Transitioning from the acute sickness model to a prevention model in long term care using non-invasive computer monitoring
This entry has been selected as a finalist in the
Innovations for Health: Solutions that Cross Borders competition.
Volunteers of America est une ONG de services à la personne qui vient en aide à plus de 2 millions de personnes dans plus de 400 communautés à travers 46 états.
About You
About You
About Your Organization
Organization Name
Volunteers of America
Organization Website
Organization Country
United States, MN, Eden Prairie, Hennepin County
Country where this project is creating social impact
United States, MN, Several cities in Minnesota, Colorado, Iowa, Arizona and Vermont, Hennepin County
Is your organization a
Non‐profit/NGO/citizen sector organization
How long has your organization been operating?
More than 5 years
Has the organization received awards or honors? Please tell us about them
References - Please provide two references with a two-sentence biography, email address, and phone number for each
Wayne Olson is the Senior Vice President of Healthcare Operations and Development for long term care at Volunteers of America. Mr. Olson is a visionary who continually works to improve efficacy of efficiency of healthcare cost and quality.
wolson@voa.org
(952) 941-0305
Phyllis Stengal is the Director of Home Based Services for Volunteers of America. Ms. Stengal is a leader in developing best practices for older adults to age in place with decades of clinical and corporate experience.
pstengal @voa.org
(952) 941-0305
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Innovation
Select the stage that best applies to your solution
Established (past the previous stages and has demonstrated success)
How long have you been in operation?
Operating for 1‐5 years
The Need: What problem are you trying to solve?
In the USA, the older population (≥65) was 40 million in 2010 and is projected to be 72.1 million in 2030; in this population, 1/3 will experience a fall (1). As older adults transition to long-term care (assisted living and nursing homes), falls continue despite having integrated environments and professional staff. In 2008, 19,700 adults died related to fall injuries; there were 2.2 million nonfatal falls in 2009 with 581,000 hospitalizations—the resulting medical cost rose from $19 billion in 2000 to $28.2 billion in 2010 (2). Chronic and neurological disease further complicates this. Due to limited funds in healthy aging and Medicare/Medicaid services, it is crucial to devise practical measures to stop and regress the exorbitant costs and high death rates.
The Solution: What is your solution? Be specific!
In long-term care, the solution is a simple, noninvasive system of sensors and software that gathers and measures data on a secured server, accessed by professional caregivers. Using a system of wireless sensors from the WellAWARE corporation, clinical staff amass clinical and daily performance data on specific activities of daily living, including: sleep, heart rate, respiration, toilet visits, showering and movement in room, 24 hours a day. No cameras or microphones are used to maintain independence and privacy. From the data, analytical software compiles trends to give a baseline for each person. Professional staffs review data daily to address quality of sleep and emerging health conditions like urinary tract infections, bacterial/viral infections and poly-pharmacy issues to reduce falls. The impact of this novel solution has been proven in a clinical setting. It has the potential to revolutionize long-term care nationwide to help older adults age without fear of falling.
The Model: Walk us through a specific example of how your solution makes a difference; include your primary activities
Our mission is to transition from a sickness model to a prevention and wellness model of care in long-term care using non-invasive sensor monitoring to reduce falls and increase the quality of life for older adults. We can monitor safety, disease processes, pain and medication management to proactively intervene when issues develop over the course of days or weeks. Changes in a person’s baseline activities and behaviors tend to sync with disease processes to provide information for a proactive, preventative care model to reduce risks of falling and ensure success for aging in place. The implementation of the WellAWARE system has been installed and piloted in 6 assisted living residences and 5 skilled nursing facilities. The result of the multi-site pilots in Minnesota and Colorado has produce astonishing results. Within three months of implementing the WellAWARE system in a busy skilled nursing facility in Colorado, there was a 66% reduction in monthly falls, from 9 to 3. In addition to the effectiveness in fall reduction, the data mined from the sensors has fostered vital insight into sleep patterns for each resident—it allowed front line staff to tailor pain medication closer to 3 resident’s bedtimes to increase longer and restful sleep, prevented increases in 4 potential urinary tract infections and reduced caregiver stress on staff by evincing residents who could not re-position themselves during the night, who in fact could. This model can blossom into a national prevention medical model to impact the lives of older adults in long-term care.
The Marketplace: Who are your peers and competitors? Identify others also working to address the needs you are and what differentiates you from them. What challenges could these players pose to your success or growth?
To date, we are unaware of any partnering organizations or competitors who are advancing work in this frontier of prevention and productive aging. Good Samaritan Health System has begun to look at this technology and may implement it in assisted living facilities. Volunteers of America advocates to be an innovator of integrating this concept in long-term care as evidenced by our multi-site and state pilots and potential expansion into all facilities. We have created several models: (I) prevention, (II) risk factors for aging older adults, (III) measuring the relationship and success of this program, (IV) multifactorial overlapping domains of caregivers, the older adult and monitoring system (models provided in media section). No one else is addressing this issue in this concerted manner.
This Entry is about (Issues)
Social Impact
Founding Story: We want to hear about your "Aha!" moment. Share the story of where and when the founder(s) saw this solution's potential to change the world.
The Executive VP of Operations for VOA, Wayne Olson, has had the forethought and belief in this technology from the beginning thus, committing to the installation of this technology into all of the VOA/NS skilled nursing facilities at not cost to the residents. He attests that if this technology is effective in the assisted living setting, why would we not utilize in our skilled nursing facilities. It has the potential to increase the quality of life for our seniors in any living situations. We aver this has the potential to change the world; we do believe it has the intrinsic capability to forever change the future of healthcare, allows older adults to safely age in place and the ability to reduce billions of dollars resulting from falls annually. We believe the feasibility and unique role of this technology makes a novel solution to this problem.
Please describe the goal of your initiative; outline what you are trying to achieve
The Institute for the Future of Aging Services reports aging adults with neurological conditions including memory loss do not often have insight or cannot self-report changes in daily health. Staff, family or friends who deliver care are responsible for noticing the changes and coordinating care delivery (3). Our goal is to create a sustainable and replicable model of prevention monitoring to reduce accidental falls to less than 10 percent based on national statistics and improve the quality of life of older adults. Our long-term goal is to have this technology present in long-term care facilities and homes of older adults to eliminate falls. The technology exists—we will prove the efficacy and ease of use by gathering data and publishing results in peer-reviewed journals.
What has been the impact of your solution to date?
Sleep deprivation leads to increased falls, disorientation, emotive changes and overall decrease in quality of life (4). More than 65% of residents living in long term care experience clinically significant sleep disturbances (5). As mentioned, we did not anticipate how innovative and encompassing the results were. Since we piloted the monitoring system in our facilities, we have seen widespread impact across all venues of daily living beyond just fall reduction. We have noticed an overall decrease in on-set of urinary tract infections, increased efficiency of medication regime tailored to each resident, decreased skin integrity issues and an overall improvement in sleep patterns. Both the residents and staff report an overall improvement in quality of life and care from the pilot periods of 2-3 months. These results were replicable across all 11 multi-site pilots. This system operationalizes prevention based on data and fosters partnership between older adults and staff.
What is your projected impact over the next five years?
In the next 5 years, we expect noninvasive sensory monitoring to be integrated in long-term care facilities nation-wide. We recognize the import and causalities this technology holds in creating a model of preventative care and reducing costs in accidental falls and other illness. We envisage a reduction in medical expenses will nurture a networking of long-term care agencies to collaborate on a national model of preventative care to transgress the current medical model of acute management. Based on this success, cost of the technology will significantly drop and families will be motivated to implement it for older adults living with them/living alone. We acknowledge that national recognition and buy-in are two initiatives needed to impel change in practice and to impact current trends.
Winning entries present a strong plan for how they will achieve and track growth. Identify your six-month milestone for growing your impact
Identify three major tasks you will have to complete to reach your six-month milestone
Task 1
Train two staff to collect 3-month data from each pilot site using fall history/risk, scales on quality of life and depression.
Task 2
Write manuscript on technology, objective measurements and correlates of impact and success from all data gathered.
Task 3
Send manuscript for external review and submit to peer-reviewed journals post revision; Potential Journals: AJOT, JAMA & others.
Now think bigger! Identify your 12-month impact milestone
Identify three major tasks you will have to complete to reach your 12-month milestone
Task 1
Implement the WellAWARE monitoring systems in all our long-term care facilities—both assisted living and skilled nursing.
Task 2
Consult with WellAWARE Company to create a national committee to implement a preventative model of care for long-term aging.
Task 3
Collaborate with researchers at Washington University School of Medicine and Brown School of Social Work to look at efficacy.
Sustainability
Tell us about your partnerships
VOA has community and corporate partners. For this initiative, we have already partnered with WellAWARE systems; they have various partners including, Good Samaritan Society, Eden Alternative, Phillips lifeline and Blue Highway. We have also initiated conversations with Washington University School of Medicine (WUSM) for collaborative research on reliability and validity of this project and national implementation. WUSM is currently ranked 4th in research and 2nd in academic rigor according to US News and World Repot. Our partnerships will be a force to change healthcare in America.
Are you currently targeting other specific populations, locations, or markets for your innovation? If so, where and why?
The first phase will target older adults in 14 long-term care VOA facilities nationwide; then we hope to bifurcate to all non-VOA long-term care in the US. By partnering with WellAWARE systems, we can expand to other partners and present the results and its efficacy. This will require multi-site, national collaboration between non-profits and for-profit organizations. Another promising market is the government. The Affordable Care Act plans to improve preventative health coverage in state Medicaid programs in 2013. This serves as a fertile venue to approach and launch on a national scale (6).
What type of operating environment and internal organizational factors make your innovation successful?
We aver this innovation is a groundbreaking success based on extant analyzed pilot data. We need to demonstrate the efficacy of the intervention and its potential to revolutionize long-term care nationally. Our company has invested substantial capital in this technology with 11 pilot sites across 4 states. We believe it is the future of preventative care and healthy aging. We have begun discussions with Washington University School of Medicine about its potential implications and they are willing to collaborate pending an expanded, galvanized data set with results. Washington University is a leader in healthcare and would be a crucial ally, thus we are confident that upon validation of this model and technology, we can move to discussion with other agencies for national implementation.
Please elaborate on any needs or offers you have mentioned above and/or suggest categories of support that aren't specified within the list
The work we are proposing has never been done in practice, research or academia and is perhaps the most novel. With soaring healthcare costs and a burgeoning population of older adults change is imminent now. This grant would be invaluable in proving the efficacy of this innovation. We already have the plan, support and network, but are lacking the funds to impel the process.
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| institute_of_medicine_disability_model.png | 143.13 KB |
| global_population_growth.png | 53.02 KB |
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| comp_model_details.jpg | 99.3 KB |
| risk_factors_for_older_adults.jpg | 74.73 KB |
| comp_model_measures.jpg | 92.04 KB |
 | 66 weeks ago Ganesh Babulal updated this Competition Entry. |
| 66 weeks ago Ganesh Babulal updated this Competition Entry. |
| 67 weeks ago Ganesh Babulal updated this Competition Entry. |
| 67 weeks ago Ganesh Babulal updated this Competition Entry. |
| 69 weeks ago Ganesh Babulal updated this Competition Entry. |
| 71 weeks ago Ganesh Babulal updated this Competition Entry. |
| 71 weeks ago Ganesh Babulal updated this Competition Entry. |
| 71 weeks ago Ganesh Babulal updated this Competition Entry. |
| 71 weeks ago Ganesh Babulal updated this Competition Entry. |
| 71 weeks ago Ganesh Babulal submitted this idea. |
