Telehealth Intervention Programs for...

Telehealth Intervention Programs for Seniors

TIPSTIPS FELLOWS PROGRAM ORGANIZATIONAL MEETING

PACE UNIVERSITY GRADUATE CENTERAPRIL 24, 2014

Mae Carpenter, Commissioner

Colette Phipps,Research Analyst

Westchester County Dept. of Senior Programs & Services

Telehealth Program Recap:NYC & Westchester Partnerships

David Sachs, Professor, IT, Pace University

Jean F. Coppola, Assoc. Prof, IT, Pace University

John MigliaccioTIPS Project Consultant

What is TeleHealth?

Use of Electronic Info & Communications Technologies to Provide & Support Health Care When Distance Separates Participants (Inst. of Medicine) Remote Patient Monitoring (RPM) Ambient Intelligence

– Home Sensors Telemedicine

Telehealth Pilot Project Timeline

CommunityPartner

Semester # OlderAdults

Hallmark Spring 2013 22Isabella Geriatric Fall 2013 32

Grant Street Fall 2013 38

My Second Home Fall 2013 12Shore Hill (Brooklyn) Fall 2013, Spring 2014 33

United Hebrew Spring 2014 24Wartburg Spring 2014 18

WPHA Spring 2014 16

Telehealth Objectives

Increase quality of care

Expand healthcare access

Reduce healthcare costs

Wellness for Older AdultsUsability and Benefits of

TeleHealth

Original Research QuestionsCan seniors learn

TeleHealth?

Are they willing to do it?

Does it help patient education?

Can they learn to do it themselves?

Methodology

Telehealth System

Health Data Inputs Telehealth Monitor

Weight

Blood Pressure

Blood Oxygen

Temperature

Pain Levels

MedicationsBlood Glucose

Questions

Clinician Dashboard

Health DataSecurity and Privacy Tablet/Web Portal: Secure Login/HTTPS Privacy: HIPAA Training & Certification Consent: Participant Enrollment Forms Data: Anonymous Participant Names Protection: Three Layer Firewalls

I. Watchguard Enterprise FirewallII. VMware FirewallIII. Windows Firewall

NYC Pilot Program

250+ Applicants

Vital Care partners with Pace University

Winner of funded 6 month pilot study

Pilot ObjectivesReduce healthcare

costs with evidence based interventions

Manage chronic diseases & prevent

hospitalization

Enable medical technology in

homes for aging in place

Train future working

professionals at University level

Pilot Design

Training

• Train Pace University student technicians and graduate RN’s• Enroll participants in community partner locations

Monitoring

• Collect health data 2 times a week at community locations• Provide individual health assessments remotely

Analysis

• Evaluate Health outcomes, Patient engagement, and Adherence• Report three and six month research analysis to NYCEDC

July -> August

August -> December

August -> December

Washington Heights, Manhattan (NORC)

32 patients1 student technician

Populations Served

Bay Ridge. Brooklyn (Low Income Housing)

33 patients2 student technicians

Battery Park, Manhattan (IL/AL)


Lower East Side, Manhattan (NORC)


Future Research

Healthcare Coverage & Costs, i.e., ER visits, etc.

Hospital Re-admissions

mHealth, esp., SmartBands, Language Translators, Mood/Depression, etc.

CARE CIRCLES OF WESTCHESTER –STEP FORWARD & GIVE BACK

CARE CIRCLES GUIDEMission and Purpose

Our Mission:

To create communities of people who volunteer to step forward and give back to older adults.

Our Purpose:

To provide caregivers AND TIPS participants with support and assistance through task-sharing to meet the desire of older adults, to age in their own homes by developing volunteers to work together to serve their needs. .

4/30/2014 CareCircle Guide Training18

CARE CIRCLES GUIDETable of Contents

TABLE OF CONTENTS

Caregiver Coalition Members

About the Caregiver Coalition

Caregiver Coalition Member Agencies Mission

SECTIONSSection 1: Care Circles and How They WorkSection 2: How to Create Care CirclesSection 3: How to Maintain Care Circles


CARE CIRCLES GUIDETable of Contents (Cont.)

Section 4: Charts & TemplatesCare Circles of Support ServicesDescriptions of Care Circles Support ServicesCare Circles Support Services TemplateWhere to Find Care Circles Members Care Circles Member Schedule SampleCare Circles Member Schedule TemplateSenior Programs & Services Service PyramidWestchester County Regional MapLivable Community Connection Sites


CARE CIRCLES GUIDETable of Contents (Cont.)

Section 5: General Information for Caregivers

How to Handle EmergenciesCaregiver QuizCaregiver Bill of RightsSafety FirstChanges that Occur as People AgeWorking with a DoctorAging and AlcoholOlder DriversElder AbuseImportant Legal Documents


Who Forms a CareCircle?

CareCircle Keeper – the primary or central caregiver who manages and coordinates what the CareCircledoes

CareCircle Members – Volunteers who perform caregiving tasks for the older adult

Older Adult - the person who receives the care


Circle Keeper(s)

Circle Member

Circle Member

Circle Member

Older Adult

An example of How a CareCircle works:John Smith, an older person, lives alone in his apartment. His son, Barry, lives about five miles away.

Over the years, John has made a number of friends who are willing to assist with his care. Barry welcomes this help because he has his own family to care for and a full-time job. He also knows his father feels comfortable accepting their help.

Among those neighbors is Mary, who can cook for John two day a week. David, another neighbor, has offered driving assistance. Thanks to this help, Barry gets some relief and does not have to visit his father every day.

They all decided that they could best care for John by creating a formal CareCircle. As the CareCircle Keeper, Barry arranges for and manages the volunteer services that will enable his father to continue to live at home. As a result, Barry is also to have some respite from his many responsibilities. He is also the main contact for the volunteers and the tasks they will provide.

For example, Mary can help with cooking meals; David, with transportation. As the CareCircle Keeper, Barry maintains a list of the CareCircle members and the services they provide on particular days and times.

It is Barry’s responsibility to see that each CareCircle Member receives that calendar. He also maintains a list of the telephone numbers, addresses and emails of those members. 23

By forming a Care Circle You Will:

Foster the notion and practice of neighbor helping neighbor Increase wellness Reduce isolation Make a significant contribution to communities Meet unmet needs Lessen or eliminate the need for paid caregivers


Caregiver/TIPS Care Coaching Program

Westchester County

There are only four kinds of people in the world –

Those who have been caregivers -

Those who are currently caregivers -

Those who will be caregivers and those who will need caregiversRosalynn Carter,

Former First Lady and President of the Board of Directors, Rosalynn Carter Institute for Caregiving

There are approximately 33,000 caregivers caring for loved ones 60 years of age and older in Westchester County

TIPS Participants can learn from the caregivers coaching program –TIPS care coaching is for people who want to be proactive about their overall health


Caregivers/Care Coaching Program

Service delivery through Volunteerism

Helps informal caregivers/TIPS participant make more informed decisions

One-on-one support for informal caregivers and TIPS participants

Volunteers trained by professionals in aging


Three day training program12 Hours Total

Prepare volunteers to be Caregiver/Care Coachesto provide support and information to family caregivers

Manualized training protocol Methods used: Lecture Role plays Simulation Case scenarios

Chronic Disease Self-Management Program (CDSMP)

Addresses the needs of Westchester residents age 60+, 90% of whom have multiple chronic conditions (such as asthma, diabetes, hypertension, depression, & arthritis)

6-week workshops/weekly 2 ½ hour sessions Highly interactive; co-led by certified Peer Leaders Topics include: healthy eating, physical activity, the mind-body

connection, emotions, how symptoms are related, communication with health care providers, & managing medications

Positive outcomes for participants are evidence-based & cost-effective

Developed at Stanford University’s School of Medicine

TIPS: Better Health at Your FingerTIPS

“The only thing that’s going to let us deal with

our aging population is technology.”

– Mae Carpenter

John Migliaccio, Ph.DTIPS Project Consultant

TIPS Fellows –TIPS Model

• Active Telehealth,or Planned < 9 months• Self-sponsored sites• TIPS Model: TIPS

RPM via VitalCareServices + Care Circle Services, etc.

• TIPS Metrics and Data

• Alternate Delivery models

TIPSFELLOWS

TIPS Fellows –Independent

• Active Telehealth, or Planned > 9 months

• Self-sponsored sites• TIPS Model or

Independent model• TIPS Metrics & Dataor Independent

Metrics & Data

TIPS Fellows – Grant Sites*• 10-WC/ 5-PA• Meet all TIPS Grant criteria• TIPS Model, Target clients• TIPS Metrics and Data

* Grant Pending

“Ideal” Client – Grant first priority

• 65+ & At/under 150% of poverty • $17,505 (1); $23,595 (2); $29, 685 (3)

• 2+ chronic health conditions (COPD; heart; hypertension; diabetes…)

• Supportive, independent congregate housing/affinity setting

• Hospital/ER within past 12 months• Prior <30-day hospital readmission• 45 eligible clients per site

Other acceptable clients

• Over 150% poverty level

• Non-targeted chronic health conditions

• Independent, community dwelling

• No Hospital/ER within past 12 months

Target clients for TIPS –Grant and TIPS model

Data and Metrics• Extensive Intake

• Health conditions• Hospital/ER

admissions• Caregiver Information• NYS COMPASS

required information

• Ongoing data collection• RPM clinical / medical• Social wellbeing• Intergenerational

Attitudes• Seniors’ attitudes

about technology

Evidence-based Results

• Training• Technical

Assistance• Care Circles• Caregiver Support

Circles/Coaching• Chronic Disease Self

Mgt.

• Webinars• Seminars• Information sharing• Supportive services• Research• Courses / Certificate

Advantages forTIPS Fellows

Comments / Questions?Please contact us for collaborations!

Dr. David Sachs, Pace University [email protected]

Dr. Jean F. Coppola, Pace University [email protected]

Mae Carpenter, CommissionerWestchester County Department of Senior Programs & Services

Colette Phipps, LMSW Westchester County Department of Senior Programs and [email protected]

Dr. John Migliaccio,TIPS Fellows Consultant [email protected]

Telehealth Intervention Programs for...

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