2010: the Technology Tipping Point?
Current Initiatives and Trends in
Technology for Older Adults
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
The Perfect Storm
 Demographics and Resource Scarcity
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
Technologies for
Independent
Living
- Uncertainty of government
safety net programs
- Uncertainty over individual
financial security
- Overstretched healthcare $
- Workforce shortages
Technological Innovation
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The Early Adopter Experience:
Veterans Health Administration
 VHA Community Care/
Health Technology:
$1,600/pt/yr
Age Distribution of all CCHT Patients
 vs. Home-based primary
care: $13,121/pt/yr,
 vs. Nursing home care:
$77,745/pt/yr
 43,430 patients enrolled
 “Systems Approach”
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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
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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 HIT
 Spending 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 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
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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
Medication Adherence
Medication Reconciliation
Assess
Prescribe
Dispense
Administer
Goals
Medication Monitoring
Monitor
Goals
Goals
Goals
Goals
•Patient history
includes a
complete and
accurate
medication list
•Patient needs
are accurately
conveyed and
understood
• Medication
orders are
documented
and shared
with patients
• Medication is
• Individual dose
made available
dispensed
• Medication picked • Individual dose
up by patient
taken by patient (on
• Patient and
time, in the right
caregivers
does, and for the
understand
right length of time)
medication
instructions
Example
Technologies
Example
Technologies
•Medication List
Software
•Personal Health
Records (PHR)
•Medication List
Software
•Personal Health
Records (PHR)
Example
Technologies
Example
Technologies
Example
Technologies
•Teleconsultations
•Online Patient
Education
•Cognitive
Assessment Tools
•Pharmacy Kiosks
•Medication
Adherence Devices
(integrated and
standalone, simple
and advanced
function)
•Personal Biometric
Testing Devices
•Wireless
Communication
Devices
•Personal Health
Records (PHR)
• Routine dosing and
tracking of medication
• Reports and trending
information from
medication log
generated
• Clinician adjusts
medication as needed
• Prescriptions refilled
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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

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Remote Patient Monitoring
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Assistive Technologies
Jitterbug Phone
Honda Exoskeleton
Cochlear Implant
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Remote Training / Simulation
 Professional, praprofessional, family
caregivers
 Modalities
 E-learning
 Video-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
Nintendo DS
Brain Age
Source:
www.brainage.com
Dakim
Sources:
www.ecumen.org
www.dakim.com
Posit
Science
Source:
www.positscience
.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 concerns
Information technology
barriers and
lack of interoperabiltiy
Inadequate reimbursement
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The Center for Technology and Aging
www.techandaging.org
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