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with MAJD ALWAN, PH.D.
Technology & Innovation: Key to Thriving Aging Services
Why should we focus on Technology? • Technology is creeping on us,
whether we like it or not!• It transformed every aspect of our
life, and older adults are no exception.
• Can support independence and enable supportive services.
For providers:– Technology is a business
imperative.– Increasing demands for
documented quality.– Increasing pressures for improved
communication and coordination.
Models & Enabling TechnologiesIntegrated/
CoordinatedHealth Care
Community-Based Support Services
Real Estate Based
+ Interoperable EHRs & HIE+ Remote Monitoring/ Telehealth+ Care coordination tools
+ Remote monitoring and assistive devices
+ Wellness & quality of life
+ Remote monitoring and assistive devices
+ Wellness & quality of life+ Facility management
http://www.leadingage.org/sites/default/files/CAST_Scenario_Planning.pdf
+ Interoperable EHRs & HIE+ Remote Monitoring/ Telehealth+ Care coordination tools
+ Interoperable EHRs & HIE+ Remote Monitoring/ Telehealth+ Care coordination tools
Potential Technologies to Consider
TECHNOLOGIES FOR
SAFETY (WEARABLE)
TECHNOLOGIES FORSAFETY (WEARABLE)
TECHNOLOGIES FORTELEHEALTH
TECHNOLOGIES FORMEDICATION ADHERENCE
TECHNOLOGIES FOR
WELLNESS (ENVIRONMENT)
Engagement Technology (including Brain Health)
Tele-RehabilitationMOVEMENT TRACKING
MOTIVATING GAMES
OUTCOMES DATA
Ziegler-CAST Technology Spending Surveys
Technology Spending
Categories
Percent Technology Spending
Ziegler-CAST Technology Adoption Survey
Chief Technology/Information Officers
Source: LeadingAge Ziegler 150
21%
33%
0%
5%
10%
15%
20%
25%
30%
35%
2013 2015
Percent of “LZ 150” with a CIO/CTO
+12%
LZ-150 Technology Adoption-I
Source: 2016 LeadingAge Ziegler 150
74.7% 76.6%75.3% 77.3%80.0%76.0%
55.3%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
Electronic Medical/HealthRecords (EMR/EHR)
Electronic Point ofCare/Point of Service
Documentation Systems
Care/Case Managementand Coordination
Software
Per
cent
age
2013 2014 2015
PERCENTAGE OF LZ 150 COMMUNITIES/OPERATIONS USING ELECTRONIC DOCUMENTATION TECHNOLOGIES
New Category in 2015
Source: 2016 LeadingAge Ziegler 150
75.2%
33.0%
73.1%77.9%
24.2%
70.5%72.7%
36.0%
77.3%
0.0%10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%90.0%
User-activatedEmergency Response
Systems (PERS)
Automatic Fall Detectors Access Control/WanderManagement Systems
Per
cent
age
2013 2014 2015
PERCENTAGE OF LZ 150 COMMUNITIES/OPERATIONS USING SAFETY MONITORING TECHNOLOGIES
LZ-150 Technology Adoption-II
Source: 2016 LeadingAge Ziegler 150
4.1% 7.6%
57.8%
21.2%
6.8% 7.3%
59.9%
39.0%
21.3% 19.3%
62.7%
44.7%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
Telehealth/RemotePatient Monitoring
(RPM)
Telecare/Telemonitoring/Behavioral Monitoring
Physical Exercise andRehabilitationTechnologies
Medication MonitoringTechnologies
2013 2014 2015
PERCENTAGE OF LZ 150 COMMUNITIES/OPERATIONS USING HEALTH & WELLNESS MONITORING TECHNOLOGIES
LZ-150 Technology Adoption-III
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Resident demographics
Advance directives
Resident medical history
Clinical notes and observations
Lists: problems, allergies, meds
Regulatory assessments (e.g., MDS, OASIS and others)
Non-regulatory assessments
Care plans
Summary reports (discharge, transfer, consults)
Lab orders and results
Radiology orders and results
Diagnostic test orders and results other than radiology…
Med orders/E-prescribing
Public health reporting (e.g., tuberculosis)
Highest Level of Electronic Information Exchange and Integration By Work Function
With non-affiliated provider/organizationWithin corporate/affiliated organizationWithin site operationNone
Source: 2013 LeadingAge Ziegler 100 Data
9 Developed a model amenable to be applied across multiple LTPAC settings
9 Create a framework to assess the level of EHR adoption and sophistication of use
9 Support post acute providers on their technology focused initiatives towards better health outcomes
Advanced EHR(Internal Quality-Focused)
Stage
5External Ancillary Services Integration
Stage
4
Basic Information System
Stage
1
Stage
6
Stage
7
Engagement & Basic Information Exchange
Interoperability & Health Information Exchange
Basic EHRStage
2
Ancillary & Clinical Administration (Non-Integrated)
Stage
3
CAST’s 7-Stage EHR Adoption Model
Advanced Functionalities- I• Stage 4-Advanced EHR:
– Clinical Decision Support Systems– eMAR/eTAR at the Point of Care– Quality Reporting, Analytics, and Dashboards
• LeadingAge InSight, eHDS offering
• Stage 5-External Ancillary Integration:– Pharmacy– Lab– Hospital Discharge/ Referral
Advanced Functionalities- II• Stage 6-Engagement & Basic HIE:
– Physician Portals & eSignature– Sending & Receiving Care Documents, like CCDs
• ONCs Project Direct, eHDS CareWatch Connect
• Stage 7-Interoperability & HIE:– HIEs– EHR Repositories– Directly to other providers
LTPAC Sector According to Vendors
Stage 110.77%
Stage 219.94%
Stage 313.58%
Stage 419.90%
Stage 523.76%
Stage 68.77%
Stage 73.37%
CAST Tools
CAST Strategic Planning & Strategic IT Planning Workbook
http://www.leadingage.org/strategic-it-planning-tools
IT Governance and Role for the CIO• IT Executive with
Management Skills• Elevates the discussion
of IT to the strategic level
• Helps create a strategic IT vision/ plan
• Oversees IT operations.
Develop Goals and Strategies
Strategic Goals• Programs• Resources• Status• Partnerships• Institutional Development• Governance
Strategies• Technology should be:
– A strategy– Enabler of other
strategies
• Consider implications on the IT infrastructure
Agree on priorities, timing and resources.
Last Few Steps• Develop an Annual
Action Plan that Addresses Goals and Specifies Objectives
• Finalize a Written Strategic Plan that Summarizes the Results and Decisions
• Build in Procedures for Monitoring, and for Modifying Strategies
Use the Strategic Plan to guide your detailed
Strategic IT Plan
Strategic IT Planning Tools
http://www.leadingage.org/StrategicITPlanning.aspx
Interactive Online Tool
CAST Technology Selection Tools
EHR Telehealth/RPM
http://www.leadingage.org/Technology_Selection_Tools.aspx
Medication Management
Functional Assessment
Shared Care Planning & Coordination
ROI on Technology Investment• Which Technology?
– Technology is broad, need to be specific by application
– IT infrastructure, is intertwined into many business aspects• Supports many different applications
– Some ROI is direct, like saving on paper, staff efficiency
– Others are indirect like Marketing Advantage, Hospital Readmissions!
Most Important Questions• ROI to whom?
– Aging Services Care Provider– Payer
• Which payer?– Care Recipient– Care Recipient’s Family
• Under what care delivery/ business/ payment model?– Providers operate in multiple settings– Have a mix of payers– Have complex case mix!
Important Immediate Opportunities• Health Reform Initiatives:
– ACOs– Bundling of Payments initiatives– Duals Programs– Medicaid Managed Care– Hospital Readmission Reduction Program– State Options & Medicaid Waiver Programs.
• National demonstrations of innovative care models that are led by, or truly emphasize long-term and post-acute care.
Provider Case Studies
Updated Business Case Studies
http://www.leadingage.org/members/cast-business-case-studies
http://www.leadingage.org/strategic-it-planning-case-studies
http://www.leadingage.org/cast/case-studies/cast-supporter-and-patron-case-studies
CAST Patron/ Supporter Case
Studies
Initiative Case Studies
CASES
EXAMPLE CASE STUDIES
DIGITAL PLATFORM EXTENDS SERVICESfrom 600 residents to 4,000+ CCRC at-home clients
http://www.leadingage.org/sites/default/files/Evangelical_Homes_of_Michigan_Case_Study.pdf
3-6%
Readmits
from 16% to 5%Readmits for congestive heart
failure
http://www.leadingage.org/sites/default/files/Jewish_Home_Lifecare_Case_Study.pdf
Technologies on the Horizon
Trends to Watch• Mobility
• Enterprise mobility• Device Management• Mobile Apps.• Client mobility
(including Wearables)• Increased demand on
bandwidth• Internet of Things!
Nielsen’s Law of Internet Bandwidth
High-endusers'
bandwidth grows by 50% per year (10%
less than Moore's Law for computer
speed).
Seniors & the Internet47% of all seniors have broadband at home
• 27% have Tablets/ eReaders• 18% have Smartphones• Communications with friends
and family, shopping, access to information are top motivations
90% of wealthy seniors use the Internet watch 55% more TVwww.pewinternet.org/2014/04/03/older-adults-and-technology-use/http://s3.amazonaws.com/rdcms-himss/files/production/public/FileDownloads/2015-10-
29%20Time%20Warner%20Connectivity%20advantage%20for%20sen%20living%20skilled%20nursing%20facilities.pdf
Advanced Materials and Smart Things!
Robotic Suits
Autonomous & Semi-Autonomous Wheelchairs/ Robots
• Touch-screen • Voice-command• Eye-tracking• EEG/Thought
controlled wheelchair.
Assistive Robotic Devices • Service/ household robots
Objects are much closer than they appear
The Future is Here High-Tech Aging Improving Lives Today!
http://www.leadingage.org/cast/resources/high-tech-aging-improving-lives-today
Join Other Technology Pioneers and Thought-Leaders…
Thank You…[email protected]
