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A new age network: The future of communication in long-term care

January 1, 2007
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A perspective from the Center for Aging Services Technologies

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.

Scenes from the CAST video

Scenes from the CAST video

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.