Hit And Positive Aging

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<ul><li> 1. Health Information Technology and Positive Aging</li></ul> <p> 2. Agenda </p> <ul><li>Public Policy Issues </li></ul> <ul><li>State of Technology in Aging Services </li></ul> <ul><li>Telehealth Overview </li></ul> <ul><li>The VA and Telehealth </li></ul> <ul><li>HIMSS Telemedicine Survey </li></ul> <ul><li>Aging Technology Ethical Issues </li></ul> <ul><li>Continua Health Alliance </li></ul> <ul><li>Reflections </li></ul> <p> 3. Public Policy Overview </p> <ul><li>The average American spends $440,000 on health care in his lifetime, and $280,000 will be spent after age 65.</li></ul> <ul><li>50% of that post-65 outlay goes to assisted-living facilities and nursing homes.</li></ul> <ul><li>Keep elderly patients in their own homes longer, without degrading quality of care a cheaper and better system. </li></ul> <p> 4. Public Policy Overview </p> <ul><li>Usingeveryday, low-cost technology - the sensors, microchips, small radios you'd find in today's PCs, in cell phones, and in Bluetooth earpieces.</li></ul> <ul><li>Endorsement and reimbursement by Medicare critical </li></ul> <ul><li>The savings achieved by keeping just 10% of the aging population in their homes can amount to $30 billion a year. </li></ul> <p> 5. State of Technology in Aging ServicesMarch 2008 </p> <ul><li>Vision: Using Integrated Information Technology Systems to Support and Enhance the Health, Safety, and Social Connectedness of Older People Living in Their Own Homes </li></ul> <ul><li><ul><li>Center for Aging Services Technologies(CAST)</li></ul></li></ul> <p> 6. Three Types of Technologies </p> <ul><li>Health and Wellness Technologies </li></ul> <ul><li>Safety Technologies</li></ul> <ul><li>Social Connectedness Technologies </li></ul> <p> 7. Types of Technologies </p> <ul><li>Health and Wellness Technologies </li></ul> <ul><li><ul><li>Telemedicine </li></ul></li></ul> <ul><li><ul><li>Robots </li></ul></li></ul> <ul><li><ul><li>Medication Adherence Devices </li></ul></li></ul> <p> 8. Home Telehealth Technologies 9. Recommended Links: Health and Wellness Technologies </p> <ul><li>Health Hero Networkhttps://www.healthhero.com/ </li></ul> <ul><li>Gecko Systemshttp:// www.geckosystems.com / </li></ul> <ul><li>ZumeLifehttp:// www.zumelife.com/index.php </li></ul> <p> 10. Polycom Healthcare Delivery </p> <ul><li>Solutions for all Healthcare Environments </li></ul> <p>HDX 4000 HDX 8000 HDX Telehealth Cart Mobile Responder Clinicians Patients HealthcareAdminEducation Private Networks NationalNetworks 11. Polycom Ultimate High Definition </p> <ul><li>Provides most life like experience possible</li></ul> <ul><li>Comprehensive, free flowing conversations with HD Video and Audio</li></ul> <ul><li>Sharing of medical content and images in HD provides high resolution images (MRI, CT Scansetc)</li></ul> <ul><li>Read body language clearly; dont miss subtle details </li></ul> <ul><li>View skin tones, color and depth perception with clarity </li></ul> <p> 12. Polycom Healthcare Delivery Technology </p> <ul><li>Polycom provides full integration of video, voice, multimedia content, bridging, recording/archiving/streaming, and support . </li></ul> <ul><li>Lockable Drawer </li></ul> <ul><li>Available over Ultimate HD architecture </li></ul> <ul><li>Two monitor functionality with one monitor </li></ul> <ul><li><ul><li>Send images while simultaneously showing participants</li></ul></li></ul> <ul><li>Easy connectivity to Medical Peripheral Devices </li></ul> <ul><li><ul><li>Otoscopes, Handheld camera, Stethoscopes, Dermascopesetc </li></ul></li></ul> <ul><li>End to end encryption </li></ul> <ul><li>Based on AES (the strongest possible encryption algorithm) </li></ul> <ul><li>Stereo sound provides high quality audio for medical interactions </li></ul> <p>HDX / VSXPractitioner Cart 13. Types of Technologies </p> <ul><li>Safety Technologies </li></ul> <ul><li><ul><li>Remote Monitoring </li></ul></li></ul> <ul><li><ul><li>Embedded Microchipsfor Alzheimers Patients</li></ul></li></ul> <ul><li><ul><li>Smart Homeshttp:// www.harris.cise.ufl.edu/gt.htm </li></ul></li></ul> <p> 14. Recommended Links: Safety Technologies </p> <ul><li>Quiet Carehttp://www.quietcare.com/ </li></ul> <ul><li>VeriChip Corporationhttp:// www.verichipcorp.com / </li></ul> <ul><li>Smart Househttp:// www.harris.cise.ufl.edu/gt.htm </li></ul> <p> 15. Types of Technologies </p> <ul><li>Social Connectedness Technologies </li></ul> <ul><li><ul><li>Wii http:// us.wii.com / </li></ul></li></ul> <ul><li><ul><li>Virtual Communities </li></ul></li></ul> <ul><li><ul><li>Brain Fitness </li></ul></li></ul> <ul><li><ul><li>Simple Cell Phone </li></ul></li></ul> <p> 16. Recommended Links: Social Connectedness Technologies </p> <ul><li>Wiihttp:// us.wii.com / </li></ul> <ul><li>Life Raft Grouphttp://www.liferaftgroup.org/about.html </li></ul> <ul><li>Brain Fitnesshttp://www.positscience.com/ </li></ul> <ul><li>Jitterbug Cell Phonehttp:// www.jitterbug.com/Home.aspx </li></ul> <p> 17. High Technology for Low Vision </p> <ul><li>Customizing a computer (LowBrowse) </li></ul> <ul><li>Cellphone with camera and feedback (KnfbReader Mobile) </li></ul> <ul><li>GPS system (Trekker Breeze) </li></ul> <ul><li>Mini magnifiers</li></ul> <ul><li>Prosthetic contacts </li></ul> <p> 18. State of Technology in Aging ServicesMarch 2008 </p> <ul><li>Barriers to Implementation </li></ul> <ul><li><ul><li>Negative Experience and Misconceptions </li></ul></li></ul> <ul><li><ul><li>Lack of Consensus on Value </li></ul></li></ul> <ul><li><ul><li>Lack of Financial Incentives </li></ul></li></ul> <ul><li><ul><li>Inadequate Infrastructures </li></ul></li></ul> <p> 19. State of Technology in Aging ServicesMarch 2008 </p> <ul><li>Recommended Actions </li></ul> <ul><li><ul><li>Raise Awareness of Benefits </li></ul></li></ul> <ul><li><ul><li>Support Research on Value Equation </li></ul></li></ul> <ul><li><ul><li>Provide Investment Incentives </li></ul></li></ul> <ul><li><ul><li>Develop Technology Infrastructure </li></ul></li></ul> <ul><li><ul><li>Incorporate Older Adults in Design </li></ul></li></ul> <ul><li><ul><li>Promote Collaboration Among Technology Firms </li></ul></li></ul> <p> 20. Telehealth Leadership Initiative </p> <ul><li>Telehealth can: </li></ul> <ul><li><ul><li>Reduce unnecessary delays in receiving Rx </li></ul></li></ul> <ul><li><ul><li>Reduce or eliminate travel expenses </li></ul></li></ul> <ul><li><ul><li>Reduce or eliminate the separation of families during difficult or emotional times </li></ul></li></ul> <ul><li><ul><li>Use MD services in underserved areas </li></ul></li></ul> <ul><li><ul><li>Allow patients to spend less time in waiting rooms </li></ul></li></ul> <p> 21. Telehealth Leadership Initiative </p> <ul><li>The use of advanced telecommunications technologies to exchange health information and provide health care services across geographic, time, social, and cultural barriers: </li></ul> <ul><li><ul><li>Telephone, radio, other voice modalities;</li></ul></li></ul> <ul><li><ul><li>Picture phones, teleconferencing;</li></ul></li></ul> <ul><li><ul><li>Fax, Emails;</li></ul></li></ul> <ul><li><ul><li>Computers for data/imaging;</li></ul></li></ul> <ul><li><ul><li>Interactive video; and,</li></ul></li></ul> <ul><li><ul><li>Virtual reality, tele-robotics.</li></ul></li></ul> <p> 22. Telehealth Leadership Initiative </p> <ul><li>What are the Different Types of Telehealth? </li></ul> <ul><li><ul><li>Tele-Dermatology;</li></ul></li></ul> <ul><li><ul><li>Tele-Radiology;</li></ul></li></ul> <ul><li><ul><li>Tele-Nursing or Ask-a-Nurse;</li></ul></li></ul> <ul><li><ul><li>Tele-Psychiatry;</li></ul></li></ul> <ul><li><ul><li>Tele-Dental;</li></ul></li></ul> <ul><li><ul><li>Tele-Ophthalmology; and,</li></ul></li></ul> <ul><li><ul><li>Tele-education / Continuing Education.</li></ul></li></ul> <p> 23. Agency for Healthcare Research and Quality: Telehealth </p> <ul><li>Telehealth can improve patient safety and quality of care. </li></ul> <ul><li>Implementing telehealth is not easy. </li></ul> <ul><li>Guidelines for reimbursement of telehealth are necessary for sustainability. </li></ul> <ul><li>AHRQ-funded grantees say technical support must be available around the clock to ensure patient safety. </li></ul> <p> 24. Agency for Healthcare Research and Quality: Telehealth </p> <ul><li>Telehealth systems should be integrated with electronic health record (EHR) systems to promote continuity of care across clinical settings. </li></ul> <ul><li>Telehealth systems can support the provision of team-based care. </li></ul> <ul><li>The AHRQ-funded laboratory of telehealth projects is producing valuable, informative lessons for the Nation. </li></ul> <p> 25. New Ways of Transforming Home Care </p> <ul><li>Three Imperatives </li></ul> <ul><li><ul><li>Provide patients with feedback systems</li></ul></li></ul> <ul><li><ul><li>Create models where population-based care is practiced and rewarded financially.</li></ul></li></ul> <ul><li><ul><li>Move care out of institution-owned physical spaces. </li></ul></li></ul> <p> 26. New Ways of Transforming Home Care </p> <ul><li>The re-conceptualization of home care telehealth can be done through the use of technology to improve: </li></ul> <ul><li><ul><li>Clinical decision-making </li></ul></li></ul> <ul><li><ul><li>Patient self-monitoring </li></ul></li></ul> <ul><li><ul><li>Both can be done through the collection of data throughremote monitoring </li></ul></li></ul> <p> 27. New Ways of Transforming Home Care </p> <ul><li>Benefits of Remote Monitoring </li></ul> <ul><li><ul><li>Permits continuous rather than episodic measurement </li></ul></li></ul> <ul><li><ul><li>Measures symptoms in the environment in which they occur </li></ul></li></ul> <ul><li><ul><li>Permits individualization of the disease process since what is normal is individual (e.g. blood pressure) </li></ul></li></ul> <p> 28. New Ways of Transforming Home Care </p> <ul><li>Home Telehealth Technologies </li></ul> <ul><li><ul><li>Personal Emergency Response System (PERS) </li></ul></li></ul> <ul><li><ul><li>Monitored medication technology </li></ul></li></ul> <ul><li><ul><li>Medical device monitoring </li></ul></li></ul> <ul><li><ul><li>Therapy tele-management </li></ul></li></ul> <p> 29. Harry Wang, Director, Digital Health Research, Parks Associates 30. The VA and Telehealth </p> <ul><li>Telehealth/Telemedicine: The use of electronic information and communications technologies to provide and support health care when distance separates the participants. </li></ul> <p> 31. Types of Telehealth </p> <ul><li>Synchronous: Real-time </li></ul> <ul><li>Asynchronous: Store-and-forward</li></ul> <p> 32. Synchronous TeleHealth </p> <ul><li>Telemental health </li></ul> <ul><li>Telesurgery </li></ul> <ul><li>Telerehabilitation </li></ul> <ul><li>Telecardiology </li></ul> <p> 33. Asynchronous Telehealth </p> <ul><li>Teledermatology </li></ul> <ul><li>Telepathology </li></ul> <ul><li>Teleradiology </li></ul> <ul><li>Teleretinal imaging </li></ul> <p> 34. Home Telehealth Technologies 35. Home Telehealth Technologies 36. VA Telehealth Outcomes: Patient Census Growth 142% 21,572 FY06 46% 31,570 FY07 101% 8,922 FY05 121% 4,430 FY04 Base Year 2,000 FY03 Change Census Year 37. Use Reductions 56 337 Depression 21 1,963 COLD 25 4,089 CHF 30 7,447 Hypertension 20 8,954 Diabetes % Decrease in Utilization # of Patients Condition 38. HIMSS Vantage Point(September 2008) </p> <ul><li>Time Towards Widespread Telemedicine Adoption </li></ul> <ul><li><ul><li>4+ Years or More </li></ul></li></ul> <ul><li>Barriers to Telemedicine Adoption </li></ul> <ul><li><ul><li>Lack of Reimbursement </li></ul></li></ul> <ul><li>Telemedicine Benefits </li></ul> <ul><li><ul><li>Improved Access to Care </li></ul></li></ul> <ul><li>Cost Impacts Of Telemedicine </li></ul> <ul><li><ul><li>Home Management of Chronic Diseases </li></ul></li></ul> <p> 39. Aging Technology Ethical Issues (Janice M. Blanchard) </p> <ul><li>Privacy of Information</li></ul> <ul><li>Privacy of Person/Place</li></ul> <ul><li>Informed Consent</li></ul> <ul><li>Equity of Access </li></ul> <p> 40. Aging Technology Ethical Issues (Janice M. Blanchard) </p> <ul><li>Autonomy Versus Dependence </li></ul> <ul><li>Paternalism</li></ul> <ul><li>Patient and Provider Relationship</li></ul> <ul><li> Medical-ization of Home </li></ul> <p> 41. Continua Health </p> <ul><li>Formed in 2006 by a group of major companies from areas such as healthcare, information technology, medical devices and wireless </li></ul> <ul><li>Create a system of standards to allow homecare devices to function together seamlessly </li></ul> <ul><li>By 2008 you should see products available with the Continua Health Alliance symbol and certification </li></ul> <p> 42. HIT and Positive Aging Reflections 43. Reflections </p> <ul><li>Keep Seniors at Home for as Long as Possible </li></ul> <ul><li>Telehealth/Telemedicine has Been Around for Years: Has Its Time Finally Come? </li></ul> <ul><li>Telehealth Can Improve Patient Safety and Quality of Care </li></ul> <ul><li>Continua as a Good Housekeeping Seal of Approval </li></ul> <p> 44. Reflections </p> <ul><li>Medicare Reimbursement is Critical, But is it Likely in Near Term? </li></ul> <ul><li>Incredible Array of Devices from Wide Range of Vendors </li></ul> <ul><li>Senior Resistance to Invasion of Privacy and Medicalization of the Home </li></ul> <ul><li>VA as a Model for Telehealth Use </li></ul> <p> 45. Reflections </p> <ul><li>Incorporate Older Adults in Product Design </li></ul> <ul><li>Leadership Roles Taken By Google and Microsoft </li></ul> <ul><li>Telehealth systems should be integrated with electronic health record (EHR) systems to promote continuity of care across clinical settings </li></ul> <p> 46. Recommended Links </p> <ul><li>Center for Aging Services Technologieshttp://www.agingtech.org/index.aspx </li></ul> <ul><li>Telemedicine Buyers Guidehttp://www.atmeda.org/news/buyersguide.htm </li></ul> <ul><li>Medgadget: Journal of Emerging Technologieshttp://www.medgadget.com/archives/ </li></ul> <ul><li>geriatrics/ </li></ul>

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