Medication Management Technology Can Improve the Lives of America's Elders

5/31/11 By David Lindeman

One of the most significant challenges facing the population of more than 130 million Americans who are older and who have chronic conditions is that of optimizing use of medications, or med-op.

Typically, med-op involves medication reconciliation (eliminating discrepancies in medication records), adherence (following recommendations) and monitoring patients’ response to medications. A variety of technologies and tools to address these three areas are now on the market.

In 2009, the Center for Technology and Aging saw an opportunity to improve medication adherence through med-op technologies, and made five one-year grants to the following healthcare organizations: the Veterans Administration of Central California Health Care System; Visiting Nurse Service of New York; the Connecticut Pharmacists Foundation; the American Society of Consultant Pharmacists Foundation; and Caring Choices.

Each group partnered with other community agencies to provide hands-on support to older patients and their families, and their physicians and caregivers. The two-fold goal was to improve these elders’ independence and help them avoid medication-related issues that could result in harm, hospitalization or higher healthcare costs.

The grantees, working with pharmacists, physicians and other clinicians and caregivers, deployed technology that included a computerized medication dispenser that helps patients take medications properly (these devices organize medications into a plastic cup or drawer and dispense them at a certain time); home-monitoring tools that collect data from multiple devices, such as weight scales and blood pressure cuffs, and communicate the information to a health tracking service; and Web, video and spoken-counseling support tools that enable providers to better assess and manage medications for complex medical conditions, or to overcome cultural and language barriers.

Positive Project Outcomes

The grantees’ hard-won knowledge now is available to help other organizations adopt and effectively use available technology tools. Across the five grant programs and with the hundreds of patients involved, technologies were used to supplement, enhance and improve the effectiveness of personal interaction—not replace it.

Thomas Buckley, grant project director for the Connecticut Pharmacists Foundation, revealed that patient empowerment was among the project’s most compelling outcomes. Buckley noted that dealing with patients’ medication issues was so essential to peoples’ well-being and daily life, that it became an avenue for patients to open up about their health, symptoms and related concerns. “They felt more in control of their lives,” he said.

The Connecticut program partnered with Khmer Health Advocates, which has been providing medical care and advocacy for Cambodian victims of torture since 1981. While these individuals’ traumatic life experiences and cultural barriers present unique and difficult circumstances, director of programs Mary Sullivan says their self-esteem and sense of life purpose improves dramatically when “we work with them respectfully and intelligently.” She said a light would often go on when a patient could understand their medications’ purpose, was given the tools to remember how and when to take them, and was monitored regularly by a caregiver.

Technology Can Improve Health and the Bottom Line

The national urgency to improve the health status of all Americans, and rein in costs through efforts such as Accountable Care Organizations or patient-centered medical homes, emphasizes the twin goals of increased patient responsibility and self-management. Medication optimization is one of the surest paths to accomplishing these goals.

The Center is working closely with these and other grantees on the next critical learning step: how to successfully situate and integrate these successful medication management technologies within a rapidly changing healthcare environment—a landscape marked by severe cost and resource constraints.

Through these projects, organizations are learning what tools providers, health plans, regulators and policymakers need in order to bring beneficial technologies to scale. There are considerable challenges to finding these adoption and readiness strategies, but the potential benefits are enormous.

Reprinted with permission from Aging Today Vol 32:3 , May-June 2011. Copyright © 2011. American Society on Aging, San Francisco, California.

Important mHealth Dates

Optional Applicant Conference Call March 15, 2011

Letter of Intent Due
April 5, 2011

Full Grant Proposal Guidelines Released April 13, 2011

Full Proposals Due
May 13, 2011

Final Grant Award Decision
June 15, 2011

Expected Date for Grants to Commence August 1, 2011

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