Presentation Transcript
HIT 4 QI:Technology Enabled Aging in PlaceNational Health Policy Conference: HIT 4 QI: Technology Enabled Aging in Place National Health Policy Conference February 13, 2007
Shannah Koss, Vice President
Health Information Technology
Avalere Health LLC
Long Term Care Faces Crisis: Long Term Care Faces Crisis Several trends in the coming years will strain the long term care spectrum and its
ability to provide adequate high quality services
Demographic shifts resulting from the aging baby boomer generation
65+ population to be 20% of population by 2030; disproportionately women and minorities
Institutional capacity and informal caregivers are insufficient for anticipated growth
Limited LTC insurance and financial planning leaves much of the population unable to afford adequate services
Continued Increases in public expenditures on LTC are highly unlikely
Patchy reimbursement for LTC services and varied eligibility for programs makes expansion of services difficult
Social Security solvency and changes in Medicare coverage and benefits exacerbate the problem
Expanding Aging in Place Options Could Reduce Stress on the LTC System: Expanding Aging in Place Options Could Reduce Stress on the LTC System The aging in place model emphasizes the least restrictive environment and maximizing independence through assistance with daily functioning
Aging in Place can help to alleviate the anticipated strain on LTC
Reduced need for institutional options
Reduced pressure on family caregivers
More efficiently utilized physician time, office visits, and other benefits
Technology can foster Aging in Place models and address the particular needs of this population as distinguished from those requiring acute care
Individual’s functional limitations, both physical and mental, will not improve to previous level of self-sufficiency
Individual often unable to recognize and/or seek treatment for minor illnesses and injuries that can develop into life threatening medical conditions
Needed services cut across a continuum from social to clinical services
Aging in Place Could Support Quality “Touch points” in LTC: Aging in Place Could Support Quality “Touch points” in LTC Population with multiple co-morbidities
Patients experience many care setting transitions
High percentage of patients with cognitive challenges that emphasize surrogates and related complexities
Fragmented nature of sector
Assisted living, hospice, skilled nursing, community based, home health
Lack of communication among entities
Many stand-alone independent facilities
High turn over of LTC staff
Technologies Can Enable Aging in Place: Technologies Can Enable Aging in Place Individual /
Caregiver
Assistive Devices Administrative Applications Traditional Devices Patient-Centered Software Early Warning Detection Reminders and navigational tools allow individual to maintain daily function in a safe environment Lay a foundation for other technologies enabling the exchange of information Maintain vital signs and transmit data to providers Monitor behavior patterns to help prevent acute episodes Enable physicians with ability to manage and synthesize information Allow the individual to remain engaged in his or her own care
Technology Options: Technology Options
Technology Options (cont.): Technology Options (cont.)
HIT Enabled Aging in Place Supports Quality Improvement: HIT Enabled Aging in Place Supports Quality Improvement Quality Health Care Patient Centeredness
Patient remains independent and avoids institutionalization
Patient empowered to administer and manage his or her own healthcare Monitoring and Treatment Adherence
Physician monitors patients in more efficient manner
Treatment adherence deficiencies noted and addressed
Data collection tracks patients over time
Generated data builds evidence-base Prevention of Acute Episodes
Acute episodes and life-threatening events avoided
Focus on prevention, rather than invasive procedures
Challenges Remain but Promising Models Also Exist : Challenges
Limited infrastructure
Lack of investment in HIT
Lack of coverage models that enable individual to outfit their homes
Fragmented and isolated public funding streams
No savings models or incentives Challenges Remain but Promising Models Also Exist
New Policy Directions?: New Policy Directions? LTC HIT Medicare and Medicaid demonstrations with cost-effective technology enabled LTC services
Alternative funding options
Revised certification criteria - staffing, frequency of visits, severity of illness
Certified technologies
Flexible coverage
Include technology purchases
Maintain care setting neutrality
Risk assessment for appropriate care and technology determination
Finance reform
Combine funding streams
Personal accountability and contribution