university of wisconsin active aging research center national advisory committee report and update...
TRANSCRIPT
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University of WisconsinActive Aging Research Center
National Advisory Committee Report and Update
Dave Gustafson PIJuly 25 2012
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ThankYou!
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Over 600,000 will enter nursing homes in 2012
Average NH stay 893 days; $161,500/admission
Total cost exceeds: $10,000,000,000.
Many people do not enter poor,but they leave poor.
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Does it have to be that way?
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ActiveAging
Research Center
Waukesha County
Richland County
Milwaukee County
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What will ECHESS be?
•
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Elevator Speech• There are many good technologies, products, and online resources to help
the elderly remain independent. Few are used. • Why?
– Disparate stand-alone products and services
– Not proven to work
– Not sanctioned by trusted organizations
– Environment is not prepared to adopt, sustain and spread.
• ECHESS will:– Integrate key technologies,
– Test them to find which parts work, with who, and how,
– Work with communities, payers, elders, families and clinicians, to ensure that ECHESS honors the strengths and limitations of everyone.
– Make independence-empowering technology accessible to all.
– Do it within a walled garden.
– Improve outcomes including costs.
– Reduce re-admissions to hospitals and emergency departments.
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National Advisory Committee (PoA)
• Sandra J. Ball-Rokeach Professor, Communications, USC
• Paul Batalden: Professor, Dartmouth Health Policy and Clinical Practice
• Noshir Contractor: Northwestern Science of Networks Research,
• Brian Joiner Founder Joiner Associates Inc. Quality Improvement.
• Peter Kissinger: President AAA Foundation for Traffic Safety.
• Adrian K. Lund President, Insurance Institute for Highway Safety.
• Jeffrey Michael Assoc Administrator, National Highway Traffic Safety Admin.
• Brian McLaughlin Assoc Administrator, National Highway Traffic Safety Admin.
• Wendy J. Nilsen Administrator, NIH Behavioral & Social Science Research.
• Kevin Patrick Professor, Preventive Medicine, UCSD
• Susan C. Reinhard, Senior Vice President for Public Policy at AARP.
• David Rose Innovator, Vitality LLC.
• Vinod K. Sahney, PhD, Senior Fellow, Institute for HealthCare Improvement.
• Andrew H. Van de Ven, Professor, Organizational Innovation, Minnesota.
• Nancy A. Whitelaw; President, Gerontological Society of America
• Clive Hohberger. President (Ret) Zebra Tech; Automatic identification technology
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Goals:
Use sensors, information & communication technology To help elders & family improve:
Service dependability.Loss of driving privileges.
Quality of life.Medication management.
Falls.Readmissions.
Sustain and spread to 20 other Wisconsin counties.
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Focus: Older adult (>70; Hospital discharge in 180 days)
and Family caregiver (Distant; Nearby; Live-in)
Measures• Primary
– Readmissions to hospital– Health care costs– % now living in ALF or NH– Quality of life
• Asset Based Community Development– # uses of community resources– Type of resources used– Have organizations to take on
ECHESS• Isolation
– Number of contacts per day– Minutes of contacts per day
• Driving– Attend appointments– Accidents per driver– Number still driving– Number rapid stops &starts.
• Service Dependability– Service timeliness– Anxiety of family caregiver. – Satisfaction w service quality.
• Medication – Number of adverse events– Missed medications rates
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Premise:Technology
Can Help
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Two interlocking systemsO
lder
adu
lt
“Fam
ily”
Very Preliminary
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Our challenge: Making a complex system simple.
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NAC suggested Next Steps• Stories from each group ✔• Decide on measures ✔• Elevator speech ✔• Baseline data Starting• Target population defined ✔• Simplify• Increase size of RCT Exploring• Interview OAs forced to go to NH or ALF Starting• Doing too much
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Activity
• Needs & Assets – Over 200 elders
interviewed– Information classified– Loneliness, Transport &
Community events• Developed– Stories– Vision– Elder Tree
• Being Developed– Loneliness
• Community Calendar & matching
– Medication• Side effects predictor• Glow-Caps
– Falls• Booster• Gait
– Driving• Sensors measuring drives
– Service Dependability• Pilot testing in rural area
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Next Steps
• Waukesha County– New Berlin– Implement Elder Tree in 1000
households• Getting Community Buy-in• Seeking resources
• Milwaukee County (urban)– Northwest area– Building political base– Completing asset assessment.
• Richland County (rural)– Community bought in– Asset assessment done– Community calendar
• Systems development– Programming– Data collection– Pilot tests– Integration
• Prepare randomized trial.– Final outcomes &
measures– ADRCs prepare to recruit
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To sustain,technology needs support systems
• Financing• Incentives• Processes• Regulations
• Interagency agreements• Welcoming environment• Community development
Working on this now.
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NAC Caution
We are trying to do too much!
Maybe. We’ll see.
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Thank you again