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According to the online health care Web site, HealthCommentary.org, our current health care system is not well equipped to address the immediate demands of a rapidly aging population. So what the author of the piece, Dr. Mike Magee, host of the Internet program, “Health Politics,” recommends is to place a stronger emphasis on prevention and wellness.

“We can refer to this new paradigm as “home-centered health care”—built on a system in which health management begins at home, connects to physicians and care teams, and circles back to home,” Magee writes. “The good news is that many of the pieces we need to accomplish the social transformation to this new paradigm—from intervention to prevention and wellness—are already in place.”

Magee is referring to health consumer empowerment, physician movement toward partnership, and team approaches that include clinical care and educational support, expansion of the Internet and technology to the people and their caregivers, expanded understanding of the causes and treatments for the major chronic diseases, and a very public debate about the benefits and risks of the health choices we make.

“This will drive this necessary change in health care and bring it back home again, but there is one megatrend in particular that is a force to be reckoned with—the aging of our population en masse,” he says.

The Alliance for Aging Research stated recently that the number of Americans over age 65 will double in number from approximately 35 million today to 70 million in 2030. And not only will the country be grayer than ever, but these seniors, living longer but suffering from more chronic diseases and disabilities, will require more help than seniors in previous generations.

“The shift to home-centered health care will certainly help alleviate the impending crisis of an older, increasingly dependent population,” says Magee.

According to Forrester Research and the U.S. Administration on Aging, with 81 percent of people over age 50 would prefer to avoid nursing home care even if they needed 24-hour care, and 61 percent of Americans saying they feel uncomfortable in hospitals, home-centered health care will allow seniors to age in place in order to maintain their independence.

Home-centered health care will revolve around technology and improvements to the home beyond mounting handrails in showers and installing stair lifts. Home-centered health care will include low-cost, non-invasive sensors, mechanisms for communicating with physicians, new medical devices designed for home use, and more robust connections to the Internet.

According to Forrester Research, the $2 billion home health industry, will skyrocket to $28 billion by 2020. And by 2015, they predict 12 percent of all seniors, 40 percent of all chronically ill, and 60 percent of all patients discharged after a lengthy hospital stay will adopt the new health care innovations.

The Role of Technology
The rise and potential success of home-centered health care relies largely on the use of a specific technology called telemonitoring—a developing technology that enables caregivers to monitor and assess a patient's condition from a remote location. Clinical data is sent to family members and trained practitioners, enabling them to intervene quickly at even the slightest change in a patient's vital signs, weight, oxygen saturation, or other statistics.

Other examples of how home health technology is advancing:

• Carnegie Mellon and the University of Pittsburgh are advancing some stunning new ideas, including "Guido," an intelligent walker that provides navigation assistance for people who need a mobility aid and has the capacity to adapt to the personal needs of the patient.
• The Georgia Tech AwareHome Research Initiative includes a Memory Mirror system, which helps seniors remember if they have taken their medications or if they have taken them too often. The Memory Mirror system uses RFID (Radio Frequency Identification) technology to record how often medications are taken or returned to the medicine cabinet and provides an easy-to-read graphical display of medication frequency.
• Medtronic has created a CareLink Network, a remote monitoring service for people with implantable cardiac devices. Patients with this device can "plug into" a standard phone line to send their device data to their physician from the comfort of their own home.
• The University of Rochester's Center for Future Health has created ''Chester the Talking Pill," a natural language conversational interface that acts as a single point of contact for an individual's personal health system. This can help seniors manage conditions, medications, activities, and decisions quickly and efficiently without the need for a keyboard or training.

 

The Advantages of Home-Centered Health

Dr. Magee writes that home-centered health care would be beneficial for all generations, but will most dramatically and immediate affect the aging population with:

• Improved informal care effectiveness without increasing intrusion
• Reduced burdens on the informal caregiver, reducing stress and improving mental and physical health conditions
• Extending a healthy, active and dignified life for the elderly
• Delayed admittance to specialized institutions, thus reducing the cost of formal elder care
• Ensuring safety and well-being by providing reports to the care team
• Assessing cognitive impairment more accurately by monitoring for extended periods of time
• Greater efficiency through technology
• Shorter hospital visits
• Better quality of life for patients
• Raised standard of care as improved outcomes result from new technology
• Growing empowerment of older adults to participate in decision-making regarding their own health care and treatment
• Active participation in health care decisions for patients and their families

 

“The greatest obstacle to the success of home-centered health care is ensuring that the government, private investors and the public wholly embrace this concept,” Magee says. “Home health care must also have the technology to enforce the ideas behind this system.”

He adds that fundamental advances must be made, not just in terms of getting this technology into our homes, but also in terms of understanding how to design sensor networks that are reliable, secure, and easy to install and maintain. “Assistive technology needs to be flexible and adaptive—"self-tuning"—to meet the needs of the elderly. Human-computer interaction also needs to be further developed, especially for people who are cognitively impaired and have other difficulties. Still, the potential benefit is enormous, and the building blocks are increasingly on hand for this exciting new paradigm of care.”

To learn more about home-centered health care and technology, visit HealthPolitics.org.