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Aging by Design 2006 Michael Cantor MD JD and Marc Drucker MBA, IDSA © 2006 1
Aging by Design 2006
Improving the Design of New Medical Products for Older People Using a Team Approach
Bentley CollegeOctober 23, 2006
Michael Cantor MD JDMarc Drucker MBA IDSA
Aging by Design 2006 Michael Cantor MD JD and Marc Drucker MBA, IDSA © 2006 2
Our Premise
- Chronic diseases effects the health and quality of life of the majority of older people.
- Technologies are creating opportunities for new forms of care for our aging society. The widest use of technologies by older people suffering from chronic illness are TeleHealth devices.
- Technology alone does not make a successful (efficacious) product, design is required in order to achieve usability, safety, and adoption of medical products.
- Good design for these products, like elder care, requires a team approach, engaging end-users, family, caregivers and physicians.
Aging by Design 2006 Michael Cantor MD JD and Marc Drucker MBA, IDSA © 2006 3
Experiences That Form Our Views
- Mike Cantor MD JD- Geriatrician and Assistant Medical Director at EverCare New England
- EverCare is one of the largest providers of care for older people with
over 100,000 enrollees in 35 states
- Medical Director at Dovetail Health
- Contributed the VA’s Care Coordination / Home TeleHealth Initiative
- Marc Drucker MBA, IDSA - Founder and President of Newlogic Design in Newton, Ma.
- Consultancy which has also spun-out new healthcare businesses
- Intelli-Chair, Inc.; smart healthcare furniture backed by an
industry consortium
- Intelli-Pod, Inc.; integrated home healthcare product
Aging by Design 2006 Michael Cantor MD JD and Marc Drucker MBA, IDSA © 2006 4
Introduction
1. Technology is, and will be, an important part of the
care for chronically ill and older people
2. Poor design limits the usability, acceptance, and utility
of medical products used by older people
3. Strengthening the design process is key to developing
new products that provide the maximum benefit to
users, medical care providers, and other stakeholders
Aging by Design 2006 Michael Cantor MD JD and Marc Drucker MBA, IDSA © 2006 5
Chronic Disease: Definition
- Chronic disease involves the following:- Lasts or is expected to last a year or more
- Requires ongoing care and monitoring
- Has episodes of acute worsening of the illness that may require acute or urgent care
- Aging and lifestyle are key drivers- Heart Disease
- Asthma
- Obesity
- Diabetes
Aging by Design 2006 Michael Cantor MD JD and Marc Drucker MBA, IDSA © 2006 6
Chronic Disease: Effect
- Chronic disease is common- Almost half of Americans report having a chronic medical
condition
- 75% of the medical costs are by people with multiple chronic conditions(1).
- Affects about 100 million people
- Consumes 75% of healthcare costs
- 70% of physician visits
- 88% of drug prescriptions
- 75% of hospital admissions
- Accounts for 7 of every 10 deaths in US
Aging by Design 2006 Michael Cantor MD JD and Marc Drucker MBA, IDSA © 2006 7
Growing Global Impact
- There is a direct correlation between the prevalence of chronic illnesses and population age
Source: WSJ WALDHOLZ ON HEALTH By MICHAEL WALDHOLZ: November 20, 2002Data from: Harvard Public School of Health's project on the global burden of disease
Aging by Design 2006 Michael Cantor MD JD and Marc Drucker MBA, IDSA © 2006 8
Addressing Chronic Disease
- Systemic:
- Need to change current, acute and episodic-care focused healthcare
system to one that better manages chronic illness
- Research:
- Need more basic, clinical and population science research into how to
best prevent and manage these diseases
- Professional:
- Need for increasing numbers of health care professionals trained in
geriatrics and chronic illness
- Technology:
- Need to create new tools and technologies that help
the chronically ill and older people self-manage
their health.
Aging by Design 2006 Michael Cantor MD JD and Marc Drucker MBA, IDSA © 2006 9
TeleHealth Products are an Important Tool in the Care of Older People
- Represents the latest technological innovation in the
delivery of care to chronically-ill homebound patients.
- Remote patient monitoring products capture vital sign
data for people with chronic illnesses
- Sophisticated data processing technologies
- Promises better care management at lower cost
- Faster adjustments to changes in condition
- Earlier awareness of drug interactions
- Reduce ER visits and hospitalizations
Honeywell/HomMed
Aging by Design 2006 Michael Cantor MD JD and Marc Drucker MBA, IDSA © 2006 10
TeleHealth Products are Transformative
- TeleHealth has a profound impact on three key
aspects of healthcare:
- Role of patient into activated participant
- Role of professional from parent to coach
- Relationship and communication between
professionals and patient
Honeywell/HomMed
Aging by Design 2006 Michael Cantor MD JD and Marc Drucker MBA, IDSA © 2006 11
Driving the Adoption of TeleHealth Products
- Managed care organizations
- Home healthcare helps reduce the cost of care
- Home healthcare providers
- Reduces need for routine in-home visits
- Family members and adult children
- Increases their sense of safety
- Awareness of parents’ health conditions and activity levels
- Early warning system
- End users
- More older people are taking responsibility for their careHoneywell/HomMed
Aging by Design 2006 Michael Cantor MD JD and Marc Drucker MBA, IDSA © 2006 12
Benefits of TeleHealth Products for Older People
- Increases patient’s knowledge of disease
- Provides new health management tools
- Sense of security for users and families
- Encourages patient compliance with treatment plan and reinforces necessary lifestyle/behavior changes
- Faster adjustments to prescriptions
- Earlier awareness of drug interactions
- Reduces ER visits and hospitalizations
- Improved quality of life
Aging by Design 2006 Michael Cantor MD JD and Marc Drucker MBA, IDSA © 2006 13
Challenges of TeleHealth Products for Older People
- Pilot project at large, federally sponsored healthcare system- 15 Health Buddies deployed to patients with congestive heart failure
(CHF)
- Required daily use of blood pressure cuff and scale
- Monitoring by CHF clinic nurse practitioners
- Key Research Finding: Many barriers to use were design-related- Difficulty with cords, connections, and cable management
- Non-intuitive, difficult, device set-up
- GUI, screen and visibility issues
- Required analog in-home phone
- Product Design Results:- User frustrations, poor experience
- Increased adoption curve
- Reduction of overall usabilityHealthbuddy
Aging by Design 2006 Michael Cantor MD JD and Marc Drucker MBA, IDSA © 2006 14
5 Principles for Designing TeleHealth Products
1. Integrate the team into the solution
2. The product should holistically address the specific
capabilities of older adults
3. Recognize the importance of emotional support
4. New Design, not new technology, is the key to success
Aging by Design 2006 Michael Cantor MD JD and Marc Drucker MBA, IDSA © 2006 15
Our Principles Illustrated: The Intelli-Pod™
Aging by Design 2006 Michael Cantor MD JD and Marc Drucker MBA, IDSA © 2006 16
Principle 1: Integrate the Team into the Solution
- Not the development team - THE PATIENT’S TEAM- Healthcare providers
- Family network
- Emergency services
- Monitoring services
- Successful products do not work in a bubble, they
engage the end-user and their support network
- Facilitate the participation of multiple users (spouse and
children)
- Allow others to program custom alerts and easily look in on
the patient’s health trends
Aging by Design 2006 Michael Cantor MD JD and Marc Drucker MBA, IDSA © 2006 17
Principle 2: Design should react to the specific capabilities of older adults
ZERO GRIP STRENGTH REQUIRED
OVERSIZED, HIGH-CONTRAST GUI
STANDARD FUNCTIONS ARE SELF INITIALIZING NO USER INPUT REQUIRED
RARELY USED, ADVANCED FUNCTIONS, ARE ACCESSED THROUGH A TOUCHSREEN INTERFACE
VOICE FEEDBACK
CAN BE LOCATED ANYWHERE IN THE HOME
GUI FOLLOWS GOOD DESIGN GUIDELINESPERFORMANCE TESTING WITH END-USERS
Aging by Design 2006 Michael Cantor MD JD and Marc Drucker MBA, IDSA © 2006 18
Principle 3: Don’t Underestimate the Importance of Emotional Support
Aging by Design 2006 Michael Cantor MD JD and Marc Drucker MBA, IDSA © 2006 19
Principle 4: Great Design is the Key to Success
- The HHC market is evolving
- Initial HHC products were modifications to hospital devices
- Current products are driven by sensor, software, and
communications technologies
- Next generation will be focused on the user experience
- Great example: Philips Motiva
- Winner of a Medical Design Excellence Award in 2005
- Named one of the "Top 5 Disease Management Ideas of
2005
Philips
Aging by Design 2006 Michael Cantor MD JD and Marc Drucker MBA, IDSA © 2006 20
Take These Home With You
- Good design delivers a powerful impact on the usability, safety, and efficacy of home healthcare products leading to improved business success
- Older people, both as a demographic, and individually, are undergoing many changes, products for them need to be specifically designed for their needs
- Care for older people requires a team approach, integrating the needs of children, caregivers and geriatricians
- Use these products as opportunities to create a positive emotional experience
Aging by Design 2006 Michael Cantor MD JD and Marc Drucker MBA, IDSA © 2006 21
Aging by Design 2006
Improving the Design of New Medical Products for Older People Using a Team Approach
Bentley CollegeOctober 22, 2006
Michael Cantor MD: MikeCantor@rcn.com
Marc Drucker MBA IDSA: marc@newlogicusa.com