A Future-Proofed Facility

Cypress Gardens will be a multi-building, 170-unit campus providing both assisted living and Alzheimer’s care. The unusual thing about Cypress 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.

Two factors led to the conclusion that this project needed to incorporate all current "best-of-breed" technology;

· The increased demands for connectivity on the part of seniors and their family members, and the positive impact broadband “always-on” connectivity has on the health, well-being and satisfaction of seniors

· The operational advantages, cost savings, efficiencies and revenue-generating possibilities that come with wiring an entire building

Some of the many issues that the owners are reviewing before they make final decisions:

· 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 of an on-site telemedicine suite.

· The need for HIPAA compliant software, encryption, and training.

· The build-out into resident rooms, including always-on broadband, television, Internet access, phone lines, video-on-demand services, distance learning, etc.

· Remote monitoring of residents in the Alzheimer’s unit via web cams.

· The creation of an interactive web site that will market Cypress Gardens using video, virtual tours, and 360⁰ photos.

The owners hope to use Cypress 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.

The sections below describe information technology systems, infrastructures, and standards that are typical to assisted living and/or specialty care facilities.

Business Office Solution

1. Optical fiber access for high-speed data and video connections - if available via 100Mps or greater connections, or via multiple T1 trunk connections. Access equipment and building interconnect equipment will be located in the Equipment Closet and will require dedicated power with surge protection, and be isolated from other electrical systems.

2. Enterprise Network - Computer Room in a Box (CRIB) – to include Enterprise Information System (EIS) Server, Exchange (Email) Server, network switches, hubs, routers, and other specified equipment.

3. Equipment Closet – located near Telco vendor demarcations for network, EIS, and video servers, patch panels, backboards, head-end equipment, telephone/PBX system, and building interconnect equipment. Space must be air-conditioned, include dedicated power with surge protection, and be isolated from other electrical systems.

4. Desktop Computers – to include workstations, laptops and/or PDAs, monitors, keyboards, mice, cables, network interface cards, and desktop software, i.e. Microsoft Windows O/S, Office (word processing, spreadsheet, database), and utility software (i.e., virus protection). Both personal and group printers and scanners can be included.

5. Enterprise Software – Best of Breed Clinical Enterprise Information System (EIS) including Assessment, Medication Order Entry & Monitoring, Activity & Care Planning; and Best of Breed Financial EIS to include Billing, Accounts Payable, General Ledger, Budgeting, Fixed Asset Tracking, and other selected accounting modules. Customer Relationship Management (CRM) and Pharmacy modules might be included in the selected EIS.

6. Business Class Telephone System - PBX supporting voice, data, and IP services including: private lines with internal extensions, long distance, internet services, frame relay and VPN services, high-speed broadband access, voice messaging, 911 access, and value-added features such as call-waiting, call-forwarding, and caller-ID.

7. Automated Call Detail Recording (ACDR) System – Software system to capture daily business and resident telephone usage and provide summary and detail reporting, billing by dwelling unit, and other management features.

8. HIPAA compliance – All EIS, Intranet, Internet, and/or virtual private network (VPN) systems and infrastructures must meet these standards to insure privacy and security of resident information.

9. CCTV monitoring system for internal and external video monitoring and security.

10. Training and Support for the above software and hardware systems.

Telemedicine Suite

1. A four-station Video Conference platform.

2. A 32-inch or larger TV.

3. Diagnostic Medical Devices (list and specifications to follow).

4. Dedicated, secure line if IP or high-speed fiber connection not available.

5. Training and Support

Resident Solution – Assisted Living Building

1. Televisions (27-inch or larger) in each apartment with Internet/Intranet access features for web-browsing, community activity calendar, daily menu, and other resident-focused information, as well as enabled middleware that supports MPEG encoding for Video-on-Demand (VoD) in each room

2. Digital Cable Television access for broadcast and cable TV viewing.

3. Digital Music access for on-demand listening to resident-selected music choices.

4. Video-on-Demand (VoD) system for pay-per-view movie viewing and access to other video resources (wellness, travel, exercise, documentary, education, and other video library materials).

5. Web Cameras for in-room use enabling residents to videoconference with staff, family, healthcare providers, or friends.

6. A small, common-area computer lab for residents, with two or three workstations as well as flatbed scanners, fax machines, and printers.

7. In-room phones connected to central IP or PBX network with speed dialing, voice mail, and other advanced telephone features. Local and long distance call usage will be tracked and billed via the call capturing software system (ACDR).

8. Training and Support for all Residents on equipment and resident-focused applications, as well as an eight-week training curriculum for the activity directors or community directors to use with all new residents as a core activity.

Alzheimer’s Building

1. TV- set-top boxes (STBs) in all residents’ rooms for staff use only as a bedside data capture tool.

2. Point-of-Care (POC) Data Entry software and system integration to EIS.

3. Training for Staff to use the installed system and software.

4. Training for the cognitively functional residents so they can learn hardware interaction and web surfing skills.

5. “Granny-cam” for remote monitoring and web cams in common areas for family interaction with residents.

6. Remote diagnostic medical devices.

7. Support for staff.

Affinity (Customized) Portal and/or Community Intranet

1. Co-branded and customized portal faceplate and content that is specific to the building and local community.

2. Electronic distribution of activity schedules, menus, and newsletters for residents and family. A reduced paper-flow environment will result as more staff/resident communication occurs over the Intranet.

3. On-line meal selection to assist in ordering, procurement, dietary and nutrition planning, and resident satisfaction.

4. Condition and wellness management reminders and instruction.

5. Continuing education and in-service materials delivered to the staff and other healthcare workers, using distance learning and web-based training methodologies. These materials will be particularly helpful when new hires, or replacement workers, have to be trained quickly and efficiently.

6. Customer Relationship Management (CRM) software for lead generation, tracking, retention, and customer satisfaction functionality.

Pre-Construction and Pre-Leasing Marketing Communications Materials

1. Website Development for the entire property, as well as hosting if required.

2. Collateral Materials (brochures, flyers, other print materials) to support database-marketing efforts.

3. Advertising Campaign in appropriate local media.

4. Internet-based promotion of property via websites such as: www.aplaceformom.com, www.snapforseniors.com, www.seniorcenter.com and others.

5. Virtual Tour capabilities

This project will change the game for many existing providers; it is specified, and could be coming soon to a town near you

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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 techno phobic. 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 cameras, video monitors, speakerphones, an interface to a 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.

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Health Care Renewal: Putting on the Ritz?

Health Care Renewal: Putting on the Ritz?