2010: the Technology Tipping Point? 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 Current Initiatives and Trends in Technology for Older Adults

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 Technological Innovation Technologies for Independent Living

3 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

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

5 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 up from 64 percent in billion mobile subscribers end of 2009

6 Health Information Technology US putting $19 Billion into HIT Spending on HIT rapidly increasing by percent of physicians and 58 percent of non-users plan to implement Electronic Health Record programs 72 percent of the hospitals increasing HIT implementation

7 Telehealth American Reinvestment and Recovery Act of $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

8 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

9 Medication Optimization Assess Prescribe DispenseAdminister 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

10 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

11 Remote Patient Monitoring

12 Assistive Technologies Jitterbug Phone Cochlear Implant Honda Exoskeleton

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

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

15 Cognitive Fitness/Assessment Cognitive training tools Source: Dakim Nintendo DS Brain Age Posit Science Source: Sources:

16 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: Source:

17 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 concerns Information technology barriers and lack of interoperabiltiy Inadequate reimbursement

18 The Center for Technology and Aging