Web-based Care Coordination Tool?

I was asked the following question today – is there a client management product that can be used for Care Coordination — either on a Mac or PC, which would make it possible for long distance caregivers or distant family members to share notes, for a professional care manager or home care agency to post reports, upload documents that others on the care team may need, put activities on a schedule to see what mom and dad are up to, etc.  The idea is that instead of lots of emails back and forth there would be a place on the web where family members and the care team can go. Everyone would have a password so that they could sign in to and see updates at any time. Wouldn’t this be great?

The question made me think of my favorite graph from the National Alliance of Caregiving eConnected Family Caregiver Study that came out this past January.  The graph shows what technologies family caregivers would find helpful, or if there were barriers to their use.  The top two technologies that family caregivers thought would be helpful and would be the easiest for them to use were:  Personal Health Record Tracking and a Caregiver Coordination System both of which could be handled by the tool my colleague was asking about.  Interesting, no?

eConnected Family Caregivers Study, National Alliance for Caregiving, January 2011

So, what’s the answer to my colleague’s question?  Well, there are a bunch of products being developed that can support care coordination but there aren’t too many  yet.  These are basically personal networks, which is a type of social network like Facebook that is designed for caregiving and can be accessed only by specific people.   They are different from other social networks because the personal information is never disclosed to anyone outside the private network.

There are a couple that I can think of –  MyRemCare and Tyze.

RemCare is intended for professionals and keeps track of everything including medication lists and other health information, care provider notes, schedule, and reports and photos of client activities.  Last I checked, the cost for a single user was as high as $50/month but the cost goes down for multiple users (i.e. multiple clients, not multiple users on one account).  Also, some home care and home health agencies include it for free if you hire their care provider – a very nice value added as long as the agency and care provider otherwise does a good job.  The company web site mentions that home care agencies such as Home Instead, Senior Helpers, and Right At Home use this product; I personally have access to it through a client who has a care provider with BrightStar Care.  Care managers could also offer this service to clients as well and if it is a high need client it may be worth offering it at reduced cost.

The company that does MyRemCare has recently evolved to offer another great looking product called “Care Team Connect” – an enhanced case management product that is geared towards care transitions for Accountable Care Organizations and Patient-centered medical homes.   Care transitions will be the topic of another blog it’s an entirely different topic.

Tyze networks are private, personal, online environments that coordinate involvement. They help families, friends, neighbours, and professionals develop what they call a connected circle of care around an individual or community. This product includes private document storage and sharing, private email conversations, a calendar to schedule everything from birthdays to medical appointments, a list of goals and tasks as well as a virtual “to do” list and a place to share pictures and stories.  Cost is $129/year for unlimited access by everyone in the network.

Tyze is intended for all of the following groups:

• Adult children caring for their aging parents.
• People experiencing acute or chronic illness.
• Families supporting a member with a disability.
• Individuals facing a life challenge.
• Professional care providers seeking to provide coordinated care.
• People seeking to enrich their connections with family and friends.

There are a bunch of lower cost or free tools such as LifeLedger, eCareDiary, and CaringBridge – Each of these does a great job but none of them has all of the tools in one place like MyRemcare and Tyze do.   There are more products like this coming soon and I can’t wait to check them out and share them here.

I’d love to hear whether readers like any of these products and what else has worked for you.

Commercial Integrators Need Us

Commercial integrators are poised to enter the Aging in Place technology market.   An article in this week’s “Commercial Integrator” online magazine, Healthcare Goes High Tech says that this is a market sector with “unlimited potential for growth”.  The article provides a good overview of home monitoring systems and some of the issues that technology integrators face when adding this market sector to their business.

The key that I hope that integrators do not miss is the point that was made by Stacy Pierce, director of the Peace of Mind Alternatives (POMA) division of The Oaks, an independent and assisted living community in Orangeburg, SC.  Stacy is a pioneer – background as a Certified Occupational Therapist with an extensive background working with seniors – delved into the home monitoring market a few years back and has developed a unique business installing Grand Care systems and providing other aging in place technologies.   She says she has so much work at the moment that she is thinking of using a commercial integrator to do the installations for her but expresses concern that integrators don’t completely understand this market.  She says:  “what integrators really need to understand is that this is a caregiver business” and “A lot of [integration] companies may be looking at this market because their business in other markets is off, but what they have to understand is that you’re not just installing and walking away. You’re becoming part of the family. You’re with them till death.”   I hope that Ms. Pierce’s guidance is heard by commercial integrators as working with seniors and their families is not a simple install and walk away proposition.

What does this mean to me?  I believe that this speaks to an opportunity for both integrators and those of us who are in the senior care field.  A team approach is needed where a specialist in care issues and family systems (like a care or case manager – a professional with extensive experience working with seniors and their families typically with a background in social work, nursing or gerontology) can do an assessment and work with the integrator to get a system installed and running.  The case manager can then work with the care team to make sure that the system is working well.  As the research shows, technology for aging in place is not a set and forget proposition. As I have suggested before, new business models need to be created, so that the consumer is the one who ultimately wins.

Aging In Place Technology Marching Orders

Too much or not enough?  I dropped in for at least a few minutes of most of Laurie Orlov’s seven(!) sessions at the American Society on Aging – 2011 Aging in America Conference and the What’s Next Boomer Summit in San Francisco a couple of weeks back.  Last but not least was the session that she had invited me to participate in, “Technology for Seniors at Home:  Who and What Makes it Work“ (there must be interest in this, it was attended by Gail Sheehy, the latest poster-woman for family caregiving and recipient of the ASA award for the individual who has made an outstanding contribution to the field of aging).  Part I describing my session is the subject of my 5/7 guest blog on Laurie’s Aging in Place Technology Watch.  Today’s is devoted to Laurie’s recurring and emphatic message which resonated to me like marching orders. Her message was also repeated in her Aging in Place Technology Watch piece on 5/1.

The recurring message was that those in the room (every single room) are responsible for turning the technology for aging in place industry from a task oriented “cottage” industry to a “cathedral-builder’s” industry of innovation and creativity (think flying buttresses).  This analogy was put forth in 2006 in the inspiring article by Joseph Coughlin of MIT’s Age-Lab’s article, Cathedral Builders Wanted:  Constructing a New Vision of Technology for Old Age.  The message is that the aging and technology business is made up of a bunch of cottage industries fulfilling some basic task or need that need to develop vision and think bigger, beyond the basic health and safety requirements and towards a “comprehensive approach to longevity”.

Get the word out.  Orlov said that not enough is being done to get the word out that there are tech products for the home.  Aging service professionals are seeing the potential of these products for their parents, not their elderly constituents. She encouraged them to get their organizations to start thinking more creatively about how to accomplish this.  I completely agree with her, change needs to come from within the aging services industry, and the vendors (such as those in the Aging Technology Alliance – AGETEK) need to support making it easy to get products out there.  Her message brings to mind the Center for Aging Services Technologies (now known as LeadingAge CAST) “Imagine – the Future of Aging – Vision Video Discussion Guide”  from 2008 that prophetically laid out a strategy for professionals to get their organizations to start adopting technology.  I wonder who read that report (aside from myself) and used those recommendations?  It’s worth checking out.   Being naïve, I referenced the CAST report in my own publications and at professional conferences including the National Association of Professional Geriatric Care Managers and the Professional Fiduciary Association of California. Back then, the eldercare professionals who I spoke to were excited about this message, but I was told by leaders in the field that I was “ahead of my time”.  It is now starting to make sense.  Most aging professionals are waiting to be told what products truly work before they recommend them to their clients.

Back to Orlov’s mantra.  She repeatedly described the “digital divide” and emphasized the need to focus on the 75+ market, not the 65+ market because this population doesn’t have broadband or video, they’re not looking at apps on their smartphones and they are sadly not Skyping.  Connections between seniors and providers need to be tightened and the caregiving world needs to have an overlay of technology.  Products should be simple to use and intuitive.  She went on to make the following recommendations to providers of aging services:

1. The home security system is the most basic type of technology that all homes should have.
2. Find the cheapest internet service plan and get it for your client.
3. Make friends with a good IT person (or a technology integrator).
4. Get a computer for your client, a simple one with a touchscreen (e.g. the Telekin Touch or Pointerware) with video calling, email, and internet capability.

Little by little.  All of this being said, it may be easier for the professionals in the aging field to start with task-oriented products that are easy to install such as the Presto Printing Mailbox or MyCelery for email without a computer, a senior friendly cell phone such as Jitterbug or the Doro Phone Easy, a wifi-enabled Photo Frame, motion sensor systems such as BeClose and SimplyHome, finder devices such as EmFinders or the Alzheimers Association Comfort Zone, fall detection/plus devices such as MyHalo or AFrame Digital, or what about putting a tablet (iPad or other) into a client’s home for the care provider to use…(there are so many possibilties…)

OK folks, we have our orders, so let’s put our best foot forward and MARCH!

 

My Guest Blog on Aging in Place Technology Watch: The Research is In

Check out my guest blog (5/7/2011) on Laurie Orlov’s Aging in Place Technology Watch entitled:  The Research is In (Part I):  What Makes Tech Work for Seniors in the Home summarizing recent studies.   I presented this info last week at the 2011 ASA Aging in America Conference along with Laurie and Susan Estrada of Happy@Home.

Part II, the practical side, will be coming soon!

Relief, some practical advice.  Last but not least at ASA last Saturday was the session that Laurie Orlov of Aging in Place Technology Watch had invited me and my comrade Susan Estradaof Aldea Communications and Happy@Home to participate in, “Technology for Seniors at Home:  Who and What Makes it Work“. Despite the timing of the session, we had a good time sharing our message with an intrepid passle of supporters including folks from a wide range of aging services organizations.  I think these folks were relieved that someone was finally going to provide a few practical suggestions.  “The Research” is Part I of a two piece blog on who makes technology work (or not work for that matter).  Part II will be more on the practical side.

The research is compelling.  Several recent studies point to the fact that family caregivers will embrace technology if they can just get a little support from an aging services professional.  First and foremost is the recently published National Association of Caregivers eConnected Family Caregiver.  Family caregivers were asked to rank a list of technologies as to how helpful they were and whether there were barriers to adoption. They liked but identified barriers to adopting technologies such as chronic disease monitors (e.g. Health Buddy, Ideal Life, etc.), video phones (e.g. ASUS Skype Phone, Skype on a computer with a simplified interface), interactive engagement software (e.g. interactive games like Dakim, audiobooks). Family caregivers were also asked what the top influences on technology selection were, and guess what?  Top on the list is (and I quote), “a health professional who is involved with you or your [relation] telling you it would be helpful”.  Second was a “how-to explanation showing that it is very simple to install and use”.  Technology companies should hear this loud and clear – aging services professionals who know about your technology can be beneficial to your bottom line.

Gotta love the Center for Technology and Aging.  I am sooo lucky to live in the same city (Oakland, which otherwise sometimes has a bad name).  These folks are working so hard on their fabulous grant program, traveling around the country giving presentations, and creating and overseeing peer reviewed journal issues — that they barely have time to eat.  They recently published two issues of the journal Ageing International devoted to guess what subject?  (Answer: Tech and Aging!).  Two articles in particular stand out to me.  First is CTA’s own ADOPT for Aging Services Model:  AcceleratingDiffusion of Proven Technologies.  ADOPT is a conceptual model where seven technology diffusion strategies are identified: Design User-Friendly, Relevant Technology; Establish Technology Value; Create Business Model; Promote Technology; Form Partnerships; Identify Technology Champions; and Coach Users.  To reach the goal of widespread health outcome improvement and promotion of independent living tech, a group of “Collaborators” (aging technology developers and individuals who work directly with older adults) need to implement the seven suggested strategies.  Their main point is that ADOPTION of technology is the first step towards DIFFUSION.

She is a DIVA.  Who, you might ask?  Diane Feeney Mahoney, Professor of Geriatric Nursing at the Massachusetts General Hospital Institute of Health Professions.  She has devoted her career to developing innovative ways to use telecommunication-based technologies with frail and cognitively impaired older adults and their family caregivers.  Why do the non-academics not know about her?  I don’t know, I follow her every move (guess I’m a closet academic)!   I’ll share more about that some other time.  In the article “An Evidence-Based Adoption of Technology Model for Remote Monitoring of Elders’ Daily Activities” in the Ageing International set edited by the CTA folks, Dr. Mahoney creates an extremely practical model based upon her years of research.  From my (non-evidence based) experience, I suggest that the Mahoney Model (my moniker) should be applied to any technology for aging in place situation.  Key to adoption of technology is a facilitator (the aging services professional, a family or professional caregiver) who is willing to learn about and use the product, has the ability to perceive the benefits, and can tailor the product to personal needs.  Other considerations of this model are affordability, the issue of safety vs. independence, privacy, liability, and whether the tech is compatible with the end user’s culture.  The facilitator must be able to derail perceived barriers (including privacy concerns, intrusiveness, workload, too many alerts, liability) and make sure that technologies are working well to avoid dissatisfaction and therefore rejection.

In case you haven’t figured it out, there is a general thread running through all of the above.  Family caregivers want aging professionals (e.g. Care Managers, Case Managers, Discharge Planners, and folks from all aging services organizations listed in our local Area Agencies on Aging) to know enough about products so that they can support the family caregiver. They also want easy-to-install products.  Both models involve a champion or facilitator who perceives the need, understands the benefits/advantages, has proficiency to be trained, and the ability to tailor the technology to the client so that the technology works well and is thereby accepted.  This requires partnership and collaboration and perhaps new business models.