Older Adult Consumers and electronic-Personal Health Records (e-PHRs)

Older Adult Consumersandelectronic-Personal Health Records (e-PHRs) A Presentation to the LTC-HIT Summit August 22-23, 2005 Chicago, IL Prepared by Russell E. Morgan, Jr., Dr. PH President SPRY Foundation 10 G Street NE, Suite 600 Washington, DC morganr@ncpssm.orgwww.spry.org

SPRY Foundation • Founded: 1991, national, non-profit, research and education organization, partner as an “operating foundation”, not grant-giving. • Mission: To help All people age successfully • Areas: Health/Wellness; Mental Wellness, Financial Security, Intellectual Connectivity • Focus: Empowering older adults to understand and make better choices and decisions through better access and use of information • Strategies: Harnessing the capacity of new technologies

SPRY Foundation • Organized National Conferences, developed guides, training programs and technical assistance, to promote interests and help older Americans to use of computer-based technologies and Internet. Key Learning: Older Americans and their family caregivers must be directly involved in the design, development and policy process, if the introduction of new technologies for health care are going to be successfully adopted.

U.S. Caregiving Challenge: • Give to more people//increase coverage • Better care//improve quality • For less cost

Driving Forces: • Demographic Transition • Family Caregiving Trends • Senior’s Access and Use of Internet • Health Literacy • Health Care Expenditure

Population Pyramid for United States1950

Health Spending has taken offReal average annual growth in health spending VS percentage rise. 7.5% 6.3% National Health Expenditures Percentage rise 3.8% 1 year 1 year 6 years

FROM THE OLDER ADULT CONSUMER’S PERSPECTIVE: -Longevity is being combined with the desire of people to live a better Quality of Life, and -Increased Life Expectancy is often coupled with managing multiple chronic diseases through more effective and more expensive medications and/or medical equipment. FOR EXAMPLE: -110 million Americans manage at least one chronic disease daily -70 million Americans manage two or more chronic diseases daily -Adults 50+ are most likely to manage multiple chronic diseases However, with the current health system---in hospitals alone---there is increased demand and sever understaffing---as a result, when assessing health care quality for older adults: -1 in 7 hospitalizations occurs because previous health records are not available -1 in 5 labs are repeated because previous data is not available -12% of orders are not executed as written -1 in 6.5 hospitalizations are complicated by an avoidable drug error; and -1 in 20 outpatient prescriptions are complicated by an avoidable drug error Source: J. Perlin, Acting Undersecretary Health Dept. of Veterans Affairs

ESTABLISH A NATIONAL HEALTH INFORMATION SYSTEM THE GOAL

A Consumer/Patient Centered Philosophy Envision an adequate health information system: • Giving consumers and providers the latest information to make informed decisions • Expanding consumers’ ability to participate in their own care • Facilitating patient-to-provider interaction

Envision an adequate health information system • Speeding and adding accuracy to professional consultation • Reminding us when to take our meds, report for tests, and renew prescriptions • Storing for easy retrieval all the medical information in the world

Benefitsof using electronic-Personal Health Records (e’-PHRs)An Older Adult’sPerspective

“Interoperable” Electronic Health Records • Centralized Personal Health Information • Provide Portability • Decrease Medical Errors

Improves Information and Communication • Increases access to and use of quality health information through specially designed websites and portals • Increases consumer self-esteem and empowerment • Increases older adult patient-caregiver-provider communication • Provides “equal access” to low SES populations that have special needs, and helps level field and reduce health disparities • Provides consumer/patient with on-line education and peer-group “support”, particularly useful when home bound.

NIH - NLM http://nihseniorhealth.gov/ http://medlineplus.gov/

Coordinating Care-Management • Provides “one stop” location for medical records, for both multiple health providers and for multiple family caregivers • Enables consumers and family members to have more quality time together, and facilitates “aging in place” or living at home. • Enables provider to spend more quality time with patient and family caregiver • Coordinates other non-health caregiving functions, such as transportation.

Real-time Monitoring provides access to quality data • Improves effectiveness of disease management by linking monitoring to clinical pathways • Monitoring using SENSORS in homes, rooms in institutions such as nursing homes, etc, facilitates independent living by determining location, vital signs or status of patient, falls/injury; lost (safety)

Increases Access and Compliance/Adherence to essential pharmaceuticals • E-pharmacies on-line eases family caregiver role • Monitoring and reinforcement for adherence of medications

Assisting Patients with Daily Living Functions • Safety support through use of on body sensors • Assist in performing tasks of daily living robotics

Telemedicine Functions • Provides quality care for “hard to reach” populations or • Overcome geographic boundaries

The health and quality of life of the older adults should always remain the primary focus; the harnessing of technology is a resource to help achieve this goal.

Foundation Setting Priorities for Retirement Years Dr. Russell E. Morgan, Jr President 10 G Street, NE, Suite 600 Washington, DC 20002-4212 (202) 216-0401 (202) 216-0779 Fax www.spry.org

Older Adult Consumers and electronic-Personal Health Records (e-PHRs)