HealthCare Manager: A Remote Medication and Personal Health Plan Support System-P

描述（由申请人提供）：随着众所周知的婴儿潮一代涌向退休年龄，这一代7800万老年人如何在越来越多的慢性疾病和认知能力下降的负担下保持尽可能的独立，这个问题变得越来越重要。在残疾老年人数量急剧增加的同时，由于经济状况和预算限制，医疗保险系统预计将继续减少服务。此外，对专业卫生保健和直接护理工作者的需求速度预计将在未来十年大大超过供应。因此，以社区为基础的残疾老年人护理将越来越多地掌握在个人自己和他们的家庭照顾者手中，他们从专业护理机构获得的指导有限。家庭护理机构面临的最大问题之一是缺乏经验或更换护理人员造成的护理缺乏一致性，以及监测健康计划遵守情况的家访费用高昂。这些不足的结果往往是，许多残疾老年人过早地被转移到限制性更强、费用更高和机构性更强的生活环境中，如果能够以更一致的方式和可预测的质量提供家庭保健，就没有必要这样做。帮助避免过早离开社区生活安排的一种方法是，利用新技术帮助改善自我指导的个人保健依从性，同时为专业护理人员提供远程健康监测工具，使老年人能够“就地养老”，同时最大限度地提高对残疾老年人的护理质量。因此，在本项目中，我们将以第一阶段的成功成果为基础开发HealthCare Manager，这是一个使用功能强大的移动计算机设备的个人医疗保健支持系统，使老年人更容易执行个人医疗保健活动，例如了解何时以及如何服用药物或遵守治疗程序，并跟踪已完成的医疗保健行动。这种创新的方法将有助于使老年人“就地养老”，最大限度地提高自我护理的一致性和质量，并避免过早地转移到机构设置。这种方法利用新技术帮助老年人进行自我指导的个人保健，同时还为护理人员和卫生专业人员使用远程健康监测工具。AbleLink的项目合作伙伴科罗拉多大学老年学中心在第一阶段开发了一个原型系统，并对32名老年人进行了可用性测试。结果为HCA系统的实用性和可用性提供了强有力的初步支持。例如，当使用HCA技术时，老年人以99.1%的准确率执行一项新任务，而事先不知道如何完成特定的医疗保健任务。此外，使用HCA系统的老年人能够在100%的时间内响应基于时间的提醒来执行特定的医疗保健任务，即使在测试期间观看自然电影的轻微分心。

DESCRIPTION (provided by applicant): As the well known baby boomer generation surges toward retirement age, the issue becomes more significant each day of how this generation of 78 million seniors will be able to remain as independent as possible while increasingly burdened by the onset of multiple, chronic, medical conditions and a decline in cognitive abilities. Concurrent with the dramatic increase in the numbers of seniors with disabling conditions, the Medicare system is expected continue to reduce services due to economic conditions and budgetary constraints. Additionally, the rate of demand for professional health care and direct-care workers is expected to dramatically outpace supply over the next decade. Consequently, community-based care of seniors with disabilities will be more and more in the hands of the individuals themselves and their family caregivers receiving limited guidance from professional care organizations. One of the biggest issues that face home care agencies is the lack of consistency in care giving caused by inexperienced or changing caregivers and the high cost of home visits to monitor health plan compliance. The result of these inadequacies is that all too often many seniors with disabilities are prematurely moved to more restrictive, expensive and institutional living environments that would not be necessary if home health care was provided in a more consistent manner with predictable quality. One approach to help avoid premature removal from community living arrangements is to use new technologies to help improve self-directed personal health care compliance along with remote health monitoring tools for professional caregivers to enable seniors to "age in place" while maximizing quality of care for seniors with disabilities. Therefore, in this project we will build on the successful results of Phase I to develop HealthCare Manager, a personal healthcare support system using powerful mobile computer devices to make it easier for seniors to perform personal health care activities, such as knowing when and how to take medications or comply with therapy routines, and to track health care actions that have been completed. This innovative approach will help enable elderly individuals to "age in place," maximize the consistency and quality of self-care, and avoid premature relocation to institutional settings. This approach uses new technologies to help seniors engage in self-directed personal health care while also employing remote health monitoring tools for caregivers and health professionals. A prototype system was developed in Phase I and tested for usability with 32 seniors by AbleLink's project partner, the University of Colorado's Gerontology Center. The results provided strong preliminary support demonstrating the utility and usability of the HCA system. For example, when using the HCA technology seniors performed a novel task at a 99.1 percent accuracy rate, with no prior knowledge of how to complete the specific health care task. Additionally, seniors using the HCA system were able to respond to the time-based reminders to perform a specific health care task 100 percent of the time, even with the mild distraction of watching a nature film during the testing period. PUBLIC HEALTH RELEVANCE: The objectives of this project are to research, design and develop HealthCare Manager (HCM), a software system for improving consistency and quality of implementing home health care regimens for seniors living in their own homes. This relates to the mission of NIH by providing a support tool that will enable seniors to perform personal health care tasks more consistently and accurately, thus promoting individual health and quality of life.