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Where digital health and seniors meet: An interview with Dr. Wen Dombrowski

December 27, 2013 10:49 am by | 11 Comments

elderly mobile health ipadAt first thought, seniors and digital health technology don’t exactly seem to go hand-in-hand. For some of the 65+ population, just learning to use a computer can be like learning a foreign language, and less than 20 percent of U.S. seniors use a smartphone.

But Dr. Wen Dombrowski, CMIO and vice president for connected health at VNA Health Group, thinks that just because someone is older doesn’t mean they can’t use the Internet or mobile technology. It just means that what they’re using needs to be better designed to accommodate their needs.

A geriatrics physician by training, Dombrowski now works with VNA Health Group on collaborating with industry partners and technology companies to identify new tools that could improve care delivery and promote better outcomes for the group’s patients. VNA Health Group is the largest nonprofit visiting nurse association in New Jersey that provides home care, hospice and community health services.

Broadly speaking, she sees two worlds of technology coming into play here. The first is information sharing and analytics — the kind of behind-the-scenes technologies that hospitals are using to store and analyze electronic data and coordinate care between facilities. Long-term care and home care are lagging dramatically here because they were left out of the meaningful use program and aren’t eligible for federal incentives for using EHRs.

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“It’s pretty sad because if you look at (the costliest) Medicare patients, they’re elderly, disabled patients often requiring home care or long-term care,” she said. “We recognize that there’s a lot of opportunity to innovate care for these patients. I think a combination of technology on the healthcare side and on the consumer side could help manage these high-risk populations.”

As baby boomers age, there simply won’t be enough people, money or ways to take care of all of them effectively, she said. That’s where the consumer technology - telemedicine, sensors and apps - could really make a difference.

Much of the innovation here will likely come from the consumer market, in terms of miniaturizing sensors and creating a great user experience, she said. Then it will be up to healthcare companies to adapt those technologies to be used by seniors.

The problem she’s seen with that so far is that some sensors and apps try to address the senior population as one homogenous markwen dombrowskiet, when really it comprises endless sub-populations of people with varying literacy levels, functional statuses and cognitive abilities.

“With medication management, for example, there are generic all-in-one apps for someone with memory problems, but they don’t segment the population well,” Dombrowski explained. Someone with mild dementia would likely have different needs for reminders than someone with full-blown Alzheimer’s.

Then there are a few universal design principles that should always be, but aren’t always, considered when designing a product for seniors. For example, an app or website that uses 8-point fonts would be just too hard to read. And, a lot of older adults might have arthritis or inflammation in their fingers, so their ability to touch or manipulate things is different than the average cell phone user’s. They might need to use two or three fingers or different motions to complete a task.

“Sometimes entrepreneurs are designing things with a theoretic customer in mind; I encourage people to actually spend some time with those users,” she said.

The good news is, the startup community seems to be catching onto the need to connect technology companies with seniors. StartUp Health struck a collaboration with AARP earlier this year to support entrepreneurs in realizing what seniors really want in new products. And a new Bay Area accelerator called GENerator provides funding and support for startups developing solutions to improve long-term care or enhance the lives of older adults.

In the future, Dombrowski sees uses for more sophisticated gadgets in senior care — for example, robots that could automate some of the more basic duties of a nurse assistant and allow her to work more at the top of her skill level.

“The concept of internet of things is also very exciting — combining sensors with computing,” she said. “I think there’s a lot of very interesting use cases for pairing a motion sensor with gesture and voice, and to really make monitoring less intrusive. Right now to many people it’s kind of science fiction, but there are some very interesting IOT technologies that I think will become more widely available.”

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Deanna Pogorelc

By Deanna Pogorelc MedCity News

Deanna Pogorelc is a Cleveland-based reporter who writes obsessively about life science startups across the country, looking to technology transfer offices, startup incubators and investment funds to see what’s next in healthcare. She has a bachelor’s degree in journalism from Ball State University and previously covered business and education for a northeast Indiana newspaper.
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11 comments
3dPrintingWeek
3dPrintingWeek

Hello Wen:  Nice story, it is great to see this often-neglected segment of the population looking out for their interests.

Overall, I think this segment of geriatrics will be more plugged into healthcare than before.  They will be more monitored with sensors, even better than refridgerators are now!  Fevers will be picked up quicker, hypotension, wandering AMA, hypoxia, arrhythmias all this data can be picked up quicker.

In addition, the relationship between nurse practitioners and doctors will improve with telemedicine.  The doctor can speak face to face with the nurse practitioner, and focus on problem patients, and even see the patient, if needed.  Less, "Oh, send them to the ER for evaluation" and you know how much that costs.


best


john bennett md


P.S  I am even preparing for my Golden Years; I bought the domain name,


www.geezermd.com


because like RateCEdotcom, my mind, as well as other MD's, may be sharp, and be able to give a word or two of advice to these young whippersnapper MD's, who may spend too much time with the computer devices, and not enough with the patients.

HealthcareWen
HealthcareWen

Dear Dr B,


I love your example, thank you for sharing about your experiences!  It highlights the point I frequently reiterate -- that seniors should not be treated as one homogeneous market, when really it comprises of micro-segments of individuals with varying levels of literacy, physical function, cognition and tech savvy-ness.  Products should be tailored to specific segments' needs.

I also frequently advocate that technology use is not limited by age per se, but based on individuals' interest in exploring tech, their learning agility, and each product's usability (whether gadget or site is designed to be user-friendly).


Thanks again for sharing about your entrepreneurial work with http://www.ratece.com .  Best wishes to you in the new year!


Wen 


WayneCaswell
WayneCaswell

Market researchers get so caught up in the business opportunities of serving the aging baby boomer market that they seem to use the term "Senior" to refer to anyone over age 65 and now Medicare-eligible, but what of those who are 75, 85, 95 and older? When industry and government follow suit, what's a real senior with no PC or Internet access to do with their electronically deposited Social Security "check," and how are they to get health care in the future when more doctor visits go online? (http://www.mhealthtalk.com/2013/11/tech-adoption-by-real-seniors/)

A few months ago I spoke to about 40 "Real" seniors at a nice assisted living facility here in Austin on Moore's Law And The Future Of Healthcare. Not one person in the audience used a PC or owned a smartphone, so I promoted the Apple iPad for its extreme ease of use, relatively large screen size, accessibility features, ability to access the Internet from anywhere, and do FaceTime video calls with family, friends, and the doctor once he gets on board.

The iPad initially required a home network and PC, but now with iCloud and a cellular connection, no PC skills are needed, and no PC either. It's well suited for seniors age 82 just as it is for toddlers age 2, but tech adoption and Internet access by real seniors is still low, although RateCEdotcom (who commented below) is an obvious exception. (http://www.mhealthtalk.com/2011/06/ipad-for-all-ages/)

Jane Bardwell
Jane Bardwell

I am a 62 year old woman, self taught in computer graphics and IT, who has developed a scheduling and monitoring tool with the potential to revolutionize life- and health-care for seniors and others with short term memory impairment. This system, CUE YOU, uses a website in conjunction with an app for Apple mobile devices. A 'caregiver' - either an allied services professional or family member - creates, updates and monitors a schedule of detailed reminders and messages illustrated with video (for instance a rehabilitation exercise), audio or images (photo of a medication) that are then delivered to the impaired person's Apple mobile device in real time. Accessibility features built into the device accommodate a range of physical limitations.


The message recipient receives an alert and message preview when a reminder arrives. A swipe of the screen opens and plays the message; tapping 'I got it!' sends an acknowledgement to the website where the caregiver can monitor compliance. Additional options include a one touch phone dialer programmed by the caregiver and a 'Critical Message' alert that texts the caregiver if a critical message is ignored.


Inexpensive and easy to use - CUE YOU can make a real difference in care and safety. www.cueyoultd.com


RateCEdotcom
RateCEdotcom

I'm 77 years old, I am fortunately healthy and mentally capable (so far). I develop and code web sites, I am an advanced user of Photoshop and Lightroom and an ardent photographer. I use a smartphone (and try to code apps). I am in process of launching a new startup site for rating and reviewing dental continuing education.  Last year, I sold a web based business that I started in 2008 to a larger company. Yes, there are seniors whose computer needs are basic, but, please, don't make generalizations about what "older adults" can and cannot do and what our needs are. We can be and are those entrepreneurs.

Anonymous Guest
Anonymous Guest

I agree with you. Articles, speech and implications that seniors are "inept with technology" are no different than saying a "(selected minority) is lazy".

Most articles written about "seniors" treat our group like we are all a bunch of feeble technology illiterates. Such profiling is no longer acceptable in our society. Look what happens to Paula Deen and Duck Dynasty when generalizations and stereotypes are made about people.

Seniors are no different than any other segment of the overall population: we are retired scientists, engineers and IT specialists as well as other professions.

Do treat me (or others) as though we're unable to use a touch screen when we can design one. Don't presume that just because we're 65+ we can't develop patents for new applications using mobile technologies.

If we Seniors hadn't supported the evolutionary development of these technologies in the first place, they wouldn't exist. And as we learned as scientists, engineers and IT professionals, our interests result in continuous lifelong learning.

I suppose the lesson here is that journalists are idiots, eh?

RateCEdotcom
RateCEdotcom

@Anonymous Guest Hey Journalists, get off my lawn! ;-)

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