Janet Sullivan Wilson, PhD, RN Associate Director, Community Based Interdisciplinary Research

1. Staying Healthy, Engaged, and at Home:  Preparing for the Baby Boomers Janet Sullivan Wilson, PhD, RN Associate Director, Community Based Interdisciplinary Research Reynolds Center for Geriatric Nursing Excellence University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma

2. Donald W. Reynolds Center of Geriatric Nursing Excellence

3. Reynolds Center for Geriatric Nursing Excellence (RCGNE) • Funded by the Donald W. Reynolds Foundation, 2008 • One of 10 centers of geriatric excellence across the country • As part of OUHSC College of Nursing, the Center benefits from: • Interdisciplinary programs • Faculty expertise • Technology • Statewide Case Management Program

4. OUHSC College of Nursing Case Management Program • Our case managers: • Serve as care coordinators, advocates, for all healthcare needs • Help navigate the complicated health-care environment • Deciphercomplex medical language to help understand all facets of illness. • Help with understanding medical insurance , emotional issues related to caring for family members

5. Reynolds Center for Geriatric Nursing Excellence Mission • Prepare, mentor doctoral students for gerontology scientist roles in community based interdisciplinary research • Translate gerontology science for use within Oklahoma to solve older adult problems • Support a community based aging in place model • Create a statewide network of faculty geriatric champions • Disseminate evidence based geriatric care practices and resources

6. Health Care’s Perfect Storm Health Care Reform Innovations in Technology Baby Boomer Demographic Shift

7. Healthcare Reform 2 Seminal Institute of Medicine Studies (IOM) Drove Healthcare Reform: • To Err is Human: Building a Safer Health System (2000) • Crossing the Quality Chasm: A New Health System for the 21st Century (2001) http://www.iom.edu/About-IOM.aspx

8. IOM Safety Recommendations • Create leadership, research, tools and protocols to enhance the safety knowledge base • Identify, learn from errors (e.g. Aviation industry model) so system continues to be made safer for patients • Raise standards by using oversight organizations, group purchasers, professional groups • Design safety systems inside health care organizations through implementation of safe practices at the delivery level

9. IOM 10 Rules for Healthcare Redesign • Care is based on continuous healing relationships • Care is customized according to patient needs and values • The patient is the source of control • Knowledge is shared, information flows freely • Decision making is evidence-based

10. 10 Rules for Healthcare Redesign 6. Safety is a system property 7. Transparency is necessary 8. Needs are anticipated 9. Waste is continuously decreased 10. Cooperation among clinicians is a priority

11. Technology Innovation American Telemedicine Association Vision Statement: • Telemedicine will be fully integrated into transformed healthcare systems to improve quality, equity and affordability of healthcare throughout the world.

12. Telehealth Monies • Department of Commerce: • $482.4 million or 35 ARRA investments to bridge tech gap, boost jobs, economy, improve education, healthcare • Includes funding for telehealth, other IT projects • NTIA with Dept. Agriculture RUS are administering $7 billion ARRA initiative to expand broadband services • DHHS: • $32 million in federal funding to support rural health care • $4 million for telehealth projects

13. Technology Innovations Mobile Technology • Phone Apps for Health Promotion: • Weight Watchers; Jenny Craig • Text4baby.org - free text messages to phones to help through pregnancy + baby’s first year • HealthTxts – for behavior change (to exercise, stop smoking, lose weight) • Wearable Devices • FitBit – tracks sleep, calories burned, exercise • DirectLife – weight control

14. Mobile Devise that Monitors EKG, Transmits to iPhone

15. Technology Innovations • Remote monitoring • Wireless devices • Videoconferencing & remote monitoring of exams • Home Devices • ingested pills with microchips that transmit heart rate, body angle, temperature, sleep, and other parameters through electronic bandaid • Implanted monitors for glucose detection, etc. • Signaling Devises for: • medications • Rx pick-up (Walgreen’s Rx Text Alerts) • Appointments • Exercise

16. Remote Wireless Monitor

17. Remote Wireless Display

18. Technology Innovations Social Media • Disease focused Face Book communities • YouTube channels • Mobile Technology • Websites, blogs • Twitter • Patient Empowerment Blogs (“Why can’t Medicine be more like Car Talk?”; CNN) • Webcasts • Webinars

19. Technology Innovations • Empowered Health Care Consumer • eRecord • Personal eRecords • Webinars • Online support groups

20. The Baby Boomers

21. What The Boomers Look Like • Born between 1946-1964 • Record # of births • Make up 28% of population today • Women = 51% • Baby boomer turns 50 every 8.5 seconds • 1/1/06 – first baby boomer turned 60

22. What the Boomers Look Like • 74% work • Hold $13 trillion in assets or 50% of US asset base • 50% of all visits to PCP were made by Baby Boomers • 27 million PCP visits made for diabetes • 42% shop online for vitamins and natural food • more patients, fewer caregivers

23. What the Boomers Look Like • Boomers spend several hours online daily • 16.5 million seniors engage in social networking including Facebook, Twitter and My Space. • Baby Boomers on My Space average 204 minutes a month. • Out of 130 million members on MySpace, Baby Boomers account for 6.9 million.

24. Older Adults & the Social Media

25. 99 Year Old Woman Using iPad

26. What This All Means • Client safety • Evidence based • Interdisciplinary collaboration • Community Based • The Healing Environment • Green Healthcare • Telehealth

27. Creating a Culture of Patient Safety • Design of 82-bed St. Joseph’s Hospital, Wisconsin Maintaining quality, cost

28. Evidence Based Practice “Evidence-based practice involves using the results of research into what types of design promote patient health and staff efficiencies and incorporating those findings into actual building plans.” George J. Mann, AIA

29. Tiger Place, Independent Living, Columbia, MissouriMarilyn Rantz, PhD, RN, FAAN

30. Interdisciplinary Teams • No longer can each discipline work in their own silo • Purpose is to synthesize knowledge perspectives from across various disciplines for best practices

31. Community Based

32. The Healing Environment

33. Sustainable, Environmentally Friendly, Energy Efficient

34. Telehealth

35. The RCGNE Initiative • Create academic/community collaborations to utilize expertise to apply to problems of older adults • Create innovative solutions for Oklahoma older adult problems • Utilize gerotechnology for innovative solutions • Translate gerontology science for community use

36. Navigating Healthcare’s Turbulent Waters No one ever learned to navigate only in calm waters . . .