A Tablet-based Tool to Promote Self-management of Older Adults with Chronic Health Problems Cynthia Jacelon, Jeung Choi, David Fisher, Allen Hanson, Eva Hudlicka, Raeann LeBlanc, Jenna Marquard Computer Science Students Nursing Student(s) Engineering Student(s)
Who Older cohort fastest growing segment of population 12-27% of the world population – Italy and Japan have the same percentage of older adults as Florida Over 80 fastest growing group US: 4% live in institutions (nursing home) US: 25% will spend some time in an institution Longer life, more chronic illness
Who As many as 85% of these individuals have one or more chronic health problems The management of multiple chronic health problems can be complicated and involves balancing the demands of maintaining optimal health with other aspects of community living Ineffective self-management may lead to exacerbations of symptoms and hospitalization for up to 30% of older adults annually
Self-management Self-management is a dynamic process in which individuals actively manage chronic illness (Schulman-Green et al. 2012) It is more than compliance or adherence to health prescriptions; it is a strategy for living with chronic disease. Self-management implies that the individual with the chronic condition engages in daily management of their conditions by making informed decisions regarding health and life choices.
Specific Aim The specific aim of this pilot project is to develop and test a computer tablet-based tool to support older adult's self-management of chronic health problems
Background In previous research a model for self- management of chronic illness was created: Individuals balance: – Activity – Attitude – Autonomy – Relationships – Health
Function All chronic illness affects function Individuals must be able to function to manage their health problems Because function is critical to self- management, our project will not be disease focused, but on function
The Device: hardware Tablet-based Touch screen Of a size that is easy to use – Large enough to see – Touch screen big enough to accommodate the individuals hands – Patient enough to allow response time for an older person
The Device: software User friendly Supports self-management Provides feedback to the user Talks to peripherals Data can be collected and analyzed
Project phases Develop a computer tablet-based prototype of a self-management tool based on concrete use cases. Design, develop, and test the tablet user interface for the tablet-based self- management tool to insure effectiveness and usability. Evaluate the usability and effectiveness of the tablet-based tool with community dwelling older adults who are managing chronic illness.
Time line January 2014: The team presents the goals and the broad overview of the desired application. Target 1/30/14. We need to know exactly which sensors we will be using. February 2014: The students present the draft use cases, possibly with some UI mock ups to illustrate. Target 2/20/14. March 2014: The students present final use cases. Target 03/04/14. We expect to have listed all the expected interactions. Spring semester 2014: The students present iterative prototypes (on the simulator). Every third week target 03/25/14, 04/15/14. May 2014: The students present the final demo, on simulator and deployed on the tablet. May, during finals period.
Timeline (cont) Summer 2014: Older adults with chronic illness use the device and provide feedback on user interface and application. Revisions as necessary Continue to test and analyze data. Spring 2015: Apply for funding to test on a broader scale.
Rehospitalization Readmission to the hospital for the same health problem within 30 days of initial discharge Return to a more acute level of care for the same health problem within 30 days. Up to 25% of older adults who are discharged from the hospital will be re-hospitalized within 30 days
Rehospitalization The Affordable Care Act (Obama Care) – Containing costs for healthcare – Denying payment to hospitals for re- hospitalization within 30 days A lot of research on how healthcare providers can help individuals stay out of the hospital