© 2010 center for technology and aging1 consumer digital health: technology assessment and outcomes...
TRANSCRIPT
© 2010 Center for Technology and Aging1
Consumer Digital Health:Technology Assessment and Outcomes Measurements
Lynn Redington, DrPH, MBASr. Program DirectorCenter for Technology and Agingtechandaging.org
vital: the consumer digital health event San Francisco, 6 October 2010
© 2010 Center for Technology and Aging2
Center for Technology and Aging
Established in 2009 with funding from The SCAN Foundation, located at the Public Health Institute
Accelerate diffusion of proven technologies (ADOPT) that help older adults remain healthy and independent
CTA initiatives
Technology Diffusion Grants Program
Independent, non-profit resource—research briefs, advocacy, tools and
lessons learned (ADOPT toolkit)
Older adults: A large, growing population with high medical and social service needs
© 2010 Center for Technology and Aging3
Technology Assessment Factors --CTA’s Selection Criteria for Grant Program Focus Areas-
Population Applicability Large, growing, high-need, high-burden population segments
Health Outcomes Control existing health conditions, prevent exacerbations/adverse events
Economic Outcomes Health service use—reduce use per patient, or increase overall efficiency
Caregiver/Workforce Relief “Downshifting”--from high-acuity/skilled to low acuity/unskilled care
Technology Viability Rogers DoI Theory: Relative advantage, compatibility, complexity, etc.
Stakeholder Readiness Ready or resistant? Note: technology viability/stakeholder readiness tradeoff
Policy Relevance “Authority-driven” adoption: QI/Cost Savings Initiatives, Subsidies
© 2010 Center for Technology and Aging4
Promising Technology Focus Areas --Focus of CTA’s first 3 Grant Programs--
1. Medication Optimization Technologies Medication adherence
Medication reconciliation
Medication monitoring
2. Remote Patient Monitoring Technologies Chronic disease monitoring
Safety, falls monitoring
3. Technologies for Post-Acute Care Transitions/Readmissions
© 2010 Center for Technology and Aging5
Focus Area Medication Adherence, Remote Patient Monitoring
Population Vets with CHF, hospitalized within past year
Technology Health Buddy using POTS,
Med Adherence Algorithm, weight scale, BP cuff
Outcomes Reduce hospital/ED visits; improve patient activation, QOL &
satisfaction (randomized, controlled trial)
Workforce Relief Patient Self-Support, Care coordinator (RN), MD oversight,
Automated clinician alerts
Readiness VHA: world’s largest telehealth user, rural health = telehealth
Policy
Relevance
VHA mandated to efficiently change from acute care provider to
a chronic care/preventive care provider
Veterans Health Administration (Central CA) --Example CTA Grantee Project--
© 2010 Center for Technology and Aging6
Technology Intervention Outcomes Measures --Examples from CTA Grantees--
Medication
Adherence
Morisky scale, Beliefs about Medicines, Meds possession ratio
Medical service
utilization
# of hospitalizations, ED visits; cost comparisons between usual
care and technology-enabled care
Technology
adoption
Surveys regarding adoption process, points of resistance,
barriers/drivers, clinician satisfaction, organizational readiness
Patient Patient QOL: SF 12, SF 36, Lorig
Patient Activation: PAM, other empowerment surveys
Caregiver
Burden
Zarit scale
Clinical Weight, BP, A1c, other condition-specific indicators
Study Design
Issues
RCT is gold standard
Validity of pre-post & cohort comparisons?
© 2010 Center for Technology and Aging7
Center for Technology and Aging
www.techandaging.org