Chapter Contents

Telehealth
Paying for Enhanced Technology
Resident/Client-Owned Technology and Resident/Client-Facing Technology
Social Connectedness Technology
Functional Assessment and Activity Monitoring Technology
Safety Technology
Technology Application for Containing Pandemic
Cybersecurity During a Crisis
Necessary Technology/Connectivity Infrastructure
COVID-19 and its Contribution to Technology Development

Technology is playing a significant  role during the COVID-19 pandemic. For example, staff that are not providing direct care or hands-on services can now safely work from home by leveraging technology. Residents can use video chat technology to communicate and stay socially connected and engaged with family, friends, and staff while social distancing. Screening and contact-tracing technology can be used to minimize chances of bringing the virus into communities, and contact tracing in case of exposure.

Telehealth technology can bring health care services to wherever the individual lives, certainly for routine check-ins and even for some acute care needs. A few last examples include technology to support information exchange, to enhance care coordination, disinfection technology to prevent infections, and monitoring technology to help stay on top of cases.

There are several ways telehealth can be used during a pandemic or other emergency. For example, residents can use real-time video/audio calls to communicate with their physicians remotely. Physicians can leverage remote patient monitoring to remotely monitor a patient’s vitals from their home or senior living community. Lastly, staff can use telehealth to continue to receive health care services from the comfort of their homes.

Telehealth

Resources from LeadingAge and CAST:

• Telehealth/RPM Selection Tool (newly updated, Oct. 2020): The tool includes a white paper providing background on telehealth/remote patient monitoring (RPM) technologies, types of available systems, benefits, and the most important planning steps that long-term and post-acute care (LTPAC) providers should consider before adopting and implementing these solutions. It also includes a product selection matrix and an online selection tool that helps providers select the most appropriate solution for their setting/business line, functional requirements, and needs. Finally, a set of provider case studies are available. See details of the Oct. 2020 update to the tool.
• Telehealth, Telemedicine and Remote Patient Monitoring (QuickCast): In this 16-minute QuickCast, Majd Alwan offers an overview of the recent CMS payment policies and regulatory flexibilities for telehealth and remote patient monitoring during COVID-19.
• Report Recommends Ways to Preserve Expanded Telehealth
• The Future of Telehealth in Senior Living
• Telehealth May Be Here to Stay
• Pilot to Connect Affordable Housing Residents to Telehealth
• New CAST Case Study: Quick Telehealth Solutions: A new LeadingAge CAST case study explains how CAST Patron HumanGood quickly implemented telehealth when the COVID-19 pandemic started.
• Surveys Show Increased Tech Spending & Telehealth Adoption
• Member Ideas and Inspiration: Expanded Telehealth Options Connect Residents and Clients With Health Professionals
• New Research: Pros and Cons of Telehealth in Nursing Homes (LeadingAge CAST): Telehealth has pros and cons, and recent research identifies ways that senior living organizations can make telehealth sessions as successful as possible for residents and for staff.

Other resources:

• Collection of COVID-19 resources, including telehealth (GeroCentral)
• Innovation Through Regulation: COVID-19 and the Evolving Utility of Telemedicine (JAMDA)
• Resources to support you with managing patients at home in person, via telephone or telemedicine (Elsevier)
• Building a Telehealth Program? (Telehealth Resource Centers)
• Center for Connected Health Policy resources on telehealth
• Using Telehealth to Expand Access to Essential Health Services during the COVID-19 Pandemic (CDC)
• Resources from the National Telehealth Technology Assessment Resource Center
• Telemedicine in the Time of Coronavirus (Journal of Pain and Symptom Management, via ScienceDirect)
• Palliative Care Telehealth Sample Guidelines (Center to Advance Palliative Care)
• Medicare Telehealth Billing During COVID-19 (Center to Advance Palliative Care)
• Telemedicine Association Is Making the Most of Its Moment: (Associations Now)
• Technology for health care and communication: FAQs from AMDA
• Telehealth program focuses on COVID-positive patients discharged from hospitals (McKnight’s Senior Living): COVID-positive patients at some Texas hospitals now can be treated and monitored at home throughout their recoveries as part of a program through Dallas-based TheraCare Home Health. This can enable partnering hospitals to reduce patients’ length of stay while also optimizing staffing resources and bed use, according to the company.
• Sample COVID-19 technology resources: LeadingAge and CAST work with Blue Orange Compliance, which has developed several policy templates and resources related to COVID: telehealth, telemedicine, and other technology policies.
• LeadingAge Sets 2021 Tech and Telehealth Policy Priorities (LeadingAge CAST): In 2021, our field is asking how to capitalize on the progress made during the pandemic. Concerns include how to incorporate telehealth into practice in an equitable and accessible way, and to make it cost-effective for the government and providers.
• What we’ve learned about using telehealth to reach older adults during COVID-19 (McKnight’s Senior Living): As COVID-19 case counts rose and sheltering in place became a public health mandate, telehealth use skyrocketed nationwide as previous regulatory restrictions were lifted and providers and patients found safe ways to access care.
• LZ 200 Finds Telehealth and Data Analytics on the Rise (LeadingAge CAST): In 2020, as the nation’s largest nonprofit senior living providers grappled with the pandemic’s impacts, they significantly increased their use of telehealth, social connectedness technologies, and data analytics, according to the newly released LeadingAge Ziegler 200, or LZ 200.
• Feds must embrace telehealth, not overregulate it, post pandemic (McKnight’s Senior Living): An expansion of telehealth flexibilities has been transformative for the long-term care profession and at least one expert is hoping that the federal government welcomes the changes rather than bog down telehealth programs with too many regulations.

Due to the pandemic, a few new funding opportunities have been made available to support technology.

Paying for Enhanced Technology

Due to the pandemic, a few new funding opportunities have been made available to support technology. Nursing homes can get communicative technology, e.g., a tablet, with CMP Funds. CMS has increased its flexibility with regard to telehealth reimbursement, such as making the home an eligible site, and the FCC created a COVID-19 telehealth program to support telehealth.

• Nursing Homes Can Get Communicative Technology with CMP Funds (LeadingAge)
• COVID-19 and Telehealth: CMS Expands Access, New Funding Available (LeadingAge)
• COVID-19 Telehealth Program (FCC)
• CAST Telehealth Case Studies: Collection of provider written case studies highlighting use cases of different types of technologies being used in different care settings. Each case study includes a business model section which describes how the technology is being paid for.
• CAST Technology Selection Tools (whitepapers have sections on business models to support technology)
• Pandemic Makes Future-Proofing Technology Critical (LeadingAge CAST): Strategic planning that future-proofs technology, and nationwide broadband, are among current priorities for technology aging services.

Resident/Client-Owned Technology and Resident/Client-Facing Technology

Many technologies can help facilitate health and wellness, safety, social connectedness and engagement, lifelong learning, leisure and entertainment activities, and assistive devices for residents.

• The Resident/Client Technology Guide (LeadingAge CAST): This guide was created to aid LeadingAge members and other aging services organizations in understanding different support, training, and potential business models for resident/client technology. Includes a white paper, an interactive guide, and case studies.

Social Connectedness Technology

Resources from LeadingAge CAST:

• Social Connectedness and Engagement Technology Selection Tool (LeadingAge CAST): The portfolio includes a white paper providing background on social connectedness and engagement technologies, types of available systems, benefits and the most important planning steps that long-term and post-acute care (LTPAC) providers should consider before adopting and implementing these solutions. In addition, the portfolio includes a product selection matrix and an online selection tool that helps providers select the most appropriate solution for their setting/ business line, functional requirements and needs. Finally, a set of provider case studies are available. The purpose of the portfolio is to aid LeadingAge and CAST members, LTPAC providers, and other aging services organizations in understanding how social connectedness and engagement technologies may fit the needs of the organization.
• Supporting Social Connectedness through Technology (QuickCast): In this 7-minute QuickCast, Scott Code offers ideas to leverage a variety of available technologies to connect older adults during times of social distancing.
• Improving System-Wide Communication with Connected Living Enterprise Platform During the COVID-19 Crisis (CAST case study)
• Reducing Social Isolation Through Virtual Group Activity (CAST case study)
• Containing COVID-19 with Resident Engagement Tech (CAST case study)
• Survey Finds Engagement Tech Grew in Importance
• Virtual Reality Calms Residents During COVID-19 (LeadingAge): After COVID-19 ended group activities at The Pillars, virtual reality brought more calm and less sundowning among more than 400 residents at 4 Pillars senior living communities in Minnesota.
• Google Nests See Continued Engagement (CAST): In the senior living industry where tech pilots do not always fly, an engagement tool introduced in 2020 has seen promising results.
• Low-tech program helps assisted living residents socialize, med students learn during pandemic (McKnight’s Senior Living): A simple social calling model launched during the pandemic gave medical students real-life practice in geriatric assessment skills while providing socialization opportunities for residents of assisted living communities, according to an on-demand panel presentation at the AMDA conference.
• Pandemic Spurred Online Engagement (LeadingAge CAST): Explore which new policies and programming tactics are connecting older adults.
• Helping Residents Stay Connected During the Pandemic (from LeadingAge Member Ideas and Inspiration):
  • Pandemic Inspires Fundraising to Upgrade Communication for Residents
  • Adult Day Programs Find New Ways to Stay in Touch
  • Adult Day Program, Shut Down by Coronavirus, Keeps Serving Elders and Caregivers
  • Video Series Tells the Stories of Residents, Families, and Staff
  • Expanded Telehealth Options Connect Residents and Clients With Health Professionals
  • Family Webinars Plus a “Facetime Team”
  • Upgraded Resident/Family Portal Keeps Everyone Informed

Other resources:

• 15 Smartphone Apps for Older Adults to Use While in Isolation During the COVID-19 Pandemic (Western Journal of Emergency Medicine)
• Living your life through technology: A qualitative study about technology usage during a global pandemic (Umeå University, Sweden)
• Teaching Technology to Older Adults During the Coronavirus Pandemic (Public Health Degrees)
• Technology is key for seniors during COVID-19 pandemic (My Central Jersey)
• These seniors are turning to cutting edge technology to stay connected during the pandemic (CNN)
• Parker Homes Residents Experience Virtual Reality (video re VR technology to improve resident engagement during the pandemic)
• Internet Basics for Seniors (Allconnect.com): A guide to using the internet, a breakdown of common online scams, and tips and resources to avoid and report online scams.
• Video Games Re-engage Older Adults During COVID-19 (LeadingAge CAST): Transformation occurred when Complete Care Management used the Obie platform to offer interactive games for seniors. Residents move from their rooms to a table in the common room to choose games to play, giving them a much-needed change of pace.
• Senior living sees success using virtual reality to combat loneliness during pandemic (McKnight’s Senior Living): Virtual reality use within senior living has gotten a big boost amid the pandemic, as operators shifted strategies to keep residents engaged amid restrictions on visitors and in-person activities.
• Innovating With Technology to Boost Resident Engagement (member story): With its volunteer program shuttered during the pandemic, Kendal at Oberlin, a technology company, and creative students joined forces to entertain residents.
• Relationships Grow, Isolation Drops Thanks to Technology (member story): Miravida Living adapted simple technology tools to boost communication and community during the pandemic.
• Technology helps California senior living community through pandemic (McKnight’s Senior Living): Technology is helping residents of one California senior living community get to know who is behind the mask while maintaining pandemic safety.

Functional Assessment and Activity Monitoring Technology

• Functional Assessment and Activity Monitoring Technology Selection Tool (LeadingAge CAST): A comprehensive portfolio of hands-on resources that help providers understand, plan for, select, implement, and adopt the appropriate technology while advocating for innovative care models. The complete portfolio of functional assessment and activity monitoring technology tools include activity monitoring technologies (including embedded sensors, wearables, location tracking, or other personal devices. They can be categorized as passive (generally embedded and requiring little or no action on the part of the owner) and active (which may require the monitored individual to go through a certain routine and/or input specific data).
• Virtual Dementia Care Assists During COVID-19 (LeadingAge CAST)
• RPM Technology Reduces COVID Deaths (LeadingAge CAST): Automated text messages aimed at remote monitoring slightly reduced deaths from COVID-19, found a recent study.

Safety Technology

• • Safety Technology Selection Tool (LeadingAge CAST):  Aportfolio of safety technology selection tools including a primer and selection guide, an interactive selection guide, an Online Safety Technology Selection Tool, a selection matrix, and provider case studies. The complete portfolio of functional assessment and activity monitoring technology tools include emergency notification and response systems, pendants or personal emergency response systems (PERS), nurse call systems, two-way staff communications systems, fall detection and prevention technologies, and more.

Technology Application for Containing Pandemic

• Thermal Imaging to Screen for COVID-19 (LeadingAge): Recent Tech Time news that highlights some of the available thermal imaging technology available to long term care providers.
• UV Lights Installed to Prevent COVID-19 (LeadingAge)
• Vocera Badge Improves Efficiencies in COVID-19 Care (CAST case study)
• Nanowave Technology to Prevent COVID-19 Comes to Senior Living (LeadingAge CAST): Nanowave technology, which is being used to prevent the spread of COVID-19, has come to senior living. Presbyterian SeniorCare Network® has become the first aging services provider to deploy a new Nanowave technology device made by Dynamics.

Cybersecurity During a Crisis

• CAST Cybersecurity Resources: These were created to help aging services organizations understand cybersecurity threats, how to mitigate them, and how to respond if attacked. They include a Cybersecurity White Paper, case studies and a benchmarking questionnaire that will help providers identify where they may be at risk, so that they can work to plug those vulnerabilities.
• COVID-19 Resources and Topics (Blue Orange Compliance): includes PDFs and guidance regarding telehealth, telework, and how to navigate our new reality

Necessary Technology/Connectivity Infrastructure

• Strategic IT Planning Tools: To bridge the gap between the strategic-level guidance and the operational hands-on technology selection tools that CAST produced, CAST, along with the Strategic IT Planning workgroup, created an educational module aimed at executive team to help organizations:
  • Identify the role of technology applications on the organization’s strategic goals.
  • Identify technologies to help achieve these goals.
  • Conduct strategic IT planning to update the communications and information infrastructure to support all technology applications that support strategic business goals.
• Residents Need Robust Wi-Fi and Tech Support (CAST): Senior living organizations are uniquely positioned to support residents in using health and wellness technologies.
• Bridging the Digital Divide in Affordable Housing Communities: A Practitioner’s Resource for Multifamily Operators (Stewards of Affordable Housing for the Future): COVID-19 spotlighted the inadequacies and inequities of broadband access for many older adults, especially those in affordable housing. Includes case studies.
• Number of operators investing in video conferencing capabilities for residents has quadrupled since 2018 (Ziegler): Three-fourths of senior living and care providers invested in video conferencing capabilities for residents last year, quadrupling the percentage of providers who did so just two years earlier, according to a new Ziegler CFO Hotline survey conducted in partnership with LeadingAge CAST.
• More tech needed to plug long-term care ‘service gap,’ one industry expert says (Forbes): The impending intersection of a growing older adult population and the ongoing inadequate number of caregivers employed to assist them makes it imperative that senior living and care operators continue to invest in technology over the coming years, according to a recent report.

COVID-19 and its Contribution to Technology Development

• How COVID-19 and Technology Would Reshape our Future (LeadingAge)
• Leveraging Technology During Covid-19 (LeadingAge)
• Applications of Digital Technology in COVID-19 Pandemic Planning and Response (The Lancet)
• 10 technology trends to watch in the COVID-19 pandemic (World Economic Forum)
• The COVID-19 research database enables public health and policy researchers to use real-world data to better understand and combat the COVID-19 pandemic. The database is a pro-bono, cross-industry collaborative, composed of institutions donating technology services, healthcare expertise, and de-identified data. See this LeadingAge CAST article re the database and PointClickCare’s involvement.
• Opinion: A great technology wave is cresting over America because of the pandemic—and it’s largely a good thing (Marketwatch)
• The Need for a Mental Health Technology Revolution in the COVID-19 Pandemic (Frontiers in Psychiatry)
• Recovering from the COVID-19 Pandemic: A Focus on Older Adults (Journal of Aging & Social Policy)
• Challenges faced by mental health providers and patients during the coronavirus 2019 pandemic due to technological barriers (Science Direct)
• Survey shows seniors are embracing technology and telehealth during pandemic (MobiHealthNews)
• Older Adults Technology Services Innovates to Support Seniors During Pandemic (ASA)
• Pandemic Brings More Interoperability Innovations, Coordination (LeadingAge): Innovations in interoperability and increased coordination among healthcare and regulatory entities are among recent changes named by Yardi® Director of Healthcare Solutions Fil Southerland in a recent Senior Housing News article.
• COVID-19 driving technology adoption across senior living (McKnight’s Senior Living): The pandemic has cast a long shadow over the senior living and care sector. But it’s also being credited as a catalyst for technology adoption and spending, as well as health care innovation.
• Pandemic tech changes are here to stay (McKnight’s Senior Living): Technology’s presence in senior living has been front and center during the coronavirus pandemic, with uses including telehealth for resident and staff medical appointments and communication between residents and their loved ones becoming much more common.
• How COVID-19 shed light on the mobile technology needed in senior living (McKnight’s Senior Living): To get a clearer picture of the technology landscape in assisted living communities, Ascom distributed an online survey to senior-level administrative and information technology professionals.
• A Technology Workaround to Streamline Testing (member story): Friendly Senior Living adapted its EMR to comply with test reporting requirements while saving funds and staff time.
• 3 ways tech use during pandemic will change long-term care forever (McKnight’s Senior Living): Even when COVID-19 is not a daily threat anymore, its effects will linger—in a positive way—through the use of technology that will change the industry forever.
• Pandemic Changes Tech Use in Senior Living (LeadingAge CAST): See how robust Wi-Fi, telehealth, social connectedness technologies, and more have become critical to senior living.
• Seniors and technology during Covid-19: the latest insights (Ericsson): Seniors are more connected to the Internet than ever before. Studies uncover the impact technology has had on seniors from before and during the start of Covid-19.
• Was COVID-19 the catalyst for new technologies to help older adults live more independently for longer? (McKnight’s Senior Living): Confronted with the COVID-19 pandemic, older adults have had to cope with the introduction of new technologies at an astonishing pace. The pace of change will continue to increase as society becomes more reliant on apps, new services, and technologies.

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