1. 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

2. 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

3. 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.

4. 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.

5. “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

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

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

8. 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

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

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

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

12. 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

13. 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)

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

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

16. 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.

17. Questions? Majd Alwan, Ph.D. Director, CAST malwan@agingtech.org
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