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University of Wisconsin Active Aging Research Center. National Advisory Committee Report and Update Dave Gustafson PI July 25 2012. Thank You!.

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University of wisconsin active aging research center

University of WisconsinActive Aging Research Center

National Advisory Committee Report and Update

Dave Gustafson PI

July 25 2012

University of wisconsin active aging research center



University of wisconsin active aging research center

Over 600,000 will enter nursing homes in 2012Average NH stay 893 days; $161,500/admission Total cost exceeds: $10,000,000,000.Many people do not enter poor,but they leave poor.

University of wisconsin active aging research center





Richland County

Waukesha County

Milwaukee County

Elevator speech
Elevator Speech

  • There are many good technologies, products, and online resources to help the elderly remain independent.  Few are used. 

  • Why? 

    • Disparate stand-alone products and services

    • Not proven to work

    • Not sanctioned by trusted organizations

    • Environment is not prepared to adopt, sustain and spread. 

  • ECHESS will:

    • Integrate key technologies,

    • Test them to find which parts work, with who, and how,

    • Work with communities, payers, elders, families and clinicians, to ensure that ECHESS honors the strengths and limitations of everyone. 

    • Make independence-empowering technology accessible to all.

    • Do it within a walled garden.

    • Improve outcomes including costs.

    • Reduce re-admissions to hospitals and emergency departments.

National advisory committee poa
National Advisory Committee (PoA)

  • Sandra J. Ball-Rokeach Professor, Communications, USC

  • Paul Batalden: Professor, Dartmouth Health Policy and Clinical Practice

  • Noshir Contractor: Northwestern Science of Networks Research,

  • Brian Joiner Founder Joiner Associates Inc. Quality Improvement.

  • Peter Kissinger: President AAA Foundation for Traffic Safety.

  • Adrian K. Lund President, Insurance Institute for Highway Safety.

  • Jeffrey Michael Assoc Administrator, National Highway Traffic Safety Admin.

  • Brian McLaughlin Assoc Administrator, National Highway Traffic Safety Admin.

  • Wendy J. Nilsen Administrator, NIH Behavioral & Social Science Research.

  • Kevin Patrick Professor, Preventive Medicine, UCSD

  • Susan C. Reinhard, Senior Vice President for Public Policy at AARP.

  • David Rose Innovator, Vitality LLC.

  • Vinod K. Sahney, PhD, Senior Fellow, Institute for HealthCare Improvement.

  • Andrew H. Van de Ven, Professor, Organizational Innovation, Minnesota.

  • Nancy A. Whitelaw; President, Gerontological Society of America

  • Clive Hohberger. President (Ret) Zebra Tech; Automatic identification technology


Use sensors, information & communication technology

To help elders & family improve:

Service dependability.

Loss of driving privileges.

Quality of life.

Medication management.



Sustain and spread to 20 other Wisconsin counties.

Focus older adult 70 hospital discharge in 180 days and family caregiver distant nearby live in
Focus: Older adult (>70; Hospital discharge in 180 days)and Family caregiver (Distant; Nearby; Live-in)



Attend appointments

Accidents per driver

Number still driving

Number rapid stops &starts.

Service Dependability

Service timeliness

Anxiety of family caregiver.

Satisfaction w service quality.


Number of adverse events

Missed medications rates

  • Primary

    • Readmissions to hospital

    • Health care costs

    • % now living in ALF or NH

    • Quality of life

  • Asset Based Community Development

    • # uses of community resources

    • Type of resources used

    • Have organizations to take on ECHESS

  • Isolation

    • Number of contacts per day

    • Minutes of contacts per day

University of wisconsin active aging research center



Can Help

Two interlocking systems
Two interlocking systems

Older adult


Very Preliminary

Our challenge making a complex system simple
Our challenge: Making a complex system simple.

Nac suggested next steps
NAC suggested Next Steps

  • Stories from each group ✔

  • Decide on measures ✔

  • Elevator speech ✔

  • Baseline data Starting

  • Target population defined ✔

  • Simplify

  • Increase size of RCT Exploring

  • Interview OAs forced to go to NH or ALF Starting

  • Doing too much


  • Needs & Assets

    • Over 200 elders interviewed

    • Information classified

    • Loneliness, Transport & Community events

  • Developed

    • Stories

    • Vision

    • Elder Tree

  • Being Developed

    • Loneliness

      • Community Calendar & matching

    • Medication

      • Side effects predictor

      • Glow-Caps

    • Falls

      • Booster

      • Gait

    • Driving

      • Sensors measuring drives

    • Service Dependability

      • Pilot testing in rural area

Next steps
Next Steps

  • Waukesha County

    • New Berlin

    • Implement Elder Tree in 1000 households

      • Getting Community Buy-in

      • Seeking resources

  • Milwaukee County (urban)

    • Northwest area

    • Building political base

    • Completing asset assessment.

  • Richland County (rural)

    • Community bought in

    • Asset assessment done

    • Community calendar

  • Systems development

    • Programming

    • Data collection

    • Pilot tests

    • Integration

  • Prepare randomized trial.

    • Final outcomes & measures

    • ADRCs prepare to recruit

To sustain technology needs support systems
To sustain,technology needs support systems

  • Financing

  • Incentives

  • Processes

  • Regulations

  • Interagency agreements

  • Welcoming environment

  • Community development

    Working on this now.

Nac caution
NAC Caution

We are trying to do too much!

Maybe. We’ll see.