September 18, 2013 Elwyn New Jersey’s 8th Annual ‘Art of Two Palettes’ Elwyn New Jersey 1667 East Landis Ave. Vineland, NJ Contact: Jane Detweiler 856-794-5300 jane_detweiler@elwyn.org

November 7, 2013 10th Annual Student Art Exhibit and Auction Elwyn Media Campus Gym 111 Elwyn Road Elwyn, PA Contact: Susan Kroungold 610-891-7624 susan_kroungold@elwyn.org

This issue’s back cover drawing is by one of Elwyn’s first students. Records show that she was “initially uncommunicative” and after much training using 1850’s technology of a blackboard and chalk she drew this picture. From an 1858 Elwyn Publication. Many Volunteer opportunities are available at Elwyn. For further information please contact Shirley_kester@elwyn.org or 610-891-2183. To receive “Experience Elwyn ” by email, please contact info@elwyn.org.

CALENDAR OF Events

Experience

What started as a replacement for Elwyn’s laundry service has evolved into the Elwyn Commercial Laundry (ECL) capable of processing millions of pounds of linen a year. Located in a large warehouse in As-ton, PA, ECL has much room for expansion

as the business grows. It has both created an additional revenue stream for Elwyn and employed individuals with disabilities. While technology may not intuitively be associated with laundry, it is the driving force of efficiency at ECL. Using the cor-rect combination of water, heat, chemical, and wash time are crucial when mass-producing clean linen. The proper balance of these variables can reduce water con-sumption by 50% or more. This translates to millions of gallons of water saved per year.

Washers holding anywhere from 100 to 400 pounds of linen per load are computerized and networked. When linen is loaded, the washer begins a precise predetermined for-mula optimizing rinses, wash cycles, chemi-cals, temperature, and time based on its pro-gramming. Surgery-room linen, for exam-ple, requires a different formula and process than bath towels. ECOLAB’s chemical pump system precisely delivers the exact amount of each required chemical and then flushes each line clean. Cutting edge technology is also evident in the boiler room. It is the heart of the plant and responsible for powering all the equip-ment. Two high efficiency boilers create the steam that generates heat for the water, steam infusion for the washers and heat for the large ironer in the finish area. These two boilers work simultaneously, side by side, and can independently power the plant when necessary. A heat reclaim system was designed to direct all hot waste water leav-ing the washers to adjacent inflow pipes with cold city water. As a result, while us-ing no new energy, city water is delivered to the water heater already heated by 30 to 40 degrees! Another energy saver is the water recycling. A pit in the boiler room contains water from the last rinse of all wash cycles. The last rinse of a wash is generally clean water with the last bit of soap rinsed from the load. This water is saved, maintaining its heat, and used for the first rinse of the next wash! This first rinse need not use perfectly clean water as it is delivering moisture and tem-

perature to loosen the dirt on soiled linen. The large computer controlled ironer is the single piece of equipment that most people wish they could take home. Hand this ma-chine a wet sheet from the washer and within seconds it will dry, iron, perfectly fold and neatly stack it with others of the same size. Feed it different sizes and it will form separate stacks based on size! Even fitted sheets are no match for this ironer! Technology allows ECL to process large amounts of linen with fewer resources than otherwise possible. Currently over one mil-lion pounds of linen per year passes through ECL that is processed by individuals with various disabilities. ECL is aggressively pursuing growth and serves regional hospi-tals, nursing homes and medical offices in Southeast, PA, Central and South Jersey, Delaware and Maryland. For further infor-mation about ECL call Tony Brooks at (856) 296-6496.

July 2013 A publication for family and friends of Elwyn.

The technology revolution has impacted everyone’s life and Elwyn is on the cutting edge of using technology to promote independence and increase efficiency. Applied digital technology is supporting independence in a number of different service lines. Tracing its roots to Elwyn’s ground-breaking use of technology for people who are blind and visually challenged, digital technology is now enabling people with a number of sensory and developmental challenges to improve communication and promote independence. Digital hearing aids are fitted and used by hundreds of people through Elwyn’s Audiology Clinic. Genetic technology is enabling the development of targeted pharmaceuticals for specific neurodevelopmental syndromes. Likewise, the “new technology” is integrated into the functioning of Elwyn’s educational, work and residential services in many ways. Technology increases the ability to communicate and promotes a safer environment through

digital security and information systems. Technology is also being

used in ways that foster community integration and workplace efficiency. Grace Pharmacy, Elwyn’s Commercial Laundry and Bandage Production facilities are on the cutting edge of the use of technology to pro-mote efficiency and the integra-tion of people with disabilities into the workplace. While the technology revolution has impacted the way Elwyn de-signs and implements supports

for people with disabilities, it has also greatly impacted the way these supports and services are

documented and billed. With the continued imple-mentation of the Affordable Care Act, integration among currently disparate United States support systems such as Health, Behavioral Health and Intellectual Disability is crucial. Fiscal incentives and the very ability to deliver services will necessitate a state of the art information handling system. This sys-tem has many components and includes the ability to monitor, track progress and integrate across service lines and payers.

It is now crucial for all disciplines and departments to be able to quickly communicate and digitally share information about individuals. Elwyn continues to be ahead of the human services curve in developing and implementing programmatic and fiscal information systems. Such an integrated information system will be the means by which seamless supports are delivered, progress is tracked and reimbursement is obtained.

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Elwyn’s “NEW” Technology

ARTICLE PAGE Technology 1 From the President 2 Technology for Security 2 Educational Technology 3 eShare 4-5 Bandage Production 6 Nefi’s iPad 6 Aquaponics 7 Targeted Pharmaceuticals 7 ECL 8 Calendar of Events 8

IN THIS ISSUE

July 2013

2 Experience ELWYN

FROM THE

President

Elwyn Experience: A Quarterly Publication of Elwyn Elliott W. Simon, Ph.D. Editor Walter Fernandez Photography and Layout Editor Kunil Park Photography Candy DeMarco Copy Editor Tony Catania Copy Editor Dennis Ritrovato Content Editor Brian Boxall Content Editor Mike Pinto Intern

Elwyn’s strong embrace of technology to promote high quality care, safety, compliance and crisp financial processes is high-lighted in this issue of Elwyn Experience. The articles demonstrate the breadth and depth of our investment in new technologies, ways of thinking and tools to facilitate applications. We are interested in partnering with you in this journey. Please let me know your thoughts, observations and suggestions at info@elwyn.org. Sincerely, Sandra S. Cornelius, Ph.D. President P.S. We would like to increase the proportion of communications via the internet. Receipt of your e-mail address would be appreciated. Contact us at info@elwyn.org

With advances in technology, security at Elwyn has recently changed dramatically and plans are in place to continue ensuring that Elwyn maintains a secure environment for the people who work here and access supports. Recently, Elwyn’s Media Campus Security Department has updated its radios to improve the ability of the officers to communicate with each other and with other departments. These new radios give Secu-rity the ability to scan the other channels used on campus and gives Security a private channel. The campus is now able to be monitored remotely through security cameras. New surveillance cameras have been installed and security can monitor these cameras in the department office. In today’s world, school security has taken on new importance. Additional cameras are being planned for Davidson School and its perimeter. Maintaining school security is an ongoing process and there are plans in place to continue upgrading the current system. These include a system that will require staff at the school to use a swipe badge to gain entrance. A buzzer system will be installed and all visitors will be required to wear a visi-tor’s badge. Elwyn is also investigating a system where a visitor’s picture

will be taken and printed on a visitors badge with an expiration date. This will keep track of people who are entering and exiting any building in which it is installed. As with other areas of Elwyn’s operations, through continuous improvements and ongo-ing officer presence, Elwyn is on the cutting edge in its use of technol-ogy to ensure a safe and secure environment.

Technology Updates for Security

Experience

7

New to Elwyn last year was the green-house’s Aquaponics Program. Aquaponics is a food production system that combines a traditional aquaculture (raising fish) with hydroponics (growing plants in water) in a cooperative environment. In aquaculture, wastes accumulate in the water, increasing toxicity for the fish. This water is led to a hydroponic system where the wastes from the fish are filtered out by the plants as vital nutrients, after which the cleansed water is recirculated back to the animals. The term aquaponics is a combination of the terms aquaculture and hydroponic. Aquaponics is 100% organic, sustainable and uses 90% less water than any other method of growing. With this project El-wyn is able to grow vegetables and fish in its greenhouse. The Aquaponics Program began last year and was started by David-son School teacher Ethan Brazell. The

project takes place on Elwyn's Media Campus, The Connections Program in West Chester, and The Opportunities Pro-gram in Reading. Brazell has received approval for an Environmental Protection Grant, which brought the new system to the Elwyn greenhouse. Students aged 14-21 from Davidson’s Transition Program helped Brazell set it up. “I think this is good because it gives all the kids in the school a chance to inter-act. From the kids who just come down to watch and feed the fish, up to the kids who helped me put everything together,” said Brazell. In a couple of months the students will have fresh vegetables and fish to eat. Elwyn is excited to see its Aq-uaponics Program flourish and grow along with the organic and sustainable fish and vegetables that are produced.

Aquaponics Technology Comes to the Greenhouse

Targeted Pharmaceuticals for Fragile X Syndrome

“Ground-breaking Genetic Research Gives Hope for Potential Treatment of Autism’s and Fragile X Syndrome’s Core Symp-toms.” Headlines about the promise of scientific technology in the development of medications to treat Fragile X Syndrome and Autism are changing how we conceive neurodevelopmental disorders and giving new hope to children and adults with developmental disabilities. Fragile X Syndrome is the most common inherited genetic condition associated with

both intellectual disability and autism. It is diagnosed by a simple DNA blood test while autism and intellectual disability are diagnosed by a cluster of behavioral and cognitive symptoms. The link between Fragile X, autism and intellectual disability continues to be studied, and some treat-ments that are successful with Fragile X Syndrome may also help treat autism and intellectual disability not associated with Fragile X Syndrome. Unlike most medications that target symp-toms such as hyperactivity and anxiety, scientists set out to translate breakthrough discoveries in the laboratory to advance and develop pharmaceuticals designed to correct the underlying mechanism of Frag-ile X Syndrome. Fragile X Syndrome is caused by a change in FMR1 gene. Since scientists know what the gene does it was an ideal candidate for study. The technol-ogy of developing a “knockout mouse,” a mouse with Fragile X Syndrome, helped scientists to advance experiments with medications with the animal model so that they were able to move forward more quickly to trials with humans. Clinical drug trials are only approved after many years of research and safety studies with healthy adult subjects. These trials are designed to assess if the medication is

tolerated well, safe and effective. Pharma-ceutical companies and study sites are care-fully regulated and monitored both inter-nally and externally. Prior to enrollment, people are carefully evaluated for inclusion and exclusion criteria e.g. medical condi-tions, current medications, and behavior. The Elwyn Fragile X Center, one of 26 Fragile X centers in the United States, is a resource for hundreds of Fragile X families reaching across PA, NJ, DE and MD. Dr. Shivkumar Hatti, Principal Investigator & CEO of Suburban Research Associates, is a board-certified psychiatrist practicing in Media, PA for the past 32 years. In addi-tion to his extensive work with pharmaceu-tical trials, Dr. Hatti has expertise working with people with intellectual disability. In collaboration with Suburban Research Associates, the Elwyn Fragile X Center is conducting clinical trials for children and adults with Fragile X syndrome and autism. Elwyn is participating with Suburban Research Associates in clinical trials sponsored by Seaside Therapeutics, Novartis and Roche (Hoffman-LaRoche) and Forest Pharmaceuticals. For further information, see www.elwyngenetics.org and www.suburbanresearch.com

Elwyn Industries remains on the cutting edge of technology with new machinery funded by the Defense Logistics Agency (DLA) Troop Support’s Medical directorate. Elwyn is the sole provider of critically needed camouflage bandages for the United States Armed Forces. While the old machinery could make 3,000 bandages per hour this new technology can manufacture 6,900 in the same amount of time. The people who supply our troops with these field bandages are very pleased with the pro-duction capabilities that the machinery brings to Elwyn’s Bridgewater facility. Theresa Rucci, a Medical Inte-grated Supply Team supervisor for the government, said the faster production time is important because in the past there have been shortages. Rucci is also proud of her association with Elwyn. “Elwyn is a very reliable and important factor in contingency op-erations and the quality product supplied provides support to the warfighter while maximizing employment opportunities for peo-ple with disabilities. Supporting the warfighter with quality prod-ucts from Elwyn gives me an extreme sense of pride.”

According to Mike Medora, chief of the DLA Troop Support Medi-cal contingency contracting inte-grated support team, “The equip-ment upgrade was necessary in order to keep our warfighters sup-plied with this mission-essential and critical item.” By speeding up production, Medora said there will also be less backorders for military unique bandages that occur during peak demand, especially during periods of surge and sustainment.

The new machines are driven by state-of-the-art Servo motors, allowing machines to be synchronized. This saves change-over time by relieving the operator of adjusting a multitude of gears and switches. Elwyn manufactures 13 military-unique, mission-essential ban-dages in three categories: muslin, camouflage compress and gen-eral bandage. Elwyn Industries has partnered with DLA Troop Support since 1978.

Experience

6 Experience ELWYN

New Technology Enables a Doubling of Bandage Production at Elwyn

Elwyn NC’s use of assistive technology is unlocking a new world of possibilities that enable Nefi Jones to communicate in ways that were previously unimaginable. Almost 25 years ago, Rita Williams met Nefi at a children’s facility where Rita’s son volun-teered. Despite being unable to speak, Nefi quickly engaged Rita through eye contact, smiles, and facial expressions. Upon being told that Nefi knew how to spell, Rita initi-ated a series of exercises. She would ask Nefi a simple question and then speak the alphabet letter by letter. Nefi would vocal-ize after hearing the desired letter, and through this process, words were commu-nicated. When Nefi reached adulthood Rita became her legal conservator. Nefi moved to the Lanterman State Developmental Center and resided there for 20 years. Shortly be-fore transitioning into Elwyn NC’s Vista home last year, Nefi received an iPad. She showed an interest in the device but learn-ing how to use it effectively presented many challenges. On arrival at Vista, Rita saw that Nefi was renewing her efforts at communicating. “The Elwyn NC staff talks to her a lot more, which they really didn’t

have the time to do at Lanterman,” she said. Cindy Hill, Elwyn NC’s Regional Director for Southern California, agrees. “Right from the beginning, we made it clear that this is Nefi’s home, and we encouraged her to take ownership of her environment,” she said. “And that’s one area where she’s really grown. Nefi feels responsible for her room and her housemates, and she’s moti-vated to communicate those things.” Staff at the Vista Home then investigated specialized communications applications for Nefi’s iPad realizing that the first step was to help Nefi with the task of enabling Nefi to physically use the device. Nefi’s physical challenges prevent her from hold-ing a writing instrument or using a conven-tional keyboard. A specialized stylus with Velcro straps was purchased. This strap attaches to Nefi’s wrists allowing her to maintain a firm grasp on the pointer. Simi-larly, Velcro straps are used to secure the iPad to the lap tray on Nefi’s wheelchair. This allows her to visually focus and use the stylus to launch and use the iPad’s ap-plications. “Her intelligence was stalemated for so

long,” said Rita. “She’s made such tremen-dous progress in the six months that she’s been here.” The Vista staff is currently in the process of loading a variety of speech programs onto Nefi’s iPad, which will en-able her to communicate basic sentences at the touch of a button. These phrases will include such topics as her physical comfort, desires for daily activities, and personal messages tailored to her situation.

In addition to the iPad, Nefi now uses a cal-culator to keep track of her per-sonal fi-n a n c e s .

She is re-learning motor skills that will enable her to eat without assistance. Ac-cording to Rita this is “something that she knows she can do, but (Vista staff) actually take the time to help her do it.” Rita sums it up best when she says, “For many years, no one realized that she had these capabilities, but they’re all being developed here now. It seems like every day I get a phone call about something she knows, or something she can do.”

Nefi’s iPad

Experience

3

The integration of various computer plat-forms into Elwyn’s children’s programs has been occurring since the 1980s. Most recently, both Elwyn’s Davidson School and Children’s Residential Treatment Facility have been using the

latest Apple technology to enhance the educational experience. During the 2007-2008 school year Davidson school staff at-tended a presentation at an educational conference that featured iPod utilization. The staff then submitted a grant proposal to the Pennsylvania Department of Education (PDE) and was awarded a demonstration grant. The program design focused on students using iPods during work activities at community based transi-tional sites. Connections Program staff developed a series of videos that addressed: independent living skills, job-specific work activities, co-worker and work supervisor social interac-tion skills and community based safety skills. The intended out-come was that the students would use the iPod videos to provide visual supports at the community transition sites and would not require on-going individual staff support. Students responded positively to the use of iPods as the devices were accepted as popular age-appropriate technology devices used by peers. iPods were then introduced to the Davidson School Media Cam-pus and included in classrooms for students with autism, emo-tional and behavior challenges and intellectual challenges. At this point, staff added the use of electronic notebooks which provided increased visual screen size and enhanced the ease of device navigation. Since that time, Smart boards and Smart ta-bles have been purchased for use in the classroom. Smart tech-nology was used to deliver classroom instructional access across all curricular areas including music. Staff report increased stu-dent motivation and attention to task with these Smart technolo-gies.

During the 2011-2012 school year, iPads and curriculum-based applications for science, math, social skills, communication and pre-vocational skills for use across all pro-grams were purchased. In addition to staff training on this tech-nology, Davidson School has collaborated with families in pur-chasing an iPad and appropriate applications for their children to use at home. iPads have also become an integral part of the Elwyn’s Chil-dren’s RTF in combination with newly available WiFi access. Goals for this project include enhancing the social skills, func-tional communication, and adaptive skills of the adolescents who reside in the RTF. Four iPad Autism-related applications are in use: Proloquo2go is designed specifically for individuals with Autism who do not have the capability to communicate verbally. Featuring natural-sounding voices, speech can be gen-erated by tapping buttons with symbols or typing using the on-screen keyboard. AutisMate recognizes the unique nature of every case of autism and works to first build comprehension on a personalized level to unlock a more varied set of expressions and needs. It allows children with autism, along with their care-takers and teachers, to easily import personal images, video, audio and other information into a visual scene-based platform. Two additional applications, Behavior Tracker Pro and VB-MAPP App, are used to track and measure outcomes.

4 Experience ELWYN

Experience

Healthcare has been “going electronic” for the past 15 years in order to improve the quality, affordability, and availability of clinical ser-vices. The 2009 Affordable Care Act formalized the requirements for both electronically tracking patient information, and measuring the effectiveness of the new technology on patient health. In addition, the “Affordable” part of the law mandates that healthcare providers be “paid for performance” – not just paid for providing a service; “quality” – not “quantity” – is now the basis for reimbursement. Elwyn’s eShare Transformation was launched in 2008 – prior to the Affordable Care Act -- as a strategic initiative to ensure that Elwyn con-tinues to provide the highest quality services and supports. Elwyn’s eShare vision is transforming the way services are delivered and reim-bursed with the goal of improving quality while reducing costs. Through the efforts of Elwyn management and staff, we are now one of the leaders among human services agencies in coordinating people, processes, and technology to more effectively provide timely, accurate, and complete information about the individuals Elwyn serves and supports.

The Transformation is based on a person-centered healthcare approach that facilitates integrated case management and supports coordina-tion. Perhaps the most critical eShare deliverable is an online “3600 view” of a person’s health-related data that will be collected and summa-rized over the individual’s entire Elwyn lifecycle. This comprehensive Electronic Health Record (EHR) will enable Elwyn to measure suc-cess at both the level of an individual and in the aggregate. Implementation of this “3600 view” results in the following strategic clinical and business enhancements:

Clinical process / workflow improvement and standardization across the health system Sustained organizational and cultural change facilitating enhanced quality, effectiveness, and efficiencies Growth and acceptance of evidence-based medicine and clinical care Integration of clinical, financial, and administrative data to make information available when and where it is needed Sharing of clinical information across the entire business environment

Elwyn’s eShare Transformation: A client-centered approach to client care, facilitating integrated case management -- the ability to provide and manage a full range of behavioral, medical, and developmental services based on real-time access to a comprehensive electronic client record Promotes comprehensive, coordinated and person-

centered care Incorporates Performance Based Metrics and Outcomes Facilitates Standardization of Business Practices Provides 3600 View of a Person

Elwyn’s eShare Transformation: A client-centered approach to client care, facilitating integrated case management -- the ability to provide and manage a full range of behavioral, medical, and developmental services based on real-time access to a comprehensive electronic client record Promotes comprehensive, coordinated and person-

centered care Incorporates Performance Based Metrics and Outcomes Facilitates Standardization of Business Practices Provides 3600 View of a Person

Experience

5

This electronic health record will be a secured online repository storing the most essential data. The data will be assembled over time from all of the various applications that Elwyn uses to maintain each person’s health support system.

eShare Accomplishments:

Elwyn’s eShare transformation has already achieved a number of milestones:

Designed and documented an Elwyn “Enterprise” Workflow, outlining the core, common functions that all Elwyn Programs “eShare.” (For example: a consistent process for managing Referrals, Admissions, Treatment Plan-ning, and Service Delivery /Tracking)

Selected and initiated implementation of a new Clinical Information System

Designed and implemented a formal Elwyn Organizational Hierarchy, enabling Elwyn to formally define and maintain the names of its Service Areas, Programs, and Locations for reporting purposes

Selected and initiated implementation of an Electronic Medical Record (EMR) system to track physical health. The eClinicalWorks EMR is being rolled out to the Media Medical Suite, and will be expanded to including main-taining the physical health data for all people receiving Elwyn residential supports throughout the country. eClinicalWorks will also be part of any future medical services programs, such as the Patient Centered Medical Home.

Selected and piloted a tablet-based (touch screen) application that could be used in individual community homes to track progress (individual goals and objectives)

Researched (and will be acquiring) software enabling Elwyn to securely exchange information to other agencies, healthcare professionals, hospitals, laboratories, and pharmacies.

eShare Roadmap:

"eShare...information where & when you need it." "Less time searching for answers - More time for the people we serve."

"eShare...information where & when you need it." "Less time searching for answers - More time for the people we serve."

Elwyn’s eShare Transformation Roadmap is a dynamic process. The usage of our Clinical Information System, the Electronic Medical Record system -- and all other Elwyn “enterprise applications” that track behavioral, intellectual, and physical health needs -- will continue to ex-pand as Elwyn continues to grow through new programs and services in new geographic areas. The Electronic Health Record will serve as a central repository for storing core, summarized client data that can be shared within Elwyn and across the providers and agencies with whom we interact.

4 Experience ELWYN

Experience

Healthcare has been “going electronic” for the past 15 years in order to improve the quality, affordability, and availability of clinical ser-vices. The 2009 Affordable Care Act formalized the requirements for both electronically tracking patient information, and measuring the effectiveness of the new technology on patient health. In addition, the “Affordable” part of the law mandates that healthcare providers be “paid for performance” – not just paid for providing a service; “quality” – not “quantity” – is now the basis for reimbursement. Elwyn’s eShare Transformation was launched in 2008 – prior to the Affordable Care Act -- as a strategic initiative to ensure that Elwyn con-tinues to provide the highest quality services and supports. Elwyn’s eShare vision is transforming the way services are delivered and reim-bursed with the goal of improving quality while reducing costs. Through the efforts of Elwyn management and staff, we are now one of the leaders among human services agencies in coordinating people, processes, and technology to more effectively provide timely, accurate, and complete information about the individuals Elwyn serves and supports.

The Transformation is based on a person-centered healthcare approach that facilitates integrated case management and supports coordina-tion. Perhaps the most critical eShare deliverable is an online “3600 view” of a person’s health-related data that will be collected and summa-rized over the individual’s entire Elwyn lifecycle. This comprehensive Electronic Health Record (EHR) will enable Elwyn to measure suc-cess at both the level of an individual and in the aggregate. Implementation of this “3600 view” results in the following strategic clinical and business enhancements:

Clinical process / workflow improvement and standardization across the health system Sustained organizational and cultural change facilitating enhanced quality, effectiveness, and efficiencies Growth and acceptance of evidence-based medicine and clinical care Integration of clinical, financial, and administrative data to make information available when and where it is needed Sharing of clinical information across the entire business environment

Elwyn’s eShare Transformation: A client-centered approach to client care, facilitating integrated case management -- the ability to provide and manage a full range of behavioral, medical, and developmental services based on real-time access to a comprehensive electronic client record Promotes comprehensive, coordinated and person-

centered care Incorporates Performance Based Metrics and Outcomes Facilitates Standardization of Business Practices Provides 3600 View of a Person

Elwyn’s eShare Transformation: A client-centered approach to client care, facilitating integrated case management -- the ability to provide and manage a full range of behavioral, medical, and developmental services based on real-time access to a comprehensive electronic client record Promotes comprehensive, coordinated and person-

centered care Incorporates Performance Based Metrics and Outcomes Facilitates Standardization of Business Practices Provides 3600 View of a Person

Experience

5

This electronic health record will be a secured online repository storing the most essential data. The data will be assembled over time from all of the various applications that Elwyn uses to maintain each person’s health support system.

eShare Accomplishments:

Elwyn’s eShare transformation has already achieved a number of milestones:

Designed and documented an Elwyn “Enterprise” Workflow, outlining the core, common functions that all Elwyn Programs “eShare.” (For example: a consistent process for managing Referrals, Admissions, Treatment Plan-ning, and Service Delivery /Tracking)

Selected and initiated implementation of a new Clinical Information System

Designed and implemented a formal Elwyn Organizational Hierarchy, enabling Elwyn to formally define and maintain the names of its Service Areas, Programs, and Locations for reporting purposes

Selected and initiated implementation of an Electronic Medical Record (EMR) system to track physical health. The eClinicalWorks EMR is being rolled out to the Media Medical Suite, and will be expanded to including main-taining the physical health data for all people receiving Elwyn residential supports throughout the country. eClinicalWorks will also be part of any future medical services programs, such as the Patient Centered Medical Home.

Selected and piloted a tablet-based (touch screen) application that could be used in individual community homes to track progress (individual goals and objectives)

Researched (and will be acquiring) software enabling Elwyn to securely exchange information to other agencies, healthcare professionals, hospitals, laboratories, and pharmacies.

eShare Roadmap:

"eShare...information where & when you need it." "Less time searching for answers - More time for the people we serve."

"eShare...information where & when you need it." "Less time searching for answers - More time for the people we serve."

Elwyn’s eShare Transformation Roadmap is a dynamic process. The usage of our Clinical Information System, the Electronic Medical Record system -- and all other Elwyn “enterprise applications” that track behavioral, intellectual, and physical health needs -- will continue to ex-pand as Elwyn continues to grow through new programs and services in new geographic areas. The Electronic Health Record will serve as a central repository for storing core, summarized client data that can be shared within Elwyn and across the providers and agencies with whom we interact.

Elwyn Industries remains on the cutting edge of technology with new machinery funded by the Defense Logistics Agency (DLA) Troop Support’s Medical directorate. Elwyn is the sole provider of critically needed camouflage bandages for the United States Armed Forces. While the old machinery could make 3,000 bandages per hour this new technology can manufacture 6,900 in the same amount of time. The people who supply our troops with these field bandages are very pleased with the pro-duction capabilities that the machinery brings to Elwyn’s Bridgewater facility. Theresa Rucci, a Medical Inte-grated Supply Team supervisor for the government, said the faster production time is important because in the past there have been shortages. Rucci is also proud of her association with Elwyn. “Elwyn is a very reliable and important factor in contingency op-erations and the quality product supplied provides support to the warfighter while maximizing employment opportunities for peo-ple with disabilities. Supporting the warfighter with quality prod-ucts from Elwyn gives me an extreme sense of pride.”

According to Mike Medora, chief of the DLA Troop Support Medi-cal contingency contracting inte-grated support team, “The equip-ment upgrade was necessary in order to keep our warfighters sup-plied with this mission-essential and critical item.” By speeding up production, Medora said there will also be less backorders for military unique bandages that occur during peak demand, especially during periods of surge and sustainment.

The new machines are driven by state-of-the-art Servo motors, allowing machines to be synchronized. This saves change-over time by relieving the operator of adjusting a multitude of gears and switches. Elwyn manufactures 13 military-unique, mission-essential ban-dages in three categories: muslin, camouflage compress and gen-eral bandage. Elwyn Industries has partnered with DLA Troop Support since 1978.

Experience

6 Experience ELWYN

New Technology Enables a Doubling of Bandage Production at Elwyn

Elwyn NC’s use of assistive technology is unlocking a new world of possibilities that enable Nefi Jones to communicate in ways that were previously unimaginable. Almost 25 years ago, Rita Williams met Nefi at a children’s facility where Rita’s son volun-teered. Despite being unable to speak, Nefi quickly engaged Rita through eye contact, smiles, and facial expressions. Upon being told that Nefi knew how to spell, Rita initi-ated a series of exercises. She would ask Nefi a simple question and then speak the alphabet letter by letter. Nefi would vocal-ize after hearing the desired letter, and through this process, words were commu-nicated. When Nefi reached adulthood Rita became her legal conservator. Nefi moved to the Lanterman State Developmental Center and resided there for 20 years. Shortly be-fore transitioning into Elwyn NC’s Vista home last year, Nefi received an iPad. She showed an interest in the device but learn-ing how to use it effectively presented many challenges. On arrival at Vista, Rita saw that Nefi was renewing her efforts at communicating. “The Elwyn NC staff talks to her a lot more, which they really didn’t

have the time to do at Lanterman,” she said. Cindy Hill, Elwyn NC’s Regional Director for Southern California, agrees. “Right from the beginning, we made it clear that this is Nefi’s home, and we encouraged her to take ownership of her environment,” she said. “And that’s one area where she’s really grown. Nefi feels responsible for her room and her housemates, and she’s moti-vated to communicate those things.” Staff at the Vista Home then investigated specialized communications applications for Nefi’s iPad realizing that the first step was to help Nefi with the task of enabling Nefi to physically use the device. Nefi’s physical challenges prevent her from hold-ing a writing instrument or using a conven-tional keyboard. A specialized stylus with Velcro straps was purchased. This strap attaches to Nefi’s wrists allowing her to maintain a firm grasp on the pointer. Simi-larly, Velcro straps are used to secure the iPad to the lap tray on Nefi’s wheelchair. This allows her to visually focus and use the stylus to launch and use the iPad’s ap-plications. “Her intelligence was stalemated for so

long,” said Rita. “She’s made such tremen-dous progress in the six months that she’s been here.” The Vista staff is currently in the process of loading a variety of speech programs onto Nefi’s iPad, which will en-able her to communicate basic sentences at the touch of a button. These phrases will include such topics as her physical comfort, desires for daily activities, and personal messages tailored to her situation.

In addition to the iPad, Nefi now uses a cal-culator to keep track of her per-sonal fi-n a n c e s .

She is re-learning motor skills that will enable her to eat without assistance. Ac-cording to Rita this is “something that she knows she can do, but (Vista staff) actually take the time to help her do it.” Rita sums it up best when she says, “For many years, no one realized that she had these capabilities, but they’re all being developed here now. It seems like every day I get a phone call about something she knows, or something she can do.”

Nefi’s iPad

Experience

3

The integration of various computer plat-forms into Elwyn’s children’s programs has been occurring since the 1980s. Most recently, both Elwyn’s Davidson School and Children’s Residential Treatment Facility have been using the

latest Apple technology to enhance the educational experience. During the 2007-2008 school year Davidson school staff at-tended a presentation at an educational conference that featured iPod utilization. The staff then submitted a grant proposal to the Pennsylvania Department of Education (PDE) and was awarded a demonstration grant. The program design focused on students using iPods during work activities at community based transi-tional sites. Connections Program staff developed a series of videos that addressed: independent living skills, job-specific work activities, co-worker and work supervisor social interac-tion skills and community based safety skills. The intended out-come was that the students would use the iPod videos to provide visual supports at the community transition sites and would not require on-going individual staff support. Students responded positively to the use of iPods as the devices were accepted as popular age-appropriate technology devices used by peers. iPods were then introduced to the Davidson School Media Cam-pus and included in classrooms for students with autism, emo-tional and behavior challenges and intellectual challenges. At this point, staff added the use of electronic notebooks which provided increased visual screen size and enhanced the ease of device navigation. Since that time, Smart boards and Smart ta-bles have been purchased for use in the classroom. Smart tech-nology was used to deliver classroom instructional access across all curricular areas including music. Staff report increased stu-dent motivation and attention to task with these Smart technolo-gies.

During the 2011-2012 school year, iPads and curriculum-based applications for science, math, social skills, communication and pre-vocational skills for use across all pro-grams were purchased. In addition to staff training on this tech-nology, Davidson School has collaborated with families in pur-chasing an iPad and appropriate applications for their children to use at home. iPads have also become an integral part of the Elwyn’s Chil-dren’s RTF in combination with newly available WiFi access. Goals for this project include enhancing the social skills, func-tional communication, and adaptive skills of the adolescents who reside in the RTF. Four iPad Autism-related applications are in use: Proloquo2go is designed specifically for individuals with Autism who do not have the capability to communicate verbally. Featuring natural-sounding voices, speech can be gen-erated by tapping buttons with symbols or typing using the on-screen keyboard. AutisMate recognizes the unique nature of every case of autism and works to first build comprehension on a personalized level to unlock a more varied set of expressions and needs. It allows children with autism, along with their care-takers and teachers, to easily import personal images, video, audio and other information into a visual scene-based platform. Two additional applications, Behavior Tracker Pro and VB-MAPP App, are used to track and measure outcomes.

July 2013

2 Experience ELWYN

FROM THE

President

Elwyn Experience: A Quarterly Publication of Elwyn Elliott W. Simon, Ph.D. Editor Walter Fernandez Photography and Layout Editor Kunil Park Photography Candy DeMarco Copy Editor Tony Catania Copy Editor Dennis Ritrovato Content Editor Brian Boxall Content Editor Mike Pinto Intern

Elwyn’s strong embrace of technology to promote high quality care, safety, compliance and crisp financial processes is high-lighted in this issue of Elwyn Experience. The articles demonstrate the breadth and depth of our investment in new technologies, ways of thinking and tools to facilitate applications. We are interested in partnering with you in this journey. Please let me know your thoughts, observations and suggestions at info@elwyn.org. Sincerely, Sandra S. Cornelius, Ph.D. President P.S. We would like to increase the proportion of communications via the internet. Receipt of your e-mail address would be appreciated. Contact us at info@elwyn.org

With advances in technology, security at Elwyn has recently changed dramatically and plans are in place to continue ensuring that Elwyn maintains a secure environment for the people who work here and access supports. Recently, Elwyn’s Media Campus Security Department has updated its radios to improve the ability of the officers to communicate with each other and with other departments. These new radios give Secu-rity the ability to scan the other channels used on campus and gives Security a private channel. The campus is now able to be monitored remotely through security cameras. New surveillance cameras have been installed and security can monitor these cameras in the department office. In today’s world, school security has taken on new importance. Additional cameras are being planned for Davidson School and its perimeter. Maintaining school security is an ongoing process and there are plans in place to continue upgrading the current system. These include a system that will require staff at the school to use a swipe badge to gain entrance. A buzzer system will be installed and all visitors will be required to wear a visi-tor’s badge. Elwyn is also investigating a system where a visitor’s picture

will be taken and printed on a visitors badge with an expiration date. This will keep track of people who are entering and exiting any building in which it is installed. As with other areas of Elwyn’s operations, through continuous improvements and ongo-ing officer presence, Elwyn is on the cutting edge in its use of technol-ogy to ensure a safe and secure environment.

Technology Updates for Security

Experience

7

New to Elwyn last year was the green-house’s Aquaponics Program. Aquaponics is a food production system that combines a traditional aquaculture (raising fish) with hydroponics (growing plants in water) in a cooperative environment. In aquaculture, wastes accumulate in the water, increasing toxicity for the fish. This water is led to a hydroponic system where the wastes from the fish are filtered out by the plants as vital nutrients, after which the cleansed water is recirculated back to the animals. The term aquaponics is a combination of the terms aquaculture and hydroponic. Aquaponics is 100% organic, sustainable and uses 90% less water than any other method of growing. With this project El-wyn is able to grow vegetables and fish in its greenhouse. The Aquaponics Program began last year and was started by David-son School teacher Ethan Brazell. The

project takes place on Elwyn's Media Campus, The Connections Program in West Chester, and The Opportunities Pro-gram in Reading. Brazell has received approval for an Environmental Protection Grant, which brought the new system to the Elwyn greenhouse. Students aged 14-21 from Davidson’s Transition Program helped Brazell set it up. “I think this is good because it gives all the kids in the school a chance to inter-act. From the kids who just come down to watch and feed the fish, up to the kids who helped me put everything together,” said Brazell. In a couple of months the students will have fresh vegetables and fish to eat. Elwyn is excited to see its Aq-uaponics Program flourish and grow along with the organic and sustainable fish and vegetables that are produced.

Aquaponics Technology Comes to the Greenhouse

Targeted Pharmaceuticals for Fragile X Syndrome

“Ground-breaking Genetic Research Gives Hope for Potential Treatment of Autism’s and Fragile X Syndrome’s Core Symp-toms.” Headlines about the promise of scientific technology in the development of medications to treat Fragile X Syndrome and Autism are changing how we conceive neurodevelopmental disorders and giving new hope to children and adults with developmental disabilities. Fragile X Syndrome is the most common inherited genetic condition associated with

both intellectual disability and autism. It is diagnosed by a simple DNA blood test while autism and intellectual disability are diagnosed by a cluster of behavioral and cognitive symptoms. The link between Fragile X, autism and intellectual disability continues to be studied, and some treat-ments that are successful with Fragile X Syndrome may also help treat autism and intellectual disability not associated with Fragile X Syndrome. Unlike most medications that target symp-toms such as hyperactivity and anxiety, scientists set out to translate breakthrough discoveries in the laboratory to advance and develop pharmaceuticals designed to correct the underlying mechanism of Frag-ile X Syndrome. Fragile X Syndrome is caused by a change in FMR1 gene. Since scientists know what the gene does it was an ideal candidate for study. The technol-ogy of developing a “knockout mouse,” a mouse with Fragile X Syndrome, helped scientists to advance experiments with medications with the animal model so that they were able to move forward more quickly to trials with humans. Clinical drug trials are only approved after many years of research and safety studies with healthy adult subjects. These trials are designed to assess if the medication is

tolerated well, safe and effective. Pharma-ceutical companies and study sites are care-fully regulated and monitored both inter-nally and externally. Prior to enrollment, people are carefully evaluated for inclusion and exclusion criteria e.g. medical condi-tions, current medications, and behavior. The Elwyn Fragile X Center, one of 26 Fragile X centers in the United States, is a resource for hundreds of Fragile X families reaching across PA, NJ, DE and MD. Dr. Shivkumar Hatti, Principal Investigator & CEO of Suburban Research Associates, is a board-certified psychiatrist practicing in Media, PA for the past 32 years. In addi-tion to his extensive work with pharmaceu-tical trials, Dr. Hatti has expertise working with people with intellectual disability. In collaboration with Suburban Research Associates, the Elwyn Fragile X Center is conducting clinical trials for children and adults with Fragile X syndrome and autism. Elwyn is participating with Suburban Research Associates in clinical trials sponsored by Seaside Therapeutics, Novartis and Roche (Hoffman-LaRoche) and Forest Pharmaceuticals. For further information, see www.elwyngenetics.org and www.suburbanresearch.com

September 18, 2013 Elwyn New Jersey’s 8th Annual ‘Art of Two Palettes’ Elwyn New Jersey 1667 East Landis Ave. Vineland, NJ Contact: Jane Detweiler 856-794-5300 jane_detweiler@elwyn.org

November 7, 2013 10th Annual Student Art Exhibit and Auction Elwyn Media Campus Gym 111 Elwyn Road Elwyn, PA Contact: Susan Kroungold 610-891-7624 susan_kroungold@elwyn.org

This issue’s back cover drawing is by one of Elwyn’s first students. Records show that she was “initially uncommunicative” and after much training using 1850’s technology of a blackboard and chalk she drew this picture. From an 1858 Elwyn Publication. Many Volunteer opportunities are available at Elwyn. For further information please contact Shirley_kester@elwyn.org or 610-891-2183. To receive “Experience Elwyn ” by email, please contact info@elwyn.org.

CALENDAR OF Events

Experience

What started as a replacement for Elwyn’s laundry service has evolved into the Elwyn Commercial Laundry (ECL) capable of processing millions of pounds of linen a year. Located in a large warehouse in As-ton, PA, ECL has much room for expansion

as the business grows. It has both created an additional revenue stream for Elwyn and employed individuals with disabilities. While technology may not intuitively be associated with laundry, it is the driving force of efficiency at ECL. Using the cor-rect combination of water, heat, chemical, and wash time are crucial when mass-producing clean linen. The proper balance of these variables can reduce water con-sumption by 50% or more. This translates to millions of gallons of water saved per year.

Washers holding anywhere from 100 to 400 pounds of linen per load are computerized and networked. When linen is loaded, the washer begins a precise predetermined for-mula optimizing rinses, wash cycles, chemi-cals, temperature, and time based on its pro-gramming. Surgery-room linen, for exam-ple, requires a different formula and process than bath towels. ECOLAB’s chemical pump system precisely delivers the exact amount of each required chemical and then flushes each line clean. Cutting edge technology is also evident in the boiler room. It is the heart of the plant and responsible for powering all the equip-ment. Two high efficiency boilers create the steam that generates heat for the water, steam infusion for the washers and heat for the large ironer in the finish area. These two boilers work simultaneously, side by side, and can independently power the plant when necessary. A heat reclaim system was designed to direct all hot waste water leav-ing the washers to adjacent inflow pipes with cold city water. As a result, while us-ing no new energy, city water is delivered to the water heater already heated by 30 to 40 degrees! Another energy saver is the water recycling. A pit in the boiler room contains water from the last rinse of all wash cycles. The last rinse of a wash is generally clean water with the last bit of soap rinsed from the load. This water is saved, maintaining its heat, and used for the first rinse of the next wash! This first rinse need not use perfectly clean water as it is delivering moisture and tem-

perature to loosen the dirt on soiled linen. The large computer controlled ironer is the single piece of equipment that most people wish they could take home. Hand this ma-chine a wet sheet from the washer and within seconds it will dry, iron, perfectly fold and neatly stack it with others of the same size. Feed it different sizes and it will form separate stacks based on size! Even fitted sheets are no match for this ironer! Technology allows ECL to process large amounts of linen with fewer resources than otherwise possible. Currently over one mil-lion pounds of linen per year passes through ECL that is processed by individuals with various disabilities. ECL is aggressively pursuing growth and serves regional hospi-tals, nursing homes and medical offices in Southeast, PA, Central and South Jersey, Delaware and Maryland. For further infor-mation about ECL call Tony Brooks at (856) 296-6496.

July 2013 A publication for family and friends of Elwyn.

The technology revolution has impacted everyone’s life and Elwyn is on the cutting edge of using technology to pro-mote independence and increase efficiency. Applied digital technology is supporting independence in a number of different service lines. Tracing its roots to Elwyn’s groundbreaking use of technology for peo-ple who are blind and visu-ally challenged, digital technol-ogy is now enabling people with a number of sensory and developmental challenges to improve com-munication and promote independence. Digital hearing aids are fitted and used by hundreds of people through Elwyn’s Audiology Clinic. Genetic technology is enabling the development of targeted pharmaceuticals for specific neurodevelopmental syndromes. Likewise, the “new technology” is integrated into the functioning of Elwyn’s educa-tional, work and residential services in many ways. Technology increases the ability to communicate and pro-motes a safer environment

through digital security and infor-mation systems. Technology is also being

used in ways that foster community integration and workplace efficiency. Grace Pharmacy, Elwyn’s Commercial Laundry and Bandage Production facilities are on the cutting edge of the use of technology to pro-mote efficiency and the integra-tion of people with disabilities into the workplace. While the technology revolution has impacted the way Elwyn de-signs and implements supports

for people with disabilities, it has also greatly impacted the way these supports and services are

documented and billed. With the continued imple-mentation of the Affordable Care Act, integration among currently disparate United States support systems such as Health, Behavioral Health and Intellectual Disability is crucial. Fiscal incentives and the very ability to deliver services will necessitate a state of the art information handling system. This sys-tem has many components and includes the ability to monitor, track progress and integrate across service lines and payers.

It is now crucial for all disciplines and departments to be able to quickly communicate and digitally share information about individuals. Elwyn continues to be ahead of the human services curve in developing and implementing programmatic and fiscal information systems. Such an integrated information system will be the means by which seamless supports are delivered, progress is tracked and reimbursement is obtained.

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Elwyn’s “NEW” Technology

ARTICLE PAGE Technology 1 From the President 2 Technology for Security 2 Educational Technology 3 eShare 4-5 Bandage Production 6 Nefi’s iPad 6 Aquaponics 7 Targeted Pharmaceuticals 7 ECL 8 Calendar of Events 8

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