Is the Future of Senior Housing @ Home?

Home As The Site of Care: Redesigning Health Care For the 21st Century

An emerging philosophy in senior care emphasizes the need for Home TeleHealth, and to be put simply – keeping health care recipients in their home and improving opportunities to heal chronic illness. The components to consider are:

1. Identifying changing demographics and characteristics of the chronic disease population
2. Defining the components and implementation strategies that centers care delivery at home
3. Advocating and evangelizing the importance of evidence-based research and evaluation of the Home TeleHealth industry, to provide safe and cost effective care in the home
4. Demonstrating how patient choice and patient satisfaction are fundamental to the success of all Home TeleHealth programs
5. Defining clinical, technical and business elements necessary to sustain a successful HomeTeleHealth program
6. Providing a unique opportunity to network with industry thought leaders, clinicians and technology providers

Twenty-first century health care redesign has been achieved by identifying changing demographics and characteristics of the chronic disease that makes the home the most appropriate place to deliver care. Centering patient care in the home has clearly impacted patients enrolled in the program and Community Care Coordination Services has changed the clinical course through care coordination in the home environment, illustrated in specific patient cases.

What does Community Care Coordination mean for seniors?

The mission of Community Care Coordination is: coordinating the right care, at the right place and at the right time. The vision is that the residence is the place of care. The target market is the senior population with chronic conditions, high users, frequent system users, high risk (clinically complex) users, and high cost (over $25,000 per year) users. The program seeks to understand cost effectiveness, efficiency of care, the quality impact to patients and care givers, patient / provider satisfaction and best practices.

With this approach, patients' empowerment can be achieved by allowing independence from caregivers and the hospital. As one patient put it – who wants to go to the hospital and be away from familiar surroundings in the home? When patients take responsibility for their care, they enjoy feelings of pride and security. It enhances their quality of life by bringing the caregiver to the home and builds a bridge between the patient and their caregiver. No longer are visits performed in a rush, and with strangers. Outcomes are improved, often with results that are superior and in shorter duration. In some cases, lives were actually saved by quicker and more accurate results. Reduced hospitalizations were achieved by improved care and attention to the chronic conditions. And even though some seniors have been characterized as resistant to change, there were high levels of satisfaction with the care and technology. Indeed, Home TeleHealth is improving the quality of life for seniors and in some cases, has saved lives by being available all the time!

Training is a critical element if the technology and care are to be successful. Clinicians must prepare an assessment of the needs and issues with the interest of the patient clearly emphasized. All the staff and patients must buy-in to the process. Early champions must be willing to think outside the box to overcome problems and obstacles and not be technophobic. The first population must be respected by their peers and patients. Staff and patients must trust the technology and their ability to use it. Patient instructions must be clear, concise and include installation and orientation information. Of course there must be a patient instruction checklist for equipment maintenance, including such basic items as no food, liquids, cleaning materials on the equipment, keeping the equipment out of the reach of children and not adjusting the equipment unless instructed to do.

Some of the more typical equipment features include camera, video monitor, speaker phone, interface to communication line and monitoring equipment. The technology should be evaluated in terms of Home TeleHealth priorities such as the patient's needs, provider's needs, the agency requirements and ease of technology implementation. The technology should not be invasive of the patient's needs and care, and in fact, if that is the case, it should be discontinued from use. However, with the success of the equipment, this is not the case with practitioner and patient attention and approval

It is clear that with the tremendous success of various pilot programs, this is a model which should be carefully evaluated and followed by other members of the private and public health care provider community. It has dramatically reduced the cost of providing care to the chronically ill and provided immediate quality of life benefits to the patients.

What does the above concept say to the owners of senior housing organizations? Are we facing a paradigm shift centered around "Aging in Place?"

Food for thought . . .

BB

Opus Gardens: Doing it Right from the Ground Up—A Case Study

Editor’s Note: In the first issue of TSH , we promised to carry real world stories about how senior housing sites were bringing the benefits of technology to their marketing, operations, staff, and residents. Thanks to the owners of Opus Gardens, TSH has been given a unique opportunity to follow a deployment story from conception, to groundbreaking through Grand Opening. To help our readers understand the many considerations and decisions that go into installing a state-of-the-art technology platform, TSH begins in this issue an on-going series that will include photos and interviews; we call it, Technology from the Ground Up: The Evolving Story of Opus Gardens. Stay tuned and enjoy your ringside seat! In the following post the names have been changed to protect the privacy of the parties.

Located in the town of Tukwila, Washington, just outside Seattle, Opus Gardens will be a multi-building, 151 -unit campus providing both assisted living and Alzheimer’s care. The unusual thing about Opus Gardens is that the owners are dedicated to incorporating a full range of cutting edge technology—hardware and software—in the building before they even break ground. The technology infrastructure will support the building’s day-to-day operations and also ensure complete broadband connectivity to every resident.

Opus Gardens was conceived and designed by Crescent Capital Investment, a development firm with a successful track record developing multi-tenant, multi-unit living spaces. CCI has partnered with a nationally known expert in senior living communities, and together the two make a winning combination that may help usher in a new type of senior housing community.

Several factors led this team to the conclusion that their project needed to incorporate cutting edge technology:

• The increased demands for connectivity on the part of seniors and their family members
• The positive impact broadband (“always on”) connectivity has on the health, well-being and satisfaction of seniors (much as Richard Adler outlines in his study—see “What’s New)
• The operational advantages, cost savings, efficiencies and revenue generating possibilities that come with taking a holistic approach to business operations, resident care, quality of life, and customer satisfaction
• The Ownership’s express desire to make the entire project a showcase for technology
• A regulatory requirement to be fully HIPAA compliant from the start (as detailed in “Hip on HIPAA”)

Some of the many issues that the owners are reviewing before making final decisions include:

• What kind of hardware and software and in what quantities should be provided to support operations and marketing.
• What kind of hardware and clinical systems will support the care staff, including whether such devices should be wireless.
• Outfitting an on-site telemedicine suite with high-speed videoconference capabilities.
• The need for HIPAA compliant software, encryption, and training.
• Video and web conference capabilities for the residents to communicate with friends, family, and healthcare providers.
• The build-out into resident rooms, including an always-on IP-based broadband network, digital television, Internet access, phone lines, video-on-demand services, digital music, and interactive gaming.
• Remote monitoring of residents in the Alzheimer’s unit via web cams and remote monitoring medical devices.
• The creation of an interactive web site that will market Opus Gardens using video, virtual tours, and 360⁰ photos.

The owners hope to use Opus Gardens as a template for creating a chain of senior communities, each of which uses a cutting edge technology platform to improve returns and also make life better and healthier for the residents.

As options are debated and decisions made, we’ll keep you informed so you can see, first hand, one way in which the senior living industry is responding to the collision of those two mega-trends, technology and the aging of America.

Next post we’ll feature more information from the design and specification phase of the Opus Gardens project.
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