Building Bridges: Making a
Difference in Long-Term Care
2006 Colloquium
June 24, 2006
LTC Providers Can Lead the
Revolution in Health Care Change
• It is the aging of our population that may
cause the collapse of our healthcare system.
• LTC providers will be forced to change
their models of delivering care to keep up
with demand for services.
• By leading the direction in new forms of
home based care, the LTC community can
provide the model for best practices.
Healthcare at an inflection point
“Healthcare’s costs, coverage
problems and demographic
pressures mean system
overload; it’s formal
institutions can’t cope with the
future.” Staffing shortages will
get worse and “Boomer”
demands will increase.
What will ease the pain?
“A major shift, enabled by
technology, to self-care,
mobile care, home care.”
(Forrester Report, Dec 2002)
Medicare & Medicaid
will be bankrupt by 2018
Now is the Time for Change
• Boomers will be a disruptive demography
• Ubiquity—possible because of lower cost and
convergence of computing & comm devices.
ƒ Digital home, broadband, wireless (Wifi & WANs,
WIMAX), & intelligent software
From Mainframe Hospitals & LTC
Facilities to “Home” Health: How Can
Technology Help?
• Earlier detection of problems/disease
• Promoting healthy, daily, preventive
behaviors
• Supporting family/friend caregivers
• Empowering consumers
• Higher quality care at lower costs
Future Center Of Care
Convergent Technologies Are Here
• All electronics become connected information devices
• Every device has a chip, every chip has a radio
• Everyday health through everyday consumer devices
Server
Database
STB
Car PC
Video
Games
TV
Tablet
Devices
Cell phones
Thin Clients
DVD
PDA
Laptops
and PCs
Contextual Technologies Are Growing
• Sensors collect data about our world automatically.
• Powerful software interprets the contexts we are in.
• Systems adapt to context—to real world data.
Silicon Fluid
reservoirs and
channel
20µm
280 nm
Boomer Focus Groups
Spring 2005—10 Sessions, all participants between the
age of 50 and 65
Minneapolis
Dallas
Jacksonville
Seattle
Hartford
Since CAST is about reinventing the way that care is
provided the goal of these focus groups was to
understand the problems from the prospective of the
caregiver and future consumer.
What are Boomer Concerns as They
Age?
•
•
•
•
•
•
Finances
Maintaining health and independence
Loneliness and isolation
Losing mental capacities
Burdening children
Maintaining choice for care; hopefully not
in an institutional setting
Key Caregiver Concerns
• Transportation
• Social connectedness
• Access to information – don’t know what to
do
• Not knowing “real-time” how the elder is
doing
Willingness to Pay Per month
Amount Willing to Spend on Technology Services
(per month)
10%
< $50 a month
50%
$50-$100 a month
40%
>$100 a month
90% Willing to spend $50 and up per month.
This reflects a major difference from
previous generations
Addressing Long-Term Care Concerns
Through Technology
• Integration of monitoring and sensing solutions that include
visual/audio
• Personal health device – portability and control of personal
health data for self and for loved one
• Telehealth – device in the home for specific medical conditions.
The need is to manage chronic disease, save time, and have
real-time feedback on current condition
• Solutions that increase connectedness and provide peace of
mind
• Must be easy to use, little interaction from the elder person
• Remember to maintain the interpersonal touch – don’t replace
human connection
Research Needs
• Collecting evidence-based research on these technologies
is critical. However the continual improvement of these
technologies requires new models and guidelines for
research.
• Evaluation research needs much larger trails and pilot
projects.
• Determine technologies that work best when, where, with
whom to improve quality, well-being, and independence.
• Explore implementation, efficiency, costs, and financing
strategies.
• Determine and incorporate capabilities, limitations, and
desires of a diverse population of elders and caregivers.
• Requires collaboration: tech industry, research institutions,
providers, caregivers, and consumers.
Policy issues
•
•
•
•
•
•
•
1) Reimbursement for on-site wellness and healthcare systems.
2) Federal funding is needed to support the development of
technology for pro-active care.
3) HUD regulations for senior housing should recognize the need
for ‘smart’ cost-effective housing solutions that allow seniors
extended stay in non-institutional environments.
4) Cross-state licensure opportunities for nurses and physicians
are needed to gain the benefit of opportunities in telehealth,
wellness monitoring and remote care management.
5) Real and/or perceived liability barriers are inhibiting research
and development of home health and aging-in-place technology
solutions.
6) Challenges in a global marketplace.
7) Electronic Health Records (HER) & Personal Health Records
(PHR) driven by acute care.
First Step Needed- A National Commission for creating practicable
solutions through technology to the unfolding crisis in senior
healthcare.
What Foundations & Funding
Organizations Need to Consider
• The U.S. is way behind Japan, South Korea and
Europe in developing and testing new
technologies to help older adults.
• There is little government support or foundation
support to drive new approaches to care.
• Since foundations and funding organizations
generally do not provide support for
infrastructure activities, new initiatives that can
dramatically improve care have continued to
suffer from lack of support.
• Just as the aging services field is changing, the
need is for the policies of funding organizations
to do the same.
CAST: Catalyzing the Revolution
Providers of
Aging Services
Industry
Partners
Government
Agencies
CAST
University
Researchers
Associations
What DOES CAST DO?
• Identify and drive the development and application
of proven new technologies that allow quality to
scale to the age wave.
• Help industry understand the aging services market.
• Help providers of care understand new
technologies.
• Identify and address policy issues
Concepts in the CAST Vision Video
You Will See at Lunch
• Distance
• Monitoring activities
of daily living
• Caregiver Network
• Portable Medication
dispenser and alert
• Electronic health
information
• Privacy Respected
• Smart appliances
• Personal health
records
• Two-way video
communication
• Non-invasive blood
glucose readings
• Games with embedded
assessment
Thanks…
Contact information
Russ Bodoff
Executive Director
Center for Aging Services Technologies (CAST)
(202) 508-9463
rbodoff@agingtech.org
www.agingtech.org