| focuson Technology|
Technology assist: The LTC market’s
Helen Higgins, Kari Miner-Olson, Leo Asen, Sandra Elliott, Judy Girouard, and Jeanne Mattern, PhD, LSW, CCRP, provide a special report from a Center for Aging Services Technologies study of multicity focus groups.
|It is no secret that our nation’s aging population is experiencing unprecedented growth as the baby boomers approach retirement. In less than 50 years the number of elderly will double. Just as the baby boomers have transformed every facet of life-from the growth of suburbia to the role of information and technology in day-to-day activities-it’s a safe bet that they will continue to create waves of change in the way we retire, spend leisure time and, importantly, in the way we age and support aging.|
As the boomers retire, the nation’s social and healthcare support systems will feel increasing strain that will be relieved only when new products and technologies emerge from the collaborative efforts of government, industry, community-based aging service providers, and academia. As empowered consumers, the boomers will seek out alternatives to “get the job done,” and those alternatives will surely include new and innovative uses for technology.
The Center for Aging Services Technologies (CAST) is a nonprofit program established in 2003 through the aegis of the American Association of Homes and Services for the Aging. CAST’s mission is to help unleash the potential of technology for innovative development that will reduce our nation’s escalating healthcare costs. CAST uniquely blends providers of aging services, academic researchers, and industry representatives-all interested in advancing the role of technology as one way to address critical issues in eldercare.
CAST believes that we are fast approaching a tipping point in the development of home-based, consumer-centric healthcare technologies that will transform healthcare and social services delivery. The iPod’s rapid growth and acceptance is one example of an older technology transformed and repackaged into a highly successful and easy-to-use consumer product with a robust support infrastructure. Similarly, CAST believes that once consumers accept the idea that healthcare services can be delivered in innovative and cost-effective ways, we will see many iPod-like success stories emerging to fill the inevitable demand of a very large market.
This is the market with which long-term care providers will be dealing. In fact, it already is, as boomers’ parents enter CCRCs, assisted living facilities, and nursing homes. Success in meeting new marketplace demands will determine the survival of many long-term care organizations. Because baby boomers, as tomorrow’s seniors, will be the early adopters of new technologies and products, CAST wanted to hear their interests and opinions.
CAST commissioned a comprehensive literature review that only partially answered our questions, so we decided to launch a nationwide focus group effort, led by aging-services providers, to explore such questions as: How willing are boomers and “border retirees” (those nearing retirement) to use technology as aids in caring for their aged loved ones? Do boomers see a role for technology to help manage their own health and wellness? How can CAST and, in general, the long-term care marketplace help tap into the potential of technologic solutions?
To provide the broadest possible national results, CAST recruited border retirees from five cities in different geographic regions: Minneapolis, Dallas, Jacksonville, Seattle, and Hartford, Connecticut. We conducted ten focus groups with a total of 80 participants over a 19-day period during March 2005. Respondents were between 50 and 65 years old, with current experiences in assisting an older family member or other elder at home, and as users of one form of technology, typically a cell phone or personal computer. All participants completed a brief questionnaire to help us better understand their backgrounds and experiences. Questions focused on demographic information, current caregiving experiences (for example, offering elders help with paying bills or grocery shopping), and technology experiences (for example, using e-mail).
The session moderators explored the boomers’ views of:
|The moderators introduced a short video story depicting one family’s use of technology to support an elderly relative. Some of these technologies focused on home safety by monitoring movement to detect falls, some provided reminders to take medication and to help avoid medication mishaps, other technologies provided tools to assist with activities of daily living, and some helped to combat isolation and improve quality of life. This vision-of-the-future video stimulated group discussion, creative thinking, and speculation about various in-home technologies that could ease current and future caregiving responsibilities. Three major concerns emerged from the groups:|
1. How and where to get information to be successful as a caregiver. The lack of preplanning for this type of event, often without prior experiences to draw upon, causes adult children to find themselves in the middle of their own crisis. Because many of the border retirees are currently employed and may be raising their own families, adding this additional responsibility puts tremendous stress on the adult child and the family. Participants shared their experiences of the elder parent trying to hide his or her current condition to avoid worrying the adult child, who has now become the caregiver. This is compounded by the elder’s fear of interfacing with technology and becoming frustrated, which is a regular occurrence with these families. How do the boomers best cope?
2. What the boomers want from technology. Once the group saw the vision-of-the-future video, they understood how technology could be integrated to effectively address their most pressing needs. The excitement level in the room was palpable after they viewed the technologic possibilities, which led to a very animated discussion around what boomers want from technology, i.e., ways to reduce the stress and burden of caring for aging loved ones.
3. Boomers are willing to pay for technologic solutions when they perceive value. Many participants mentioned their desire to not burden their own children with the types of experiences they were going through with their own parent. This was a strong motivator for many participants to take action and investigate or purchase potential solutions.
1. Collaboration is essential-no one can do this alone. Often reported in the past was the basic fear that “too much technology can be a bad thing.” It is a bad thing if it is helpful but not equitably available to all, is cost-prohibitive for those in most need, or does not serve its purpose or complete the job promised. Technophobia is alive and well when it comes to the idea that developments in technology might increase efficiency but at the same time replace the human connection of healthcare. With regards to the possibilities of technology improving health and quality of life, however, perhaps even the technophobes can be persuaded to embrace it. Commitment and vision need to encompass all levels-from government to academia to corporate America, as well as physicians, health systems, and community-based aging-services providers (e.g., the assisted living, skilled nursing, home care, and independent senior housing environments that will inevitably interface with these boomers).
2. The market of potential consumers is very large. There is a tremendous potential market for technologies to help caregivers and seniors as they age in place, as well as a wellspring of public-policy recommendations aimed at ensuring that innovations reach consumers in need. Our findings imply, however, that today’s technology is not far-reaching, accessible, prudent, or solution-focused enough to meet the needs of today’s and tomorrow’s diverse seniors. Much more is needed, and much more can and will be provided.
3. Technology will transform the way healthcare is delivered. Current long-term care facilities will not disappear, and there will never be enough facilities, staff, or dollars to provide this level of care to the numbers of aging adults we anticipate. Current aging-services providers, with their knowledge base and skill sets, have an excellent opportunity to lead in providing new care options through technology. New partnerships between technology companies and aging-services providers offer an opportunity to derive more successful and beneficial results from technologic applications. Care facilities will become excellent test sites and possible early adopters of these technologies.
From the CAST Needs Research Task Group: Helen Higgins (cochair) is Business Development Manager for Hewlett-Packard Co., Corvallis, Oregon; Kari Miner-Olson (cochair) is Chief Information Officer for Front Porch, Burbank, California; Leo Asen is Administrative Director of Housing and Senior Centers for Selfhelp Community Services, New York City; Sandra Elliott is Director of Aging & Senior Services Development, Meridian Health Systems, Neptune, New Jersey; Judy Girouard is Vice-President of Clinical Program Development, Hebrew Senior Life, Boston; and Jeanne Mattern, PhD, LSW, CCRP, is Senior Research Associate for Menorah Park for Senior Living/Myers Research Institute, Beachwood, Ohio. For further information about CAST and its initiatives, visit www.agingtech.org. To send your comments to the authors and editors, e-mail email@example.com. To order reprints in quantities of 100 or more, call (866) 377-6454.
| User-Friendly Data Applications|
LINTECH has released touch-screen and pocket-PC applications, affording easy data entry by clinical staff for capturing flow sheets. Users enter data through convenient graphic icons, which serve as virtual buttons.
Graphic icons benefit facilities by lowering costs and saving time needed for data entry and training, streamlining daily workflow, minimizing data entry errors, allowing ease of use by even inexperienced computer users, and giving a quick return on investment for touch-screen or pocket-PC hardware.
| Time and Attendance Software|
Timecard Monitor, Count Me In’s time and attendance software, comes in five editions to meet the varied needs and budgets of any long-term care facility. Progressive levels add more complex business rules, reporting capabilities, and system users/workstations/accessibility. All include the LightningID fingerprint identification engine that authenticates identities while “clocking” in/out times, as well as software that integrates with QuickBooks, enabling fast, accurate preprocessing payroll-without time clocks, cards, or PINs.
| CNA Charting|
American Data offers CNA Charting. To record CNA activities, the facility can choose the most suitable hardware device for its situation-PDAs, kiosks, tablet PCs, and/or laptops in resident rooms or hallways. American Data offers a variety of input methods, including infinite menus (point and click), flow sheet (touch screen), charting by picture (touch screen), or combinations of each of these methods. CNA assignments and responses can appear in alternate languages, which can be automatically translated for the patient record.
By capturing CNA service activities electronically, revenue is increased, the risk of litigation is decreased by linking CNA activities to all other documents in the clinical record, and patient care is improved.
| Business Management Software|
Corporate Vital Signs from American HealthTech contains all the elements needed to monitor the key indicators necessary to run a facility. It rolls dashboards, business intelligence, analytics, drilldowns, and automated alerts into a single tool. This module extracts data from frontline systems, applies threshold parameters, and delivers a graphic result based on the benchmarks set at the facility level.
Compare operational status across facilities, trend across multiple periods, and choose to view the results from many different perspectives. Corporate Vital Signs is flexible and easy to use.
| Electronic Charting|
MDI’s e-Charting software allows clinical staff to document at the resident’s bedside in real time to provide more accurate and consistent data throughout the system. Features include an electronic MAR/med pass system, a Task Manager, and Charting/Nurse’s Notes.
Like all of MDI’s On-Line Advantage modules, e-Charting is fully integrated, which means that information recorded on e-Charting is immediately available in the Clinical Care Solutions module. RUGs calculations from the MDS are available in the Accounts Receivable module for accurate, timely billing. MDI offers a staged implementation plan.
| Door Monitor Alarm|
The “All-In-One” Door Monitor Alarm from Smart Caregiver Corporation functions with three easy-to-use components: a door strip monitor alarm, resident wristbands, and a keypad unit. The door strip mounts easily above any doorway. When a resident wearing a wristband attempts to leave through the doorway, the door strip emits an audible and visual alarm. The caregiver can silence the alarm by using the keypad. This system can also be configured for use with a central monitoring unit that alarms at a nurses’ station or other location showing the location and resident who originated the alarm.
| Glucose Monitoring System|
The new Assure« Pro Blood Glucose Monitoring System from Hypoguard is designed for multiresident use in long-term care facilities. Assure Pro Test Strips use platinum technology for greater durability and reliability.
To test, simply insert the test strip in the convenient top-of-the-meter port. A large LCD display and backlight for low-light conditions make it easy to read results. With a strip-release button for disposal, there is no need to touch a used strip. Assure Pro is designed with SureGripÖ to reduce slipping.
The Assure system also offers a “Hypo” warning to alert users of low blood glucose readings, four programmable alarms that can be used as test reminders, and a quality control reminder when a control solution test is needed.
| Scheduling Software|
Atlas Business Solutions Inc.’s Visual Staff Scheduler« PRO (VSS PRO) can produce daily, weekly, or monthly schedules by employee, shift, department, or location. VSS PRO helps to ensure that the right employees are scheduled at the right time and place. It can also create custom schedules; ensure coverage and reduce overtime; rotate and change schedules; track time-off requests; print, publish, or e-mail schedules and reports; and export schedule data.
| Bladder-Assessment System|
Available from Direct Supply, the BladderScan BVI« aids in compliance with F-tag 315 revisions. The noninvasive BladderScan measures post-void residuals. Incorporating ultrasound technology in an easy-to-use system, the BladderScan allows staff to accurately diagnose the type of urinary incontinence and develop customized treatment schedules for each resident based on bladder volume.
| Tamper-Resistant Nurse Call Alarm|
The Secure P.A.D.S. II alarm with nurse call interface has a tamper-resistant sliding cover that locks in and conceals the pad jacks and control settings. The alarm is always on for patient safety and features an auto-reset button; three adjustable volume, tempo, and tone switches; and a low-battery indicator light.
It comes with batteries and an eight-foot nurse call cable.
| Portable Charting System|
Achieve Healthcare Technologies’ resident-side charting technology, Point of Care (POC), helps clinical staff accurately capture resident care information and promotes timely communication among physicians and care providers. POC combines the convenience of portable device documentation, the integration of new data with existing records, and the virtual elimination of paper records. It also provides security-protected real-time access to resident care information at any level of the organization.
CNAs and other users can access MDS supporting information and vitals on a number of portable devices, such as tablets, kiosk PCs, and more. This integrated system provides real-time data sharing and communication, eliminating the need to sync systems or download information.
| Fall Management|
The Sensatec« Fall Management Solution from RF Technologies monitors residents at risk of falling through specially engineered sensor pads placed on beds and chairs. As a person’s weight is removed from the oversize sensor pad, the control unit sends audible sounds to caregivers, enabling them to respond quickly to a resident in need.
Sensatec offers a choice of control units that are customizable to meet a facility’s needs. RF Technologies offers a basic Sensatec control unit or a deluxe model with adjustable volume and delay functionality.
| Wireless Emergency Call Systems|
TekTone« has introduced three new additions to its Tek-CARE« 500 wireless emergency call system: a wireless emergency call switch, a wireless call station with a +” call-cord jack, and a wireless assistance call with a resident check-in switch. Each station mounts in a single-gang plastic box and provides supervision, low-battery indication, call-assurance LED, and a field-replaceable battery.
Residents wear waterproof pendants, allowing them freedom of movement. The Tek-CARE 500 master station keeps track of all transmitters and calls and can relay calls to staff pagers. The system also maintains resident information, including photos, medical information, and family and physician contact information.
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