1. Barriers and Facilitators for Using Technology to Promote Well-being and Independence in a Technology Resistant* Consumer Base Kevin Chaney, MGS Program Manager, Health IT Agency for Healthcare Research and Quality Health 2.0 STAT: Washington, D.C. April 19, 2012

2. AHRQ’s Mission Improve the quality, safety, efficiency and effectiveness of health care for all Americans

3. Technology Resistant Who is the Technology Resistant Consumer Base? Who is the Technology Resistant Consumer Base? – Elderly, chronically ill, and underserved Are they technology resistant or is the technology resisting them? Are they technology resistant or is the technology resisting them? I argue a bit of both I argue a bit of both

4. Thoughts on Older Adults and Technology The older the cohort, the more diverse that cohort (although smaller) The older the cohort, the more diverse that cohort (although smaller) Yet, we pigeon-hole / stereotype users Yet, we pigeon-hole / stereotype users Baby Boomers will be a more diverse group of technology users Baby Boomers will be a more diverse group of technology users But will a Tech Savvy user today be a Tech Savvy user tomorrow? But will a Tech Savvy user today be a Tech Savvy user tomorrow? Technology constantly replaces itself Technology constantly replaces itself

5. Current mHealth Uses Impacting Older Adults Chronic Disease Management Chronic Disease Management Medication Management Medication Management Falls Detection / Prevention Falls Detection / Prevention Older Adult Wandering Older Adult Wandering Health Information Access Health Information Access Wellness Promotion Wellness Promotion Social Connectivity* Social Connectivity*

6. What We Know Barriers to use Barriers to use – Computer literacy and anxiety – Cognitive impairment – Physical impairment (decline in motor function and eyesight) Drivers of use Drivers of use – Gradually introducing new technology (start with familiar tools) – Using technology to integrate older users with family caregivers – Previous Internet access

7. Are We There Yet ? …will we ever be? …will we ever be? Need to better understand how older adults manage their care and information and how technology/mHealth can facilitate those activities Need to better understand how older adults manage their care and information and how technology/mHealth can facilitate those activities Accessibility still a concern Accessibility still a concern I’ve found products that are simple and impactful for some areas, but not all I’ve found products that are simple and impactful for some areas, but not all Privacy and security questions remain Privacy and security questions remain

8. How Can We Get There? Keep it simple and accessible... In some cases, very simple Keep it simple and accessible... In some cases, very simple Keep it connected to the community – family – care and service providers* Keep it connected to the community – family – care and service providers* Positive reinforcement embedded in the technology Positive reinforcement embedded in the technology User training is minimal User training is minimal

9. How Can We Get There? (cont.) User-centered design – or – universal design User-centered design – or – universal design Human factors approach Human factors approach A better understanding of the population A better understanding of the population Multi-functional technology Multi-functional technology – Camera + GPS + Phone – now in one – PERS + Med Management + Monitor

10. Informing the Field Consumer health IT Consumer health IT – Barriers and Drivers of Health IT Use for the Elderly, Chronically Ill, and Underserved http://www.ncbi.nlm.nih.gov/books/NBK38653/ http://www.ncbi.nlm.nih.gov/books/NBK38653/ http://www.ncbi.nlm.nih.gov/books/NBK38653/ – Health Care Comes Home: The Human Factors www.nap.edu/catalog.php?record_id=13149 www.nap.edu/catalog.php?record_id=13149 www.nap.edu/catalog.php?record_id=13149 – Consumer Health IT in the Home: A Guide to Human Factors Design Considerations www.nap.edu/catalog.php?record_id=13205 www.nap.edu/catalog.php?record_id=13205 www.nap.edu/catalog.php?record_id=13205

11. Informing the Field Active Aging Research Center (P50) - http://aarc.chess.wisc.edu/ Active Aging Research Center (P50) - http://aarc.chess.wisc.edu/ http://aarc.chess.wisc.edu/ Understanding Development Methods From Other Industries for Design of Consumer Health IT (RFTO) Understanding Development Methods From Other Industries for Design of Consumer Health IT (RFTO) Understanding User Needs and Context to Inform Consumer Health Information Technology (IT) Design (R01) (PA-11- 199) - http://grants.nih.gov/grants/guide/pa- files/PA-11-199.html Understanding User Needs and Context to Inform Consumer Health Information Technology (IT) Design (R01) (PA-11- 199) - http://grants.nih.gov/grants/guide/pa- files/PA-11-199.html http://grants.nih.gov/grants/guide/pa- files/PA-11-199.html http://grants.nih.gov/grants/guide/pa- files/PA-11-199.html