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David Gehm
Earlier this month, David M. Gehm was named interim international chair of AAHSA’s Center for Aging Services Technologies (CAST), replacing Eric Dishman, a CAST co-founder who’s service as the center’s chair started in 2002. Dishman will continue to serve as CAST’s senior fellow in technology innovation.
A long-time AAHSA member, Gehm is president and chief executive office of Lutheran Homes of Michigan and formerly served as CAST’s vice chair. Dishman is a fellow in the Digital Health Group at Intel and serves as that company’s director of product research and innovation.
“Eric’s vision and energetic leadership has put CAST on the right course,” says Gehm. “My job during this interim period will be to make sure that we stay focused and continue to strengthen the CAST message while maintaining the same level of enthusiasm that Eric brought to the organization.”
Dishman’s energy and enthusiasm have been abundantly clear since the day in 2002 when mid-level managers of large and small technology companies, university researchers and forward-thinking providers first gathered at AAHSA to explore technology’s untapped potential to improve the lives of older people. The energy created during that workshop led AAHSA President and CEO Larry Minnix to offer the group – which later became known as CAST – a permanent home at AAHSA.
Not one to think small, Dishman says that he’s always believed that CAST could play an important role in starting a revolution that transformed the nation’s health care system from one centered around hospitals and institutions to one focused on empowered health care consumers and their families. That switch from “mainframe” to “personal” health care is particularly needed today as providers gear up to serve an expanding older population with a dwindling workforce, says Dishman. And, he says, AAHSA members are in a perfect position to lead the revolution.
“AAHSA has already done a great deal to get people to re-imagine long-term care as a continuum of care,” says Dishman. “Now that continuum has to shift even more broadly into the individual homes of older people. We need to start asking how the AAHSA community can use technology to deliver virtual assisted living, virtual independent living and maybe even virtual skilled nursing some day.”
Dishman and Gehm agree that CAST has taken the first steps in sparking this revolution by educating various stakeholders about independent living technologies and giving policy makers a new perspective on long-term care. For the first time, they say, policy makers are including CAST, AAHSA and long-term care issues in many discussions about health care reform. Most recently, CAST succeeded in convincing lawmakers to incorporate long-term care in the definition of health care that was included in the American Recovery and Reinvestment Act of 2009.
While pleased with the progress to date, Dishman says he wants more. He’s disappointed, for example, that there aren’t more proven and interoperable independent living technologies available for purchase by long-term care providers and individual consumers. He’s also disappointed that the National Institutes of Health and the National Science Foundation are not investing more heavily in research that could prove the value of these technologies. Finally, Dishman says he’d like to see researchers testing aging services technologies in 10,000 homes nationwide.
Dishman remains confident that the “conditions are right for achieving some of these more audacious goals.” He and Gehm plan to continue working together to achieve those goals during what both leaders call “CAST’s second wave.”
“We will continue to raise the level of discourse and awareness about these technologies so we can help shape public policy,” says Gehm. “In addition, the research component of CAST will be vital in the next few years as we improve our ability to tell providers and caregivers how you use specific technologies for the best outcome. And, finally, CAST will play an important role in challenging providers to move forward as innovators who are ready to reach out to their communities in new and different ways.”
Telehealth Technology
Yesterday, the Wall Street Journal reported that the Intel Corp. and General Electric Co. plan to team up to develop telehealth technology aimed at enabling the elderly and disabled to be cared for in the place they call home.
The two companies have pledged $250 million over five years to research news products that would allow physicians to monitor patients remotely, technology known as telehealth. According to the companies, the devices will ultimately cut the overall costs of health care.
“Something like 80 percent of the spending today in the health care system is on chronic care patients,” Paul Otellini, Intel’s chief executive, told the BBC. “This has the potential to take that down dramatically because a day at home costs a heck of a lot less than a day in the hospital.”
The two companies already have telehealth products in development or on the market. Under the new partnership, Intel’s Health Guide, which will now be distributed by GE’s sales force, is a care management tool for health care professionals who manage patients with chronic conditions. GE also has its QuietCare unit, a remote passive activity and behavioral monitoring system for seniors.
Kathy Bakkenist, chief operating officer at Ecumen, an AAHSA member in Shoreview, Minn., said her company was one of the first senior housing and services providers to adopt GE’s QuietCare, which alerts care professionals to changes that may signal potential health issues or emergency situations such as a fall or emerging health problem.
The journal also noted that Intel unveiled “Arlington,” a prototype it is testing at a nursing home in Arlington, Texas, that includes a low-priced Intel Classmate PC equipped with a built-in camera. The product offers reminders to take medication, a social-networking program similar to Facebook, and brain games for seniors.
Arlington shows if the user is “slowing down,” said Eric Dishman, chair of the Center for Aging Technologies (CAST) and director of product design and innovation at Intel Health.
The partnership between GE and Intel “highlights how aging is changing in America, and the incredible opportunity we have to combine high touch and high tech in a fully integrated health care system that empowers and honors people’s individuality,” Ecumen’s Bakkenist said.
“Human beings are hardwired for independence, not institutionalization,” she added.
Ecumen’s Changing Aging blog also covered the story.
Kojo Nnamdi Show
Yesterday, Majd Alwan, director of the Center for Aging Services Technologies (CAST), was a guest on the Kojo Nnamdi Show, a live two-hour magazine program on WAMU that highlights news, political issues and social trends of the day.
Alwan and Nnamdi discussed how emerging technologies might be harnessed to make life better, help remove old barriers, and help reduce health care costs for ourselves or our older relatives.
If you missed the program, we’ve provided MP3 files of the first half of the show:
To listen to the rest of the show, visit the Kojo Nnamdi Show.
Since 2006, CAST Commissioner Kathy Bakkenist and members of the CAST Policy Committee she chairs have been touting the benefits of aging services technology to any federal legislator who will listen to them.
“I can’t tell you how many doors we knocked on and how many conversations we had,” says Bakkenist, who is the chief operating officer and senior vice president of strategy and operations at the Minnesota-based Ecumen. “But we were lucky. We had a compelling story to tell about the nation’s shifting demographics and the significant need to change how services are delivered to an aging population. It wasn’t a story of doom and gloom. It was a story of opportunity and solutions. Aging services technologies represent hope and a different way of thinking about how to support independence, choice and aging in place. To me, that was the power of our message.”
Legislators seem to have gotten that message loud and clear. In a development that Bakkenist calls “a huge success for CAST,” the American Recovery and Reinvestment Act (H.R. 1) included six provisions relating to aging services and long-term care health information technology (HIT). That legislation, also known as the stimulus bill, was passed by Congress and signed into law by President Barack Obama in February. CAST and AAHSA’s policy teams worked with several congressional offices and committees, including the Senate Health, Education, Labor, and Pensions Committee and Special Committee on Aging, and the House Ways and Means and Energy and Commerce Committees, to ensure that the long-term care sector was included in the legislation.
A New Definition of Health Care Provider
Basically, the health technology provisions of H.R. 1 put in place the governmental and private structures that will make it possible to provide every American with an interoperable electronic health record (EHR) by 2014. Most important to CAST and AAHSA is the fact that the legislation specifically broadens the definition of health care provider so that long-term care providers will be included in the nation’s efforts to meet this goal.
“Prior to this legislation, when you mentioned health information technology most policy makers interpreted that to mean physicians and hospitals,” says CAST Director Majd Alwan. “This bill offers a different definition of ‘health care provider’ that includes nursing homes, home care providers, and other long-term care providers. That is a major step in the right direction. This means that the long-term care sector will be officially integrated and included in the standards development and certification processes for interoperable EHRs.”
That integration is critical, says Bakkenist. Long-term care is a major component of the health care system and touches most Americans, whether they are receiving aging services and supports themselves or caring for someone who receives such care. It’s essential, she says, that all Americans have an EHR that includes a full record of the care they receive throughout their lives. Such a record would be particularly beneficial to older people who often have multiple chronic conditions and multiple health care providers, and who transition frequently among a variety of care setting, says Alwan. EHRs that provide a full picture of the health and functional abilities of older people in a single record that can be shared by all providers could go a long way toward reducing medical errors and repeated procedures, he says.
“If we can put a structure in place that includes information about every aspect of health care – from the pharmacist, to the physician, to the hospital, and to the nursing home – we’re going to be better off and it is going to be more cost effective in the long run,” agrees Bakkenist.
H.R. 1 authorizes a study to determine whether long-term care providers should receive financial incentives to encourage them to implement EHR technologies prior to 2014. The bill authorized such incentives for physicians and hospitals. In addition, the legislation provides funds that states can use to award HIT planning and implementation grants. Alwan expects that those grants will be made directly to regional and local health information exchanges, since the legislation emphasizes the ability of different technology systems to communicate with one another. However, entities that apply for state grants will most likely be seeking a broad range of community partners that could include long-term care providers.
Aging Services Technologies
Bakkenist is particularly excited about a study, mandated by H.R. 1, which will examine “matters relating to the potential use of new aging services technologies to assist seniors, individuals with disabilities, and their caregivers throughout the aging process.” CAST proposed this study, which was included in one of the two House technology bills introduced in the last Congress.
“Policymakers understand that technology is going to be a method by which we deliver care in the future and that we need to figure out the best way to proceed,” says Bakkenist. “We have some exciting emerging technologies but we don’t have a system in place for integrating those technologies so they are interoperable. Nor do we have a system in place that supports the research that needs to be done to prove the efficacy of the technology.”
Next Steps
H.R. 1 underscores the Obama administration’s commitment to establish a nationwide, interoperable EHR system that will include long-term care. Given that commitment, say Alwan and Bakkenist, it’s time for long-term care providers to make sure they have the capacity to participate in that system.
Providers can begin the technology-adoption process by following a few initial steps, says Bakkenist. First, evaluate your internal technology systems so you’re clear about what you have in place, she says. Then, assess what you’re going to need in order to provide EHRs to your residents and clients by 2014. And finally, says Alwan, seek out community partners, like local health information exchanges, that can help you meet your goals.
“We need to begin,” says Bakkenist. “That’s the most important message of this legislation.”
