Long-Term Care Conference Focuses on Technology, Government's Role
Kleyman, Paul, Aging Today
New applications of technology, such as simple sensors now readily available, could prevent up to 70% of falls among elders. Social networking technology similar to Facebook could provide stimulating and watchful new communication opportunities to elders and their caregivers. Home monitoring may indicate real-time developments in older adults by tracking behavioral and biological changes currently undetectable between medical appointments.
The potential benefits of these and other exciting uses of technology for long-term care clients were explored by Intel Corporation chairman Craig Barrett and David Walker, Peter G. Peterson Foundation president and Intel CEO, during a plenary session at October's annual meeting of the American Association of Homes and Services for the Aging (AAHSA), in Philadelphia. The pair called on the nonprofit association to de-emphasize lobbying efforts to improve Medicare and Medicaid payment codes and, instead, take a firmer leadership role in developing new standards and models of long-term care practice and technology use.
The pair drew a huge authence at the AAHSA conference, attended by nearly 8,960 long-term care providers. A dramatic corporate speaker, Barrett urged AAHSA members to "band together" to develop solutions for the delivery of long-term care instead of waiting for government help. "We have to act expeditiously; we can't wait five years and hope there is a bailout of the healthcare industry, just like mere's a bailout of investment banks or financial institutions," he stated.
'A FAIRY TALE'
He asserted that federal plans for developing a national health-information network to connect patient records across all platforms "is a fairy tale." Long-term care providers should not wait for large government initiatives, said the technology innovator.
Barrett has been instrumental in developing collaborative consortiums, such as the Technology CEO Council and the Continua Alliance, each with a large corporate membership and focused on developing new healthcare products. He called on AAHSA to act more forcefully through its Center for Aging Services Technologies (CAST), a coalition he helped create. CAST currendy includes 400 companies focused on developing, evaluating and adopting emerging technologies in long-term care.
Later, in a press briefing, cast chairman Eric Dishman, Intel director of product research and innovation, explained that Intel and other member companies decided to house the program within AAHSA, after forming CAST in 2002, because the association represents nonprofit providers, who take a "holistic approach to life services."
A SPECTRUM OF NEEDS
CAST's technology participants focused on long-term care providers, Dishman said, because these providers work on a spectrum of elders' functional needs, such as transportation, meals, medication management and assistance with chronic diseases. "I think it is exactly the bandwidth that the AAHSA community and the long-term care field has and, quite frankly, the rest of healthcare needs to take on."
Dishman clarified, "We're not asking the AAHSA community to become technologists; we're saying, 'You're an expert on care paradigms and how to do quality care.' Lay it out for us, and we'll learn from you about what technology will be best." Adding that CAST doesn't want AAHSA providers to worry about the technology or the policy issues, he encouraged them to "imagine and design a social-care system that works for the best quality of life for all of those involved-the family members, me senior residents, the staff. And figure out a business model, a care model that works. Then let the technology industry supply technologies that help fill those gaps."
Barrett emphasized that CAST could play a prime role in developing and coordinating common platforms of shared information. Proceeding with common technological platforms is critical, he said, because technologies to enhance independent living won't emerge if companies create proprietary approaches: "You'll all just have a hodge-podge of very expensive proprietary solutions."
He suggested, "You need to do the same sort of thing that has happened in the music and photography industries. Build around a common platform, and everybody gets to benefit. . . . So we need new industry-wide business models."
Furthermore, he stressed, "CAST needs to do something; it needs to be more energetic, it needs to be much more of an influencer on the services you deliver. Why can't you, for example, take an action item that within a year or two, you'll have 10,000 elderly people or people in their homes who are being monitored as proof of what the technology can do? [Show] how those people can continue to live in their homes [with] better quality of life, better service, longer life expectancy, higher quality of healthcare-and lower cost."
Clearly frustrated with government, Barrett remarked during the plenary, "I could also urge you to band together to drive legislation in Washington, D.C. There's probably no harm in that. But, quite frankly, I don't see how much good is going to come out of that" In die press briefing, Barrett added that developing ways to improve elders' lives does not require government "to be mandating the policies, procedures, requirements and specifications."
Asked later in the press briefing about the role of Medicare and Medicaid in financing new approaches, Barrett declared, "You're going down the wrong rathole here. My whole message was, if you wait for government to specify Medicare and Medicaid funds, and start to change the Medicare reimbursement code-which is what people love to talk about to fix the healthcare industry-we're going to be waiting forever."
Barrett recommended that the longterm care field "let the purchasing power of the individual drive what happens, not the government. If you wait for the government to change, then you'll be waiting for the next round of legislation, the next administration, the next set of political promises, and nothing will happen. You'll get the same gridlock we have today."
Walker, who until the end of 2007 was comptroller general of the United States, repeatedly called government "a lag indicator" that provides "laggardship," not "leadership." A respected conservative, who ran the independent Government Accountability Office, Walker stated that the United States needs universal and comprehensive healthcare to replace the current system.
He said health reform must include universal coverage, which should be "basic and essential, based on broad-based societal needs, not on individual ones, so that healthcare is affordable and sustainable over time and avoids heroic measures." He recommended national evidence-based standards for medical practice of medicine, a focus on prevention and wellness, and increased emphasis on personal responsibility and accountability.
A major promoter of entitlement reform, especially of Medicare and Medicaid, Walker said that imposing "a budget on what the federal government will spend on healthcare" is essential.
Long-term care, he told the AAHSA authence, "is about living support services. It is not healthcare ... by definition. [It is] something you ought to be able to address through planning, sayings and insurance. You may want some publicprivate sector model, but the last thing in the world we need, want or can afford is another government program."
ZEN AND GOVERNMENT
AAHSA president and CEO Larry Minnix, who moderated an onstage discussion with Barrett and Walker following their presentations, seemed more in tune with the shifting view of government's role. On Nov. 5, the day following the historic presidential election, Minnix began a lengthy memo to AAHSA members with a Zen proverb: "Before enlightenment, chop wood, carry water. After enlightenment, chop wood, carry water."
Although Minnix has long welcomed the involvement of private industry, his public-policy memo clearly outlined practical strategies involving Medicare, Medicaid, the U.S. Department of Housing and Urban Development, and numerous other programs and pieces of legislation aimed at increasing or clarifying government's place in the Zen woods of the new post-ideological Washington.
Former U.S. comptroller general David Walker, left, drives home a point during the onstage discussion with Intel chairman Craig Barrett, center, and a ahsa president and CEO Larry Minnix.
Government, said Barrett, shouldn't 'mandate policies. procedures, requirements and specifications.'…
Questia, a part of Gale, Cengage Learning. www.questia.com
Publication information: Article title: Long-Term Care Conference Focuses on Technology, Government's Role. Contributors: Kleyman, Paul - Author. Magazine title: Aging Today. Volume: 29. Issue: 6 Publication date: November/December 2008. Page number: 1+. © American Society on Aging Jan/Feb 2009. Provided by ProQuest LLC. All Rights Reserved.