LeadingAge Magazine · July/August 2013 • Volume 03 • Number 04

Technology as a Strategic Initiative

June 22, 2013 | by Majd Alwan, Ph.D.

Technology as a Strategic Initiative

The growing older-adult population, shifting consumer needs and preferences, and a changing reimbursement landscape (from pay for service to pay for performance) are compelling aging-services providers to revisit their strategic plans. In doing so, it is important to consider how technology can help achieve organizational goals.

To help members prepare for change, the LeadingAge Center for Aging Services Technologies (CAST) conducted strategic scenario planning and has published a report entitled A Look into the Future: Evaluating Business Models for Technology-Enabled Long-Term Services and Supports. The report identifies potential characteristics of the future operating environment. It also delineates categories of potential business models, identifies enabling technologies for each model and evaluates how changes in the operating environment would affect these models.

CAST also has produced a video, “Hi-Tech Aging: Improving Lives Today,” that incorporates the technologies identified during strategic scenario planning and presents a vision of how these technologies can deliver value to consumers and caregivers.

The video depicts Alma, age 83, who lives independently in senior housing on a modest income. Like many of the clients LeadingAge members serve, Alma has multiple chronic conditions including hypertension, diabetes and arthritis. A retired home health nurse, she uses a few affordable technologies that are commercially available today, including a personal health record and a medication dispenser.

One day Alma has a stroke and is rushed to the emergency room. Because the hospital care team has access to Alma’s electronic health record (EHR) and her personal medication adherence record, they know exactly what conditions she has, the medications she is taking, and when she last took them. Having this information at their fingertips leads to a quicker diagnosis, the right interventions, a shorter hospital stay and a better outcome for Alma.

After treatment, Alma is discharged to a skilled nursing provider for short-term rehabilitation. Upon discharge, the hospital team works with the nursing home staff on a rehabilitation and care plan and shares all the needed information electronically so the nursing home is ready for her when she arrives. There, an engaging occupational therapy platform makes Alma’s therapy sessions not only more efficacious in helping her regain functional abilities, but also fun.

When Alma is discharged and returns to her apartment, the nursing home shares her information and coordinates with a home care agency to provide clinical and supportive services. The agency uses telehealth remote monitoring to help Alma keep her chronic conditions in check. In the apartment, an activity monitoring system and a bed monitor gauge Alma’s wellness and functioning so the agency can deliver services as she needs them. To ensure that she feels safe as she recovers from the stroke’s residual effects, Alma is given a personal emergency response system that automatically summons help if she falls or needs emergency medical care. She also uses a home computer with video conferencing capabilities to consult with her doctor and to participate remotely in exercise classes at a senior center.

The video illustrates a vision of the value LeadingAge members can bring to other care partners, including hospitals, physicians, accountable care organizations (ACOs) and payers. With the right technology tools and competencies, aging-services organizations can be strategic partners with other care providers in a number of health reform opportunities, including reducing hospital readmission rates, ACOs, bundling of payments, person-centered medical homes, managed care, etc.

This vision of technology-enabled long-term and post-acute care is not only possible but also within reach, as all the technologies featured in Alma’s story are moderately priced and commercially available today.

We invite you to use the CAST video with your board, executive team and staff to help with visioning and planning. Be sure to include your chief information officer (CIO) in the process to anticipate the implications for your information technology (IT) strategic plan. Your IT plan should reflect the relevance of technology to each strategic business goal and the changes that will need to be made to your organization’s information and communications infrastructure. Namely, providers need to consider the following questions:

  • What technology applications do you need to carry out each of your organization’s strategic goals, initiatives or innovative business models/operations efficiently and cost-effectively?
  • What updates do you need to make to your existing information and communications infrastructure to accommodate the identified technology applications?
  • What are the business and operational priorities for which you can create a high-level roadmap for technology projects and identify the resources required for each project?

Finally, we also hope you will use the video as a conversation starter with potential strategic partners. The hospital readmissions reduction program is creating opportunities to partner with local hospitals to improve patient care and help them avoid penalties. Such partnerships require demonstrating the ability to stabilize newly discharged patients with congestive heart failure, pneumonia and acute myocardial infarction and reduce their 30-day readmission rate. This can be achieved through care coordination activities, including medication reconciliation, medication adherence and chronic disease management with hospitals and physicians. These activities can be performed better and more efficiently when enabled by interoperable electronic health records, electronic health information exchange, telehealth, medication adherence, remote monitoring technologies and care coordination tools. Those same tools and skills will enhance your strategic positioning with health care partners on other Affordable Care Act initiatives.

Technology has revolutionized every aspect of our lives. It has become a business imperative in every sector, including aging services. Technology is key not only to thriving in the next decade but also to surviving and being able to adapt to new payment, incentive and care delivery models, as well as consumer expectations, with respect to demands for quality services and outcomes.