Technology and Innovative Home and Community Based Care Majd Alwan, Ph.D., Director Center for Aging Services Technologies (CAST) Medicaid Congress June 5, 2008 1

Providers of Aging Services What is CAST? Government Agencies Providers of Aging Services University Researchers Tech Industry Partners CAST Associations A national coalition of more than 400 organizations working together to improve the aging experience through technology

Why We’re Here CAST Mission  Help older adults maximize their independence  Support professional and family caregivers’ needs  Improve quality of care and quality of life  Reduce our nation’s health care costs  Increase aging services providers’ efficiency Scripting Points As you all know, CAST has been working incredibly diligently over the past two years to forward our mission of unleashing the potential of technology across the continuum of health care, housing and services for the aging, and to accomplish the goals you see on the screen. And today, after 4 years of working together ~ CAST and AAHSA members and partners~ we HAVE A GREAT STORY TO TELL. IT’S A STORY OF LEARNING TOGETHER, OF TRIAL AND ERROR AND OF WILLINGNESS TO TAKE RISKS AND TRY NEW THINGS. AND FROM THESE STORIES, WE ARE NOW ABLE TO SHARE WITH YOU lessons learned that provide guidance on whether, when, which and how to use technology to meet any of these 5 objectives with special emphasis on the support of caregivers, reducing workloads and increasing efficiency. AT AAHSA, WE USE A CASE STUDY MODEL OF EDUCATION. IN the Technology Division CAST, WE HAVE COMPILED “CAST STUDIES.” Some will be highlighted in my presentation today; and the rest are AVAILABLE ON OUR WEB SITE FOR YOUR USE. These are great resources for your institution no matter where you are in the process – from exploration to implementation. TODAY’S CAST STORY IS A COMPILATION STORIES FROM YOUR colleagues. SO LET ME START BY THANKING THEM FOR THEIR GENEROSITY OF SPIRIT AND TIME DEDICATED to SHARING their information with us. PLEASE JOIN ME IN THANKING: Asbury Group Ecumen Elant Eskaton Evangelical Lutheran Good Samaritan Society Lutheran Homes of Michigan Selfhelp Volunteers of America Special thanks to UPMC Retirement Communities and Erickson retirement communities, who will be telling their story in person. Please join me in giving them a hand.

The Trends AT CAST WE RECOGNIZE THE DEMOGRAPHIC TRENDS THAT You know better than anyone. Today the healthcare spending represents 16% of the Gross domestic product and on the rise. We have over 40 million people without health insurance, and over 200 million without long-term care insurance. In only 12 years the senior population will grow to 54 Millions. We have a shortage in geriatricians and nurses and the gap is expected to increase.

“Shift Left” through Technology $1 $10 $100 $1,000 $10,000 0% 100% Healthy, Independent Living Chronic Disease Management Doctor’s Office Community Clinic HOME CARE Assisted Living Skilled Nursing Facility RESIDENTIAL CARE Community Hospital ICU Specialty Clinic ACUTE CARE COST of CARE/DAY QUALITY of LIFE

Technology-Enabled Care Services Personal Health Maintenance Service Provider Analysis & Archiving Older Adult Data Adult Child Improved Communications Healthcare Professional Preventive Interventions

Value Innovative care models with smart technology Seniors At Home Longer Costs Efficiency Earlier Intervention …more efficient care with reduced care burden

Categories of Aging Services Technologies Safety in the Environment Physical & Mental Health/ Wellbeing Social Connectedness to others EHRs & Point of Care/ Point of Service 8

Safety Technologies Wearable devices (PERS, automatic fall detectors, fall prevention patches) Life Alert, Philips Life Line Tunsatll 9

Safety Technologies Environment/Passive (motion-based sensor monitoring systems, embedded fall-detectors, stove use detectors, temperature/smoke monitors, safe lighting technologies) Sensor Element

Physical & Mental Health/Wellbeing Wearable devices (activity monitors, cardio monitor, ambulatory blood pressure monitors) Environment/Passive (motion-based activity monitors, sleep/bed sensors)

Physical & Mental Health/Wellbeing Telemedicine/ Tele-health (biometrics: blood pressure, heart rate, glucose, temperature, weight, breathing; daily wellness check; 2- way video health consultations care coordination; medication compliance) Honeywell homMed, Philips, Intel, Imetrikus, VitelCare, WebVMC and Healthbuddy

Social Connectedness Phone enhancements (amplified phones, easy to use cell phones) One-way displays Two-way video conferencing Entertainment/ Theraputainment (cognitive and/or Physical exercise)

EHRs & Point of Care Technologies Point of Care systems; Electronic clinical charting; ePrescribing

What is needed? Funding for large-scale demonstration projects (objective outcome evaluations) Reimbursing for efficacious and cost-effective technologies

Discuss technologies in the illustration (monitoring, etc) Used two-way video to talk to her son and the grand children. Electronic medication caddy notified son she took her medicine, so he did not have to nag her. u Wearable sensors transmit health vitals to healthcare professional. Wristwatch tells caregiver of her location. -- The claims that technology can offer us hope, can improve quality of life for seniors while reducing caregiver burdens and overall health care costs (both to the clients and the system as a whole), those are big claims. --What does hope look like? Like this: Discuss technologies in the illustration (monitoring, etc) --Technology is quickly changing our lives and the way we are caring for an aging population. Interactive: Ask in the room if they are using any of these for interactivity and to gauge audience. Instrumented walker assesses gait and balance. Telemedicine helped her send a picture of a scrape to her doctor, avoiding a trip to the office.

Questions? Majd Alwan, Ph.D. Director, CAST malwan@agingtech.org (202) 508-9463 www.agingtech.org