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Older and Wiser: How Technology Can Help Aging Patients

October 28, 2011 | David Lindeman, PhD | Dialogue4Health

The world approaches yet another population milestone this month -- seven billion people. Here in the United States, we are also experiencing population growth. The US Census bureau estimates that right now, there are 312.3 million of us.

But within this growth, there is an even more startling trend: we are getting noticeably older as a country. Mainly because of aging baby boomers, by 2030, about one fifth of the American population will be 65 years or older. And if present trends continue, by 2050, there will be more than 88 million in that age group. The very old are growing even faster -- the 85 and older population is expected to more than triple, from 5.4 million to 19 million, between 2008 and 2050.

Older people have specific health needs, and one of the most vexing issues in the healthcare industry in the United States today is finding how best to deliver care to them. Fortunately technology is providing some of the answers, and it's no longer in the realm of future technology -- it is already available in the form of remote monitoring, telehealth, electronic health records, assistive technologies, telemedicine, mobile health, and distance learning, among others.

A brief review of several of these approaches is illustrative of the impact technology is having on older adults, much less the potential impact it will have in the very near future. Remote monitoring and telehealth are helping to remove the obstacle of physical transportation for older people to be evaluated by health care providers. However, they also have significant potential to reduce inappropriate hospital readmissions and other unnecessary care.

A study by the New England Healthcare Institute (NEHI) looked at the use of remote patient monitoring with persons with heart failure as compared to using disease management and standard care, and identified a 60 percent reduction in hospital readmissions when remote patient monitoring was used. NEHI determined that remote patient monitoring could prevent between 460,000 and 627,000 heart failure-related hospital readmissions each year, with an estimated annual cost savings of up to $6.4 billion dollars in the U.S. alone.

The next few years will see the universal adoption of health information technology (i.e., electronic health records - EHRs). Among other benefits, EHRs will eliminate the need for shuttling records and test results between physician offices, hospitals and other health care settings, reducing time for transmission, as well as improving the accuracy of data. One study of a Kaiser Permanente electronic health records project found that the system reduced primary and specialty office visits by over 20% in its Hawaii region while increasing secure email messaging and scheduled telephone visits, leading to more efficient and patient-centered care.

Technologies now in development will help reduce in-home accidents, a major source of disability and death for older citizens. Falls are the leading cause of injury in older adults over the age of 65, and over one-third of this population falls each year in the United States. Technologies for monitoring movements of older individuals in the home will help identify those most likely to fall or who have fallen, allowing for increased prevention as well as more timely assistance.

Mobile health, or mHealth, platforms will allow accurate and time-sensitive information to be transmitted to older people, reminding them for example to take medications on schedule or to transmit health care information to a medical office. And the increased use of smart phones by health care professionals who visit older people in their homes will dramatically speed up diagnosis and care decisions, compared with traditional office visits.

Improvements in work force training technologies, including distance learning, already allow many more providers to receive accurate and appropriate training in the best ways of supporting older patients. Since much in-home care of older patients is done by family members, this is not limited to professional providers.

PHI's Center for Technology and Aging (www.techandaging.org) is in the forefront of many of these efforts. Working with providers to test the diffusion of best practices in health care technology, Center staff has provided grants to what strategies succeed in improving medication monitoring, remote patient monitoring, care transition strategies, and care protocols using mobile health. The preliminary results of these efforts have already provided examples of how technology can improve health outcomes and health care, and reduce costs of care.

Of course, advancing the use of technology for older adults will not be simple or easy. While new technologies are proliferating, many older adults throughout the world living with chronic illnesses do not have access to technologies that could be lifesavers: remote monitoring devices, internet services, and/or mobile services. Yet, I am convinced that over the coming decade, technology will be a transformative agent for both older adults and the health care work force that supports them. And advances in new technologies, many of which have not yet been created, will have a far-ranging impact on improving access, reducing costs, and improving the quality of care for older people.

It is clear that technology will change where care is provided, bringing health and social services to older adults no matter where they are. Ultimately, technology will create sustainable improvements in the health and well-being of older adults, keeping more of the seven billion of us alive longer and healthier.

David Lindeman is director of PHI's Center for Technology and Aging. Learn more at www.techandaging.org.