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

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，在这个项目中，我们将开发HealthCare Manager，这是一个使用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，例如知道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。具体来说，拟议的HealthCare Manager系统是一种便携式医疗保健支持系统，可为家庭医疗保健方案的每个组成部分提供基于时间的提示以及录制的音频、视频和基于图片的说明。HealthCare Manager提供了要提供给每个人的特定服务的基本、一致的中央信息源，并将提供用于远程监控的接口。项目完成的任务结构包括1)初步系统需求开发，2)原型设计和开发，以及3)与Westchester人类发展研究所合作进行现场测试，以确定HealthCare Manager提供的方法的技术优点和可行性，以提高老年人和家庭护理人员自我护理的一致性和准确性，从而减少家庭医疗保健提供者所经历的压力和疲劳。最后，将评估该系统改善远程监测和医疗保健专业人员提供老年人个人健康监督的时间表更新能力的能力。

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 an 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 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. Specifically, the proposed HealthCare Manager system is a portable health care support system that provides time-based prompting along with recorded audio, video and picture-based instructions for each component of a home health care regimen. HealthCare Manager offers an essential, consistent, central source of information on the specific services to be provided to each individual, and will provide interfaces for remote monitoring. The task structure for project completion includes 1) preliminary system requirements development, 2) prototype design and development, and 3) field testing in partnership with the Westchester Institute for Human Development to determine the technical merit and feasibility of the approach offered by HealthCare Manager for improving the consistency and accuracy of self-care by seniors and family caregivers, therefore reducing stress and fatigue experienced by family health care providers. Finally, the ability for the system to improve remote monitoring and schedule update capabilities of health care professionals providing oversight to the senior's personal health will be assessed. PUBLIC HEALTH RELEVANCE: This project will result in the HealthCare Manager, a software system for improving consistency and quality of implementing home health care regimens for seniors living in their own homes. The system will consist of a simplified player module used by seniors to receive notification of scheduled health related activities such as taking medications and performing home health therapies, and a web based module to allow caregivers to 1) remotely update the schedule and multimedia instruction sets used by the senior, and 2) to receive health care regimen adherence feedback. A prototype system will be developed in Phase I and tested with 32 subjects by AbleLink's project partner, the Westchester Institute on Human Development.