provider concerns privacy
Information technology barriers
lack of interoperability
– Lack of business models
© 2010, Center for Technology and Aging
Emerging Technologies for
Tele Home Care: Trends
and Opportunities
Courtesy of Ravi Nemana
© 2010, Center for Technology and Aging
Many Inventions, Few Innovations
Many Inventions, Few Innovations
• Innovation = Invention + Value
– Not just a new way of doing something
– Need to show Value too !!
• DOING something of value (Services) is the key
© 2010, Center for Technology and Aging
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Services Platforms: Remote Care
Services Platforms:
Remote Care
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Remote, but tethered
Extension of sight & sound
All care at the device
Challenging workflow
Limited “presence”
Low knowledge mobilization
No analytics
No context sensitivity
Scaling problems
© 2010, Center for Technology and Aging
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Advances in Telecare
SCOTLAND: Service
models combine
direct delivery of care
to reduce impact on
institutions.
Service models
combine monitoring,
help desk, telecare
and notification. A
hybrid Telecare +
Alarm company.
© 2010, Center for Technology and Aging
Platforms: CellScope
NextGen Diagnostics
PATIENT
#510
- BLOOD 04/09/2009
CURRENT CLINICAL DIAGNOSTIC PROCESS
PATIENT
#510
Cell Phone Screen
showing magnified
red blood cells,
some infected with
malaria
DYES
ACQUISITION & PREP
MICROSCOPE
Cell Phone
DIAGNOSIS
Services: distributed work, sensing,
remote collaboration, feedback,
decoupling dx / tx
Microscope
Attachment
Patient
Sample/ Slide
Courtesy:
Dr. Dan Fletcher
David Bresslauer
© 2010, Center for Technology and Aging
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“Programmable Rehab”
NextGen Rehab
Services: “programmable rehab”, distributed work, embedded intelligence,
collaboration, feedback
SENSORS
performance
arm position
Responsiveness evaluation
GATEWAY
Courtesy: Filippo Tempia, Telecom
Italia
© 2010, Center for Technology and Aging
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Platforms Continued
NextGen Platforms
Courtesy VG-BioI.
© 2010, Center for Technology and Aging
Proteus Biomedical (Raisin).
Courtesy CardioNET, Inc.
The Center for Technology and Aging
www.techandaging.org
© 2010, Center for Technology and Aging