Home Care Technology Report

Keeping Seniors Safer at Home Will Benefit Home Health Industry

by Liz Seegert

Paul Tang, M.D., may have one of the coolest jobs in health care. As vice president, chief innovation and technology officer at the Druker Center for Health Systems Innovation at the Palo Alto Medical Foundation, he is the driving force behind the growing success of linkAges, a new, community-based, multi-generational network designed to engage existing community resources to improve the health and well-being of seniors and family caregivers. The PAMF-funded program works with local nonprofits, neighborhood associations, faith-based organizations, and businesses to address non-medical determinants of health and to support aging in place.

One linkAges initiative that has implications for the home health care industry is called Connect. It was developed to help caregivers or family members spot meaningful shifts in the social and physical health of seniors before it’s too late. This effort, still in its early phases, uses passive signals in the home (such as utilities/water usage patterns) to prevent acute care incidents and support well-being by recognizing when something might be amiss, then sends the appropriate responder/caregiver a timely alert.

"It can automatically flag a family member or care manager if there's a change in normal patterns," he explained. A regular morning surge in water or electricity use might indicate the patient is awake and using these utilities or the aide has arrived and is cooking breakfast. If that pattern changes, the system sends an alert for immediate follow-up.

"Perhaps the person fell, or isn't well, or the aide never showed up," he said. "It's a non-intrusive way of monitoring daily activities and any anomalies."

The Drucker Center recently started working with Kelly Services in Hawaii to incorporate linkAges Connect into their iHealth Home Information system. Tang sees this as an ideal partnership. "Members in alliance help each other synergistically. We want to see how we can make Connect available and how they can use it to improve service and efficiency."

One way to do that is for home care agencies and providers to take a more holistic view of individuals as people, not as diseases, to look at their health and well-being needs, he said. Connecting and interweaving the disparate "dots" of home health, social and community services with programs like linkAges, allows people to age in place longer and improves outcomes.

Another component of the linkAges ecosystem is a community initiative called the Time Bank. "It's a way to connect neighbors, including seniors and family caregivers, through exchanges with other members that focus on their interests and skills," Tang explained. Since everyone’s time and skills are equally valued, that means that older adults can contribute as well as receive — which alleviates social isolation, loneliness and depression and helps improve quality of life.

Of course reimbursement is an ever-present issue. "It's not good business to keep people healthy – we’re looking for the future model that says your goal is to raise the health of individuals and communities – and we need to design a payment model that will reward that. Our approach takes in this new way of doing things which is to pay attention to health, not just disease."

Tang noted that seniors who are lonely have 43 percent higher mortality and 60 percent increased rate of disability — which puts more people into nursing homes. "It's a Medicaid problem, which of course becomes a taxpayer and society problem," he said. "Not until you move into ACOs where they actually begin to measure health does anyone pay attention."

However, he is confident that by aligning the right incentives the industry will embrace this approach. "So all we have to do is develop a plan that rewards this kind of strategy; it could be extraordinary. Right now we're perversely incented to do what’s not in the best interest of people."

Tang’s work on linkAges is based in three decades of health IT innovation in  healthcare organizations, industry, and national policy-making committees. In addition to his work at the Druker Center, he is also vice-chair of the U.S. Department of Health and Human Services Health Information Technology Policy Committee, and chair of its Meaningful Use workgroup. He is a member of the National Committee on Vital and Health Statistics (NCVHS) and co-chairs its Quality subcommittee. He chairs the National Quality Forum’s (NQF) Health Information Technology Advisory Committee, and chairs the Robert Wood Johnson Foundation’s National Advisory Council for ProjectHealth Design. Tang is determined to accelerate adoption and effective use of health information technology and says programs like linkAges Connect help bridge the divide between data collection, service delivery, entrepreneurship, and personal privacy. business and consumer.

He predicts the reimbursement landscape for wellness will change when about 30 percent of providers are aligned with ACOs. "I think within the next five years – by 2019, health systems will have an interest in and be looking for solutions to intervene at the community level. By then insurance and Medicare will be paying for people’s health."

It seems like a sure bet.

©2014 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan's Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com