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Aging and Community Redefined on September 27, 2013



First published on Tech-enhanced Life by Walt Maclay.

I recently joined other thought leaders at a PAMF event on Aging and Community Redefined.

The keynote was Dr. Bruce Chernof, CEO of the SCAN Foundation. His mission is to advance the development of the sustainable continuum of care for seniors. He describes the solution to the problem of the aging with three main points. One is stop perfecting 1972, the second is to address people not patients, and the third is the tipping point is simplicity plus a dose of intensity.

His first main point was that healthcare, including Medicare, is not solving today’s problems. We keep fiddling with it to perfect something designed for 1972, and it’s not helping. It’s not what people want. The chronic care industry is huge, and it’s not working. We’re wasting money and not solving the problem. The state and federal funding is a large number of different, uncoordinated programs, which is part of the failure, and he says the failure really shows up in the world’s most expensive hotel:  the hospital emergency room

Chernof’s second main point was a plea for action that we need to address people, not patients, and to look for solutions outside the medical system. Most people have chronic and functional impairment, not emergency medical needs. Medicare statistics report that people with chronic diseases cost three times as much as others on Medicare.  Also, life expectancy has increased from 69 to 78 years, making older adults the fastest-growing age group, and 70 percent of seniors will require some daily support for three years on average.  He proposed that we should have the policy goal of thinking of people that need to be cared for rather than patients that can be cured. 

Thirdly, Chernof offered a simple path forward with a dose of intensity by adapting the community to provide a sustainable continuum of care for the elderly. He gave the example of an old European village that’s totally not ADA friendly and is an excellent place for elderly people to thrive because it’s a close community. The way to fix things has to be simple, which means very small, like one block or one very small town at a time. There has to be enough intensity, enough applied to that problem in that one small area to fix the problem before going on to the next place. He mentions downtown LA was revitalized in the last six years, and for the most, people were committed to change. If people are committed, it’ll happen.

To make his point, he closed with a challenge: can we build a community that would be an alternative to 911? To do so requires us to ask these three questions:

  1. How confident are you that you have someone to call?
  2. How confident are you that, if you call, you will reach that person?
  3. How confident are you that that person will know what to do?

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When people are confident in the answers to these questions, they don’t call 911.

Following Chernof’s keynote was a diverse panel on “Stakeholder Reactions.” Here are a few interesting take-aways from the panel’s discussion and Q&A.

  • Richard Birkel, from the National Council on Aging reminds the audience that 50% of those born in 2000 will live to be 100 years.
  • Martin Entwistle, the Executive Director at the Druker Center of Innovation, discussed care improvement, including the growth of accountable care organizations.
  • Emily Lam represented the business community in her role in the Silicon Valley Leadership Group. She talked about a local effort to connect the community and people in need. 
  • Dr. Richard Slavin from Palo Alto Medical Foundation (PAMF) claimed that health care outcomes depend:
    • 20% on clinical medical care
    • 30% on your behavior (the way you live)
    • 40% on your economic condition 
    • 10% on your environment in which you live
  • Annie Valdes from IDEO encouraged everyone to start with simple short-term efforts and learn from them. 
  • Erin Westphal  from the SCAN Foundation  talked about the need to breakdown the silos between services and Medicare. 

My overall sense was there are passionate and dedicated folks actively working on change.

The speakers from the final session for the day were Michael Erikson, Liesl Capper and Kim Cranston. Michael Erikson, COO of PAMF had the best quote of the day “Healthcare is like a pizza parlor that doesn’t deliver. It’s a dine-in experience only.” All the speakers made the point that our healthcare is in the salvage business. Here is how our healthcare works – 5 percent use 50 percent of the healthcare. We take the sickest of the sick and apply most of our money there. The speaker recommended addressing the 95% who are not so sick so they become 96% (not so difficult), but at the same time the 5% of the most sick will drop to 4%, which is a huge change.

One PAMF solution talked about was LinkAges, a new, community-based, multi-generational network designed to engage and activate existing resources within communities to improve the health and well-being of seniors and family caregivers. TimeBank is one component of the linkAges system that focuses on leveraging existing resources to enrichment rather than the salvage business. It’s changing healthcare to a delivery service.

Additional resources from the SCAN Foundation




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