2010: the Technology Tipping Point? David Lindeman, PhD Director, Center for Technology and Aging Co-Director, Center for Innovation and Technology in.

2010: the Technology Tipping Point?

David Lindeman, PhDDirector, Center for Technology and AgingCo-Director, Center for Innovation and Technology in Public HealthAging in America March 17, 2010

Current Initiatives and Trends in Technology for Older Adults

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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

Technological Innovation

Technologies for

Independent

Living

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The Early Adopter Experience: Veterans Health Administration

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”

Age Distribution of all CCHT Patients

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Platforms and Technologies

Mobile TechnologiesHealth Information TechnologyTelehealthMedication OptimizationRemote Patient MonitoringAssistive TechnologiesRemote Training and SupervisionCognitive Fitness and AssessmentSocial Networking

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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

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Health Information Technology

US putting $19 Billion into HITSpending 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

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Telehealth

American Reinvestment and Recovery Act of 2009 - $7 BillionBroadband ExpansionDistance Learning and Telemedicine Expansion

e-visits and 24x7x365 nurse call centers in every state

2008: over 200 telehealth networks connecting 2000 institutions

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Medication Optimization

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

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Medication Optimization

Assess

Prescribe

Dispense Administer

Monitor

Example Technologies•Teleconsultations•Online Patient Education•Cognitive Assessment Tools•Pharmacy Kiosks

Goals•Patient history includes a complete and accurate medication list

•Patient needs are accurately conveyed and understood

Example Technologies•Medication List Software•Personal Health Records (PHR)

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)

Goals• Routine dosing and

tracking of medication• Reports and trending

information from medication log generated

• Clinician adjusts medication as needed

• Prescriptions refilled

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)

Example Technologies•Medication List Software•Personal Health Records (PHR)

Medication Adherence

Medication Reconciliation

Medication Monitoring

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Remote Patient MonitoringRemote collection of patient information using

a device: physiological, emotional, locationRPM benefits:

support patient self-managementearly diagnosisreduce ED and hospital services shift responsibilities to non-clinical providers

improve care coordinationBuilt in patient education programsimprove patient and provider satisfaction

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Remote Patient Monitoring

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Assistive Technologies

Jitterbug Phone

Cochlear Implant

Honda Exoskeleton

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Remote Training / Simulation

Professional, praprofessional, family caregivers

ModalitiesE-learningVideo-classroom training Remote simulation

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Remote Training / Simulation

Virtual Simulation Center for Geriatric Care Learning: Cornell University's Center for Environmental Geriatrics

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Cognitive Fitness/Assessment

Cognitive training tools

Source:

www.positscience.com

Dakim

Nintendo DS

Brain Age

Posit

Science

Source:

www.brainage.com

Sources:

www.ecumen.org

www.dakim.com

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Social Networking

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.

Source: http://www.tyze.com Source: http://jive.benarent.co.uk/

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Barriers to Diffusion

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 concernsInformation technology

barriers and lack of interoperabiltiy

Inadequate reimbursement

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The Center for Technology and Aging

www.techandaging.org