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)
22 patients1 student technician
Lower East Side, Manhattan (NORC)
38 patients1 student technician
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
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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
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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
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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
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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
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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
Caregiver/TIPS Care Coaching Program
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
Caregiver/TIPS Care Coaching Program
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]
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