Using Technology to Address Gaps in Care for Isolated Seniors Aging-in-Place: An Interview with Pace University’s Dr. Lin Drury
In June, Pace University and eCaring were selected as winners of PILOT Health Tech NY, a new initiative that connects innovative health technology companies with key New York City healthcare service organizations to pilot and advance new technologies.The joint partnership serves a population of high-risk, multicultural older adults at Henry Street Settlement’s NORC/Vladeck Cares facility. In the program, clients and their caregivers will receive six months of eCaring’s unique web-based care management and monitoring system. The technology will track clients’ health conditions in real time, relaying essential information and health-related alerts to care managers. Graduate nursing students at Pace University will track data to assess the effect of the new technology on the health and well-being of members of the community. We sat down with Lin Drury, PhD, RN, Associate Professor at Pace University’s Lienhard School of Nursing, a Principal Investigator on the pilot to learn more about the importance of the project and what it means for addressing gaps in care for aging New Yorkers. Tell us about the relationship between Pace University and Henry Street Settlement? How did you first begin working together to serve aging New Yorkers? Dr. Drury: Pace University’s Lienhard School of Nursing has a long commitment to vulnerable populations and preventative, primary health care in the community. Over the years our faculty have performed outreach to engage communities where nursing would make a big difference and one of those places was Henry Street. The Settlement evolved from a nursing organization to a social service provider over the years. As health care began to change in the 90s, it became more difficult for the Henry Street clients to access care due to poverty, language, and cultural barriers. The relationship between the school of nursing and the settlement came about and has worked because Henry Street was looking for help at the same time Pace was looking to get nursing students more involved in community care. It provided a great opportunity for the students to serve as nurses for Henry Street clients, with the Lienhard faculty to guide them. At Henry Street, students gain valuable clinical experience. We have been growing and developing the program ever since. What are the challenges residents at Henry Street and their care managers face? Dr. Drury: Our clients live in Vladeck Houses which is a public housing complex with somewhere between 2000-3000 people living there. It was erected in the 1940s and many of the buildings do not have elevators. As the clients age it becomes more difficult for the to get out and around. Almost 60% of clients are Spanish speaking with limited English skills. About 30% are Chinese and primarily monolingual. The language cultural barriers contribute to social isolation. Today, the population is only getting older and sicker. The people who used to be able to get out and around are now becoming homebound. In New York City the aging population is becoming the #1 group and there is not enough funding or human resources to provide adequate care and allow people to remain in their homes When did you first see the need for technology to improve the health of Henry Street’s clients? Dr. Drury: As time went on, it was apparent the clients’ needs were increasing yet resources were dwindling. It was getting more and more difficult to access care and that’s when I began looking for technology to help us. Why do you think eCaring is a good tool for this project? Dr. Drury: If I could have had enough vision to design a tool on my own, I would have designed what eCaring offers. The system is so simple, and offers a way for whoever is engaging with the client to get information out to those who are monitoring the client for those times during the day and week when we can’t get out to see them. Its just a perfect system for us. eCaring is particularly well-suited for our client population because you can use it without having to speak English or be computer literate. It captures very complex, valuable information in a simple way. It also has the sophistication to deliver data and alerts which helps identify potential problems immediately. What are you hoping this project will achieve? What makes you excited about it? Dr. Drury: We want this to give the students a sense of what public health and community health practice is about and how comprehensive it can be when you have the technological assistance to understand what’s going on when you’re not in the home. Using eCaring will give them an idea of the breadth of needs of this population that they wouldn’t get otherwise. What is unique about this trial is that we using to students to help get the clients involved and to realize they can keep their caregivers and Henry Street staff informed about how they are doing. and respond to their needs. eCaring gives us a way to engage with the client and ask more questions if, let’s say, they are losing weight. We can develop a relationship with them rather than relying on people to say “I’m Sick”. Now we can also have neighbors entering information which helps us know more about that client’s health condition we could have never known before. For clients we want to see what’s going so we can intervene preemptively and keep people healthier and in their homes. We want to avoid hospitalizations and transitioning people to nursing homes which are more expensive and less comfortable venues. Most of our clients, like most older adults, want to age in place. Our other goals for this pilot involve improving overall health and quality of life for clients as well as intercepting any potentially dangerous situations. For the care manager, whether it’s a paid case manager or a family member trying to manage someone’s care, they are continuously worried about what is going on in the home. eCaring gives them a chance to know what is going on so they can check in as frequently as they want or need to. It gives everybody a chance to have reassurance the client is safe and is okay in the moment. The case managers that work for Henry Street have very large caseloads to stay on top of and the clients are only getting older and sicker every day. With this project, we are hoping the students and the information from eCaring can help the case managers keep people in place and out of facilities.