© 2015 RCM&D. All Rights Reserved. Technology and the Aging; Upside and Downside Risk Management...

© 2015 RCM&D. All Rights Reserved.

Technology and the Aging; Upside and Downside Risk Management

Karen B. Mathura, RN, JD, CPHRMDenise M. Shope, RN, MHSA, ARM, CPHRM, FASHRM

Risk Management Consultants

October 8, 2015

Fall Leaders Forum – Embracing the Future


Participants will:

▪ Identify 2 new technologies that specifically target the needs of our aging population.

▪ Discuss the risks inherent in these new technologies.▪ Discuss interventions that can mitigate the risks with

new technology

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Setting the Stage

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▪ Aging is a disruptive force in many countries and economies. Imagine:– There are more walkers and wheelchairs than baby

carriages in parts of Europe– People over 60 in China are more numerous than the entire

population of Russia– Japan’s population by mid-century may reduce by half and

nearly a third will be over 65– 77 million American baby boomers, born between 1946-

1964 are now passing 65 nearly one every seven seconds– Even in ‘young’ South American and African nations, there

are concentrations of older adults that rival or even surpass the oldest countries of Europe

Disruptive Demographics

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▪ The new disruptive demographics of aging means many older people have:– Vast cultural, lifestyle, and economic diversity within and

across nations– Fewer family caregivers and working age adults to support

an aging society– Greater expectations of baby boomers in North America

and Europe to not only live longer but to live better than previous generations

– Higher expectations and lifelong experience with the promise of technology to improve the quality of life – from accessing healthcare, connecting to loved ones, to remaining engaged rather than ‘retired’ from society

– Better health, more education and income than their parents and grandparents

Disruptive Demographics

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http://bigthink.com/blogs/disruptive-demographics


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▪ CAST Center for Aging Services Technology (Leading Age) http://www.leadingage.org/CAST.aspx

▪ Center for Technology and Aging http://www.techandaging.org/programs_home.html

▪ Aging Well Hub by Phillips http://www.agingwellhub.org/o Community, Caregiver, Healthcare, Mind/Body/Spirit

▪ MIT AgeLab http://agelab.mit.edu/

Setting the Stage

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http://www.leadingage.org/CAST.aspx

http://www.techandaging.org/programs_home.html

http://www.agingwellhub.org/

http://agelab.mit.edu/


▪ AGNES (Age Gain Now Empathy System)

MIT AgeLab

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▪ PEW Research- Older people, 65 and older, are the most likely to reap the emotional benefits of Smartphone technology. More than any other age bracket, they consider a Smartphone to be "freeing," rather than "a leash," according to the Pew Research Center. On the other hand, 18- to 29-year-olds are the most likely to consider Smartphones a leash.

Setting the Stage:

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http://www.pewresearch.org/fact-tank/2015/04/29/seniors-smartphones/


▪ The elderly also felt more strongly than any other age group that Smartphones are "connecting" devices, as opposed to "distracting." Again, 18- to 20-year-olds were the most pessimistic: 37 percent considered their phones to be more of a distraction than a device that served to connect them to friends and family.

Setting the Stage

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▪ Communication▪ Safety▪ Health▪ Social and Learning

Application of Technology in Aging

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▪ This space is enormous and includes email, chat, games, video, cell phones, Smartphone’s and tablets, as well as personal computers.

Communication and Engagement

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▪ All manner of home security systems are springing up.

▪ The systems deal not only with possible intruders but a growing range of personal health and safety issues.

▪ They use sensors, webcams and digital communications to provide help with fall detection and the broader areas of personal emergency response systems.

o sneakers (with tracking technology for elopement risk)

Home Safety and Security

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Telehealth and mHealth (the "m" stands for mobile), medication and disease management tools and fitness products.

▪ mHealth and eHealth» Examples of eHealth and mHealth» Technology – Smartphone’s, tablets, watches, Fit Bits, » Apps – glucose meter, blood pressure monitor (

https://www.youtube.com/watch?v=xp1x82IakBc), ECG/EKG device (https://www.youtube.com/watch?v=X0NiQWFqZYI)

» The Google Glass IntelliVue Solutions

Home Health and Wellness

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https://www.youtube.com/watch?v=xp1x82IakBc

https://www.youtube.com/watch?v=X0NiQWFqZYI


▪ Digital Stethoscope and Smartphones The new-generation stethoscope wirelessly streams heart sounds to a Smartphone app, which, in turn, can save those recorded beats to a patient's electronic medical record. The record of a patient's heartbeat can be viewed as a heart-sound wave form and shared via a secure link with a cardiologist offering a second opinion.


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▪ TeleHealth and Remote Patient Monitoring


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Home-centered communications technologies▪ stay connected with friends/family▪ engage in online learning▪ participate in volunteer activities▪ earn income from home.

• AARP Tek Academy » Social Media» Online Safety» Tablets and Phones» Connected Life» Real Pad

http://aarptek.aarp.org

Learning and Social Contribution

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http://aarptek.aarp.org/


▪ Gamification– Wii ®– Rise of Nations ® Gold Edition

Karl M. Kapp, Ed.D., CFPIM, CIRMAssistant Director, Institute for Interactive TechnologiesProfessor of Instructional TechnologyBloomsburg University


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▪ From Meals-on-Wheels to Dinner-by-Drone http://bigthink.com/disruptive-demographics/from-meals-on-wheels-to-dinner-by-drone


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http://bigthink.com/disruptive-demographics/from-meals-on-wheels-to-dinner-by-drone

http://bigthink.com/disruptive-demographics/from-meals-on-wheels-to-dinner-by-drone


▪ Combines form and function– wearable gear in the form of watches, eyeglasses and

more.

The Wearable Technology

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▪ A common basic template for how they work– sensors capture impulses and translate them into

actionable data.– then, microprocessors extract, transform and load data

to a transmittable format. – finally, transmitters wirelessly send data to cloud

storage for further processing and reporting.

Wearable Technology

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Wearable technology risks fall into three main categories for the manufacturer/vendor:

▪ Cyber Risks. If data transmitted via wearables is not properly secured, companies can face class action lawsuits, costly fines and damage to their reputation.

▪ Bodily Injury Risks. Malfunctioning devices can cause injuries, illnesses and even death of wearers or patients. Device manufacturers may face a product liability lawsuit.

▪ Technology Errors and Omissions Risks. Companies can be held liable for an economic loss from the failure of a device to work as intended.

So will the manufacturer/vendor attempt to transfer this risk to the users???

Wearable Technology - Risks

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Safelet®

Google ® GlassMental Health Sensors

Apple Watch® 23


Risk Management Considerations

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Risk Management Solutions

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Preparedness

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Understand and meet regulatory compliance? Records retention schedule and policy?Do you have a response plan?Focus on Internal Monitoring

Plan

What information exists?Where is it?What format is it in?How easy or difficult is it to access?Conduct Risk Assessments

Identify


Preparedness

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Incident response teamIntegrate Risk/IT/Medical Records/Legal/PRWork with Insurers and Service ProvidersOngoing Education

Implement

Are your systems and networks secure?EncryptionDo you use compliant storage technologies?Securing or destroying end of lifecycle data?

Protect


Response

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Retain outside counsel with privacy expertiseDetermine who and what caused the breachDocument investigation and findings in a legally defensible manner`

Investigate

Determine the scope of the breach and potential notification dutyAppropriate parties contacted in a timely and professional mannerProvide a mitigation or remediationRetain crisis and reputational advisory

Respond

DefendRegulatory defenseCivil liability defense


– Recording Conversations – Protection of Information- Cyber exposure

▪ Privacy v Autonomy ▪ telemed/mHealtho legitimacy/accuracy of apps; malware/virus riskso risks to ePHI; medical identity theft

Privacy

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Safeguarding the Data

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▪ Secure Data Centers▪ Encryption▪ Recipient Authentication▪ Audit Controls▪ Individual Device Security▪ Access Security▪ Vet mHealth apps and software vendors!


– The Equipment

▪ Technology malfunction/failure▪ Display limitations, i.e. small screens, difficult to read▪ Upgrades▪ Costs▪ Operations/Logistics▪ Poor connection▪ Continuity of care▪ Embedding collected data into medical record▪ The “fine” print (terms and conditions)

The Device

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– Regulatory Considerations▪ HIPAA, FDA (mobile apps/medical devices), FCC, FTC (claims

made by apps under scrutiny - http://www.theguardian.com/technology/2015/feb/25/ftc-fines-apps-detect-melanoma)

Regulations and Control

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http://www.theguardian.com/technology/2015/feb/25/ftc-fines-apps-detect-melanoma

http://www.theguardian.com/technology/2015/feb/25/ftc-fines-apps-detect-melanoma


HIPAA Security Rule

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Administrative Safeguards

▪ Security Management Process▪ Security Personnel▪ Information Access Management▪ Workforce Training & Management▪ Evaluation

Physical Safeguards

▪ Facility Access & Control▪ Workstation & Device Security

Technical Safeguards

▪ Access Control▪ Audit Controls▪ Integrity Controls▪ Transmission Security

http://www.hhs.gov/ocr/privacy/hipaa/administrative/securityrule/securityruleguidance.html

http://www.hhs.gov/ocr/privacy/hipaa/administrative/securityrule/securityruleguidance.html


FDA

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▪ When equipment or software is intended for use in the diagnosis or treatment of a disease or other condition, it is considered to be a medical device.

▪ As of September 25, 2013, the FDA regulates mobile medical apps that:o Are used as an accessory to an FDA-regulated medical device

o Transform a mobile platform into a regulated medical device

▪ FDA applies same risk-based approach used to assure safety and effectiveness for other regulated medical devices.


FCC

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In Summary

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▪ Both mHealth & technology (wearable and more) can improve the quality of health care and the quality of life for our seniors if they are appropriately used.

▪ Assess risks before implementing an mHealth program or new technologies and monitor, evaluate, and improve thereafter.

▪ Take the time to vet mHealth applications and vendors before purchasing, implementing, or utilizing any app or software.


Daddy…

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© 2015 RCM&D. All Rights Reserved. Technology and the Aging; Upside and Downside Risk Management...

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