Meet Ernesto. He's 87 years old and has congestive heart failure, hypertension, and mild cognitive decline. He has a team of doctors managing his care. He's close with his family, although they live an hour away. Ernesto, however, lives independently at home, manages multiple medications, and still enjoys weekly poker games with friends
How does he do this? With the help of everyday technologies like cell phones and computers. Ernesto, his family, and his healthcare providers have used them to create a network that monitors Ernesto's health conditions, promotes communication among with those who care about him, improves his quality of life and, most important, allows him to live at home.
For example, Ernesto's cell phone reminds him when and how to take his diabetes medications and also prompts him to check his blood sugar. Ernesto then uses his computer to send these data to his new doctor, who can monitor any changes and send him suggestions and support with the click of a mouse. But it's not just about tests and treatments. These technologies also allow Ernesto to celebrate his birthday with his daughter using videoconferencing and play online card games to increase his cognitive fitness.
Sounds good, doesn't it? Right now, Ernesto's story is more vision than reality. But with hard work, and a little imagination, technology will help researchers, companies, and providers create what millions of seniors deserve: a caregiver network.
The Caregiver Network
What does a caregiver network offer? Communication. A caregiver network would allow individuals to connect in a new way and with information at their fingertips to deliver care in more meaningful ways. Instead of today's typical eight-minute exam room, networks will use technology to promote a proactive and preventive model of care focused on educational empowerment, behavior modification, and multigeneration life-span planning.
A powerful, capable caregiving network would also support family caregivers, especially those who are providing care from a distance. Right now, 34 million Americans provide care to older family members, and 15% of these caregivers live an hour or more away from their relative. As our population ages, the trend of providing long-distance care is not likely to reverse itself. It is imperative that individuals and family caregivers are able to be engaged and involved in the care plan.
Most important, relationships are strengthened when people can connect to each other. Technology can help collapse the distance, the thousands of miles that are separating families, and improve the senior's social network. In addition, relationships among professional care teams can be strengthened to form a partnership approach to healthcare decision making.
The Personal Health Record
The technological foundation of the caregiver network is the personal health record (PHR). PHRs consolidate an individual's health information and history so information follows the patient to different physicians and settings. Recently, foundations including the Robert Wood Johnson Foundation (RWJF) and the Markle Foundation have invested resources into enhancing the PHR's role in healthcare. RWJF is the primary sponsor of Project Health Design: Rethinking the Power and Potential of Personal Health Records, a $4.4 million initiative to design and test new tools that advance the field of PHR systems over 18 months. This new program will extend the range of uses offered by existing PHRs by supporting multidisciplinary teams to design and test a broad spectrum of innovations in how consumers can use information technology to better manage their health and more easily navigate the healthcare system.
Connecting for Health, an initiative led by the Markle Foundation, is a public-private collaborative of more than 100 organizations committed to enabling healthcare professionals and patients to use information technology to achieve the best care possible. In December 2006, it released a white paper that describes a networked environment in which consumers could establish secure electronic connections with multiple entities that hold their personal health information—not unlike the ways in which mil-lions of Americans bank online today.
In the near future, large companies such as Google also plan to become more involved in building consumer empowerment within the healthcare field. At a recent conference on connecting Americans to healthcare, Adam Bosworth, vice-president of Google, discussed what the company is doing to help people more easily find the health information they are looking for by labeling sites and pages across the Web so health-related searches are easily refined and ordered by relevance. Bosworth said innovative solutions to accessing and providing holistic, comprehensive health information to consumers is badly needed in order to enable transformational change in the way care is provided. He said everyone needs a “Health URL” to store and share personal health information to help minimize the fear and worry of those managing diseases and the people in their social network who care for them.
In-home sensoring technologies are also a key element in a network's success. The sensors can be used to monitor daily activities, remind or prompt the senior as needed, and help providers influence and shape an individual's behaviors.
What does this change mean for the aging-services field? Organizations must not be providers of care, but facilitators of it. Technology is already revolutionizing our lives and older adults are insisting on highly specialized services, on their own terms, in their own homes. Providers must develop and maintain their own networks that knit together essential services and knowledge for older adults and their loved ones. Through technology and linkages with retail stores, banks, tech companies, hospitals, and professionals, aging-services organizations will provide a seamless continuum of health, social, and consumer services for the people they serve.
Already, leading-edge providers are starting this process. Eskaton, a northern California senior housing and services provider, is pilot testing PHRs for its residents and their family members. When Eskaton was provided the opportunity to pilot a PHR system, developed by Intel, for seniors to easily store, manage, and search for their personal health and medical information in a secure, Internet-based platform, Eskaton embraced the opportunity. “Eskaton is committed to exploring how technology can help seniors live more independently, connected to the information and support that they need,” says Sheri Peifer, director of research and special projects for Eskaton.
Since the pilot began in mid-2006, a small group of committed, active residents has participated in utilizing and providing feedback to Intel about the usability and value of the PHR system. Intel has conducted several surveys and focus groups with Eskaton residents, and feedback has been useful in redesigning the PHR application for increased simplification to input, download, and search for specific health and medical records. “Intel is currently gathering information from Eskaton residents on the revised version of the PHR for further analysis,” says Peifer. Recently, all residents of Eskaton have been invited to participate in using the PHR system online.
PHRs offer consumer empowerment. When seniors and their family caregivers have control and responsibility for their health information, they are more engaged and motivated to track and monitor their health. They can also help to ensure the correctness and accuracy of information, giving a clear picture of seniors' medical histories and helping to avoid potentially dangerous and costly medical errors.
Providers who, like Eskaton, embrace opportunities to pilot technologies and, more important, who include implementation of technology solutions as part of their strategic planning will be the ones who thrive in the future. The American Association of Homes and Services for the Aging (AAHSA) recently completed its second scenario planning process to identify trends and uncertainties for the future. Increasing consumer demands and lack of a talent force to meet those demands were identified as the two greatest uncertainties facing our field. Consumer demand for specialized, tailored, at-home services will increase with the aging of the baby-boom generation, and our need for a larger workforce will grow. Technology will help us with both of these uncertainties. It is a key character in the story of our future.
The Center for Aging Services Technologies (CAST) offers providers a head start on the information they need to embrace the future and manage the uncertainties. The CAST clearinghouse (http://www.agingtech.org) has information about more than 300 pilot projects, products, and research on various communication technologies that has been posted by aging services providers, researchers, and companies. If you are involved with technology-related initiatives, please share that knowledge and experience in the clearinghouse. If you are interested in getting involved, there are a number of resources to help long-term care providers get involved in pilots.
Ernesto is the lead character of a video that CAST produced to help portray how a caregiver network can benefit consumers and providers. Showing the video to your key stakeholders can help you to bring the need to embrace existing technologies and prepare for future ones. You can view the video online or order a DVD copy to share with your organization. (To order a copy, visit http://www.agingtech.org.) The vision of Ernesto will be a reality for our nation's seniors in the coming years. It is a vision that will help providers be more effective, more efficient, and more valued in our society. Providers can help lead the effort to bring this vision to reality. We can ensure the independence, the choices, and the connections for all of us.