iage: PERSONALIZED TECHNOLOGIES FOR FACILITATING HEALTH, WELLNESS AND SUCCESSFUL AGING

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1 iage: PERSONALIZED TECHNOLOGIES FOR FACILITATING HEALTH, WELLNESS AND SUCCESSFUL AGING Binh Q. Tran, Ph.D. Director, HomeCare & Telerehabilitation Technology Center Department of Biomedical Engineering The Catholic University of America

2 Overview Societal Need/Relevance: Growing aging population worldwide: In U.S., 43 million (13.7%) > 65 y.o. ~80 million (20%) by 2040 Half have at least one disability and one-third reported severe disability Health care costs is approx. $2.9 trillion/yr or 17.4% of GDP (35% by Medicare/Medicaid). Successful Aging: (fr. MacArthur Fdn Studies) Avoiding disease and disability Maintaining high cognitive and physical function Engagement with life I. Stable Phase II. Significant Decline

3 HomeCare & TeleRehabilitation Tech Center HCTR Mission: Design, build, and test prototype technologies potential solutions to facilitate successful aging and independent living Evaluate and assess efficacy of technological solutions in the field, esp. for underserved populations (i.e. low income, minority, etc.) Key Projects: Clinical Edgewood Terrace: (senior low-income community in DC) Develop and assess home-based strategies for delivery of health care services and management of chronic illness Develop and integrate mobile, wearable sensor technologies for assessing health, wellness, and function (both physical and cognitive). Consumer SmartHome Toolkit: Develop and deploy technologies for low-cost environmental and activity monitoring of at-home residents for measuring activities of daily living (ADLs).

4 Clinical Edgewood Terrace Edgewood Terrace (ET) III-Senior Bldg First wired low-income housing facility in U.S.,200 units dedicated to low-income seniors High prevalence of chronic illness 53.7% residents high blood pressure, 29.3% diabetes Clinical estorefront Concept: estorefront: electronic storefront connecting residents to clinicians Telehomecare = Monitoring + Virtual Visits Intervention: 3-months of daily monitoring of BG / blood pressure & weight Periodic virtual visits by telehealth nurse Results: High compliance w/daily monitoring (only 4.4% missed days for diabetics and 15% for HBP). High compliance w/ virtual visits (< 5% of missed visits) 67% self-monitored for >2 months after study conclusion Improvement in self-efficacy* in managing chronic illness w/telehomecare (*p<0.05) Positive perception of telehealth* (*p<0.05)

5 Clinical estorefront: Wearable Sensors Falls Monitoring: 1 in 3 seniors will fall each year Incidences lead to fractures of which 24% of will die w/in 1 yr Wearable inertial sensors (accelerometer, gyroscope) to detect/predict falls Goal: Implementation on smartphone device or smart clothing Cognitive Assessment In 2012, ~43.7M adults in U.S. living with mental health illness (Alzheimer s, dementia, depression, PTSD, post-concussion, etc.) Goal: Develop platform for wireless, remote, assessment of mental health and cognition.

6 SmartHomes: Consumer Toolkit Smart Homes: (CUA/CPDC) Environmental/activity monitoring of residents in their homes for ADLs measurement and predicting changes in health status Measures: Duration/activity in each room, activity relative to time of day, est. active level

7 SmartHomes: Consumer Toolkit Graphical presentations of longitudinal trends in activity Irregular activity patterns identified/flagged for tele-consult Activity Level Level 9/1/02-10/15/02 Activity Level 9/1-12/31 0 9/1/02 9/8/02 9/15/02 9/22/02 9/29/02 10/6/02 10/13/02 9/1 9/15 10/1 10/15 11/1 11/15 12/1 12/31 Normal Daily Activity Onset of Illness? Depression? Other? Date Goals: Develop low-cost SmartHome Toolkit for retrofitting existing homes Develop pattern recognition algorithms for early detection of abnormal behavior

8 Common Themes & Tasks: Telehomecare & Telerehabilitation Real-time remote communication between residents and clinicians Remote delivery of education, either self-management or exercise regimens Collection of quantifiable, digital data from home environment: Telehomecare: physiologic data Telerehabilitation: exercise data, wound images, ADL activities Where does this information go?

9 Final Thoughts: PHRs Telehomecare model: Natural synergies with personal health records (PHRs) PHRs: Pros: Accessibility, Portability Cons: Privacy, lack of standards Currently over 200 PHR companies-new tech gold rush Major players: WebMD, Microsoft HealthVault, Apple HealthKit, GoogleHealth (discontinued) HealthVault (Microsoft) Platform for PHRs & data integration Automated device recognition (BP, BG, peak flows, scales) & charting Potentially reduces cost of telehomecare

10 Acknowledgements Collaborators: Elizabeth Bertera (Social Work), Howard University Al Browne, AARP Kathleen M. Buckley, RN, (Nursing), Catholic University Jeff Jenkins, EECS, CUA Harold Szu, CUA Ellen Wuertz, RN, CPDC Partners: Funding: Dept of Commerce-NTIA (TOP Grant # I04008) DOD/Army Research Office (ARO # W911NF ) Contact: Binh Q. Tran, Ph.D. tran@cua.edu