2010: the Technology Tipping Point?

1. 2010: the Technology Tipping Point? Current Initiatives and Trends in Technology for Older Adults David Lindeman, PhD Director, Center for Technology and Aging Co-Director, Center for Innovation and Technology in Public Health Aging in America March 17, 2010

2. Demographics and Resource Scarcity The Perfect Storm Changing Demographics- Increased longevity- Age wave- Increased disability incidence- Increased chronic disease among older adults- Increased desire to lead independent lives at home Scarce Resources- Uncertainty of government safety net programs- Uncertainty over individual financial security- Overstretched healthcare $- Workforce shortages Technologies forIndependentLiving Technological Innovation

3. VHA Community Care/ Health Technology: $1,600/pt/yr vs. Home-based primary care: $13,121/pt/yr, vs. Nursing home care: $77,745/pt/yr 43,430 patients enrolled “Systems Approach” The Early Adopter Experience: Veterans Health Administration Age Distribution of all CCHT Patients

4. Mobile Technologies Health Information Technology Telehealth Medication Optimization Remote Patient Monitoring Assistive Technologies Remote Training and Supervision Cognitive Fitness and Assessment Social Networking Platforms and Technologies

5. 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 Mobile Technologies

6. 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 the hospitals increasing HIT implementation Health Information Technology

7. 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 Telehealth

8. Medication information, 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 Medication Optimization

9. Medication Optimization Medication Monitoring Medication Adherence Medication Reconciliation Monitor Dispense Administer Prescribe Assess • Goals • Routine dosing and tracking of medication • Reports and trending information from medication log generated • Clinician adjusts medication as needed • Prescriptions refilled • Goals • Patient history includes a complete and accurate medication list • Patient needs are accurately conveyed and understood • Goals • Medication orders are documented and shared with patients • Goals • Medication is made available • Medication picked up by patient • Patient and caregivers understand medication instructions • Goals • Individual dose dispensed • Individual dose taken by patient (on time, in the right does, and for the right length of time) • Example Technologies • Medication List Software • Personal Health Records (PHR) • Example Technologies • Medication List Software • Personal Health Records (PHR) • Example Technologies • Teleconsultations • Online Patient Education • Cognitive Assessment Tools • Pharmacy Kiosks • Example Technologies • Medication Adherence Devices (integrated and standalone, simple and advanced function) • Example Technologies • Personal Biometric Testing Devices • Wireless Communication Devices • Personal Health Records (PHR)

10. 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 Remote Patient Monitoring

11. Remote Patient Monitoring

12. Assistive Technologies Jitterbug Phone Honda Exoskeleton Cochlear Implant

13. Professional, praprofessional, familycaregivers Modalities E-learning Video-classroom training Remote simulation Remote Training / Simulation

14. Virtual Simulation Center for Geriatric Care Learning: Cornell University's Center for Environmental Geriatrics Remote Training / Simulation

15. Cognitive training tools Cognitive Fitness/Assessment Nintendo DS Brain Age Source: www.brainage.com Dakim Posit Science Source: www.positscience.com Sources: www.ecumen.org www.dakim.com

16. Social networks help older adults communicate, organize, and share with other older adults and with their care providers. Caregivers and clinicians can use social networks to manage and coordinate care for an older adult. Social Networking Source: http://jive.benarent.co.uk/ Source: http://www.tyze.com

17. Limited experience of most providers with technology Poor preparation for adopting such technologies Lack of financial models that document return on investment Limited awareness by patients/clients Provider concerns Information technology barriers and lack of interoperabiltiy Inadequate reimbursement Barriers to Diffusion

18. The Center for Technology and Aging www.techandaging.org