The Front Porch Center for Technology Innovation and Wellbeing (CTIW) is a center of excellence within the Front Porch family of companies that collaborates with residents and staff-as well as researchers, academic institutions and other care providers-to identify the needs of older adults that can be met with the help of technology solutions.

Front Porch Case Study

On a recent visit to San Antonio, TX, I had the pleasure to visit Morningside Ministries’ distance learning center, which has state of the art video conferencing equipment and has been in operations for a few years. 


The center hosts many geriatrics, nursing and caregiving experts, educators and speakers who use the facility and the available technology to deliver quality training to both professional and family caregivers for free.


The technology available at the center allows participants in distance learning sessions to follow PowerPoint slides while watching the speaker live over the Internet. Participants can also interact with the speaker and ask questions in real-time over chat and e-mail or they can call-in with their questions.


Topics offered so far cover a wide variety of best practices in behavioral health, geriatric psychiatry, dementia and nursing care. 


What is most important is that the center and the education team, along with the expert speakers, make the education and training not only easily-accessible but also entertaining and fun. 


That’s what brings more participants to their training sessions.


Recently, the center’s sessions reached participants in all 50 States (including many participants from Alaska), as well as countries as far as Yemen and Afghanistan.


 



Don’t just take my word for it. Watch this excerpt of a sample session on hydration delivered by Maria Wellisch, vice president of corporate education at Morningside Ministries. 


 

Investments in technology-related research and development helped Eskaton deploy elec­tronic health records (EHR) and a sensor-equipped remote monitoring system, and build a national demonstration home featuring universal design, supportive technologies and "green" living features.

Eskaton Case Study

 

Investments in technology-related research and development helped Eskaton deploy elec­tronic health records (EHR) and a sensor-equipped remote monitoring system, and build a national demonstration home featuring universal design, supportive technologies and "green" living features.

Eskaton Case Study

 

Holly Morris - Virtual reality senior exercise: MyFoxDC.com


This morning, Asbury Methodist Village was featured on WTTG Fox 5 for its use of virtual reality technology to rehabilitate its residents.


According to the report, Asbury's technology is the first of its kind in the state of Maryland.


"We were looking for a way to provide therapy that involved technology and that was more state of the art," Debbie Hedges, assistant administrator at Asbury, told Fox 5. "We wanted people to be able to do something that was a little more fun, a little bit more personalized, and little bit more engaging."


 

The following are the technology-related provisions included in the Patient Protection and Affordable Care Act (H.R. 3590), which was signed into law on March 23, 2010. 


Certified EHR grant program for long-term care 


The Affordable Care Act contains a 4-year certified EHR grant program for long-term care facilities beginning in FY 2011. The grants are to be used to offset costs related to purchasing, leasing, developing, and implementing certified EHR technology and may be used for any computer infrastructure including hardware and software, upgrading current systems, and staff training. 


Long-term care facilities that receive grants are required to participate in state-level health information exchange activities where available. 


The U.S. Department of Health and Human Services (HHS) secretary is required to adopt electronic standards for the exchange of clinical data by long-term care facilities, including, where available, standards for messaging and nomenclature. 


The law made $67.5 million available to fund the EHR grants and 2 other long-term care grant programs to provide incentives for staff training and development and to improve management practices.


Demonstration project for use of HIT in nursing homes  


The Affordable Care Act requires the HHS secretary to conduct a demonstration project to develop best practices in skilled nursing facilities and nursing facilities on the use of information technology to improve resident care. 


One or more competitive grants are to be implemented by March 2011 for not more than 3 years. The Affordable Care Act authorizes an unspecified amount of funding needed to conduct the demonstrations. 


Development of Medicare Part D prescription dispensing techniques in long-term care facilities 


The Affordable Care Act requires the HHS secretary, in consultation with stakeholders (including representatives of nursing facilities), to develop specifications for Medicare Part D prescription drug plans (PDP) to reduce pharmacy waste in long-term care facilities using uniform techniques that will be determined in the analysis process.


New models of care utilizing technology  


 


  1. The Community Living Assistance Services and Supports (CLASS) Act  - A primary LeadingAge priority in the health care reform bill, the CLASS Act will enable a new model of funding for long-term services and supports, including the use of aging services technologies to meet care needs.

     
  2. Use of Technology in New Cost Efficient Payment Models – Center for Medicare and Medicaid Innovation - The Affordable Care Act establishes the Center for Medicare and Medicaid Innovation within the Centers for Medicare and Medicaid Services (CMS). One of the new center‘s programs will be to develop new funding mechanisms with costs savings by better coordinating and managing care through newly established accountable care organizations (ACO). One of the methodologies available to ACOs will be "the use of telehealth, remote patient monitoring, and other such enabling technologies."

     
  3. Use of HIT in Health Homes for Enrollees with Chronic Conditions - The Affordable Care Act authorizes states to develop a new method of providing home care for enrollees with chronic conditions. Through the use of teams of health care providers this option allows states to provide a "health home" model for such individuals. It requires participating states to include in their state plan amendment a proposal for use of health information technology in providing health home services and improving service delivery and coordination  cross the care continuum (including the use of wireless patient technology to improve coordination and management of care and patient adherence to recommendations made by their provider).

     
  4. Use of Technology in New State Options for Long-Term Services and Supports - The Affordable Care Act provides states with new state plan options for providing long-term services and supports, including a "community first choice option" for home and community-based attendant care services. Under this option, states could utilize technologies to ensure continuity of services and supports. The exact types of technologies permissible will need to be clarified, as the language prohibits reimbursement for "assistive technology devices and services" but allows "beepers and other electronic devices" as well as expenditures that "substitute for human assistance."

 


For complete information, you can download Provisions Relevant to Aging Services Technologies

 

CCHIT - Certification Commission for Healthcare Information Technology
EHR - Electronic Health Record


EMR - Electronic Medical Record


HIE - Health Information Exchange


HIO - Health Information Organization


HIT - Health Information Technology


LTC - Long-Term Care
LTPAC - Long-Term Post-Acute Care
mHealth - Mobile Health
PERS - Personal Emergency Response System
PHR - Personal Health Record
RHIO - Regional Health Information Organization


1 CCHIT - Certification Commission for Healthcare Information Technology



In addition to developing minimum criteria for functionality, security and privacy features of EHRs [electronic health records], the CCHIT certification process requires health IT products to demonstrate they have incorporated the nationally recognized interoperability standards.


CCHIT is only one of several ONC Authorized Testing and Certification Bodies (ATCB). (Source: The National Alliance for Health Information Technology Report to the Office of the National Coordinator for Health Information Technology on Defining Key Health Information Technology Terms, released on April 28, 2008)


2 EHR - Electronic Health Record



An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across more than one health care organization. (Source: The National Alliance for Health Information Technology Report to the Office of the National Coordinator for Health Information Technology on Defining Key Health Information Technology Terms, released on April 28, 2008)


3 EMR - Electronic Medical Record



An electronic record of health-related information on an individual that can be created, gathered, managed, and consulted by authorized clinicians and staff within one health care organization. (Source: The National Alliance for Health Information Technology Report to the Office of the National Coordinator for Health Information Technology on Defining Key Health Information Technology Terms, released on April 28, 2008)


4 HIE - Health Information Exchange



The electronic movement of health-related information among organizations according to nationally recognized standards. (Source: The National Alliance for Health Information Technology Report to the Office of the National Coordinator for Health Information Technology on Defining Key Health Information Technology Terms, released on April 28, 2008)


5 HIO - Health Information Organization



An organization that oversees and governs the exchange of health-related information among organizations according to nationally recognized standards. (Source: The National Alliance for Health Information Technology Report to the Office of the National Coordinator for Health Information Technology on Defining Key Health Information Technology Terms, released on April 28, 2008)


6 HIT - Health Information Technology



HIT encompasses a broad array of technologies involved in managing and sharing patient information electronically, rather than through paper records. HIT performs information processing using both computer hardware and software for the entry, storage, retrieval, sharing, and use of health care information.(Source: Alliance for Health Reform). EHR, EMR and PHR are examples of HIT.


7 LTC - Long-Term Care



Long-term care is a variety of services that includes medical and non-medical care to people who have a chronic illness or disability. Long-term care helps meet health or personal needs. Most long-term care is to assist people with support services such as activities of daily living like dressing, bathing, and using the bathroom. Long-term care can be provided at home, in the community, in assisted living or in nursing homes. (Source: Medicare)


8 LTPAC - Long-Term Post-Acute Care



The expanded definition of LTPAC encompasses a broad range of providers that include: home and community-based services; nursing homes; assisted living; long-term acute care hospitals; rehabilitation and post-acute care facilities; PACE programs; hospice; chronic disease and co-morbidity management; medication therapy management and senior pharmacists; wellness providers; and others. What distinguishes this sector is its focus on coordination of supportive services and care, restoring and maintaining health, wellness and functional abilities, and a particular, almost programmatic, focus on the particular needs and goals of each of its consumers and their families. (Source: LTPAC HIT Roadmap)


9 mHealth - Mobile Health



Mobile health typically refers to portable devices with the capability to create, store, retrieve, and transmit data in real time between end users for the purpose of improving patient safety and quality of care. (Source: eHealth-Connection)


10 PERS - Personal Emergency Response System



Equipment that monitors the safety of older people in their homes through signals electronically transmitted over the telephone and received at an emergency-monitoring center. (State of New Jersey Department of Health and Senior Services)


11 PHR - Personal Health Record



An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be drawn from multiple sources while being managed, shared, and controlled by the individual. (Source: The National Alliance for Health Information Technology Report to the Office of the National Coordinator for Health Information Technology on Defining Key Health Information Technology Terms, released on April 28, 2008)


12 RHIO - Regional Health Information Organization



A health information organization that brings together health care stakeholders within a defined geographic area and governs health information exchange among them for the purpose of improving health and care in that community. (Source: The National Alliance for Health Information Technology Report to the Office of the National Coordinator for Health Information Technology on Defining Key Health Information Technology Terms, released on April 28, 2008)

Lutheran Homes of Michigan is providing seniors and caregivers with a 1-stop information and referral system called the Aging Enriched Network to help providers meet seniors and caregivers needs, and increases home and community based services. This is the second in a series of case studies from the Preparing for the Future Report.


The Organization: Lutheran Homes of Michigan (LHM) is one of the largest nonprofit providers of residential senior services in Michigan. The organization offers a variety of housing options as well as assisted living, skilled care, memory care, hospice, and home care programs. 


In 2009, LHM received 80% of its revenues from on-campus services provided to its residents; 20% of its revenues came from home and community-based services (HCBS). By 2016, the organization hopes to receive half of its revenues from campus-based services and half from HCBS.

Technology: To increase its offering of home and community-based services, Lutheran Homes of Michigan established the Aging Enriched Network, a one-stop information and referral service for seniors, their caregivers and their families. 


The network provides more than 20 categories of services that LHM has determined older adults need to stay independent. LHM provides some of these services, including home health care, transportation, in-home safety devices and telehealth technologies. 


A pre-screened group of affiliated businesses, volunteer organizations and individuals provides other complementary services, including transportation, home repair and modification, light housekeeping, meals, financial and legal services, housing, mental health services, social activities and medical equipment. 


Aging Enriched Resource Centers, where consumers can meet face-to-face with a nurse or other health care professional, are located on LHM campuses and in some local churches. In addition, technology powers a call-in center that family caregivers can use to access the Aging Enriched Network. The software analyzes caregiver requests and provides relevant information and referrals that callers need to keep their loved ones safe, healthy and independent at home.


Business Case: In seeking to rebalance its revenue streams, Lutheran Homes of Michigan decided that its home care model needed a complete makeover. As part of that makeover, LHM’s private duty home care agency became the Personal Services Division and no longer offers a standard menu of services that it will deliver to home-based clients. 


Instead, staff members are trained and encouraged to find ways to provide whatever service a client requests or needs. Establishing the Aging Enriched Network required a modest investment from LHM to develop the program’s software. 


However, because the network represents a service delivery model that is new to consumers, LHM has made a significant investment in marketing the network.


Consumers, who can join the network for free, use either their own funds or private long-term care insurance to pay for the services they receive. LHM found that an appreciable proportion of the users of this service have long-term care insurance.


You can view the full case study for Lutheran Homes of Michigan, which will be featured in the CAST Symposium at our PEAK Conference on April 22, 2012.


You can also view all 18 case studies from the Preparing for the Future report.

Capitol Lakes, a continuing care retirement community (CCRC) in downtown Madison, WI, is now using the world’s only virtual rehabilitation system specifically designed for seniors and people with limited physical abilities. Capitol Lakes is proud to be 1 of the first retirement communities in the U.S. to implement the new OmniVR™ Virtual Rehabilitation System in its Skilled Nursing and Rehabilitation Center.


It is also the very first in Wisconsin to use this technology.


Developed by Accelerated Care Plus (ACP), a Reno-based rehabilitation technology and education company, the OmniVR Virtual Rehabilitation System is unique in the industry. The Nintendo® Wii™ and Wii Fit™ have been used to help people improve balance and range-of-motion; however, these products are targeted to higher functioning individuals and often are not appropriate for seniors.


OmniVR is the only virtual solution that provides an opportunity for seniors and people with limited physical capabilities to participate in the benefits of virtual rehabilitation.


“Through visual feedback and a fun exercise program, the residents and locals we serve in our Skilled Nursing and Rehab Center gain skill and confidence and return to their homes more quickly,” says Josh Knops, a Capitol Lakes physical therapist. 


The OmniVR system implemented by Capitol Lakes offers six different rehabilitation programs appropriate for the entire spectrum of aging adults, from very frail to independent.


The gaming system includes an innovative, three-dimensional camera that captures the resident’s image and places it in a virtual exercise environment. The resident and therapist view the progress on a large color monitor. By exercising in a game-like environment, patients are more likely to exercise harder and longer.


On multiple occasions, people that had previously lost interest in improving their health have found a renewed interest, hope, and inspiration through the OmniVR system. Results are faster and more significant, partly due to the sense of camaraderie and competition fostered while playing the games.


Residents forget that they are participating in rigorous physical therapy, and tend to enjoy the activities daily without losing interest.

 

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