Last week I had the honor of speaking to the City Club of Portland, an organization founded in 1916 to highlight the diverse opinions, issues, and talents of local leaders and organizations. I often hear their Friday Forums on Oregon Public Broadcasting radio while I am driving home from work, so it was a real treat to be there in person in the grand Governor Hotel in downtown Portland. I very much appreciate the City Club members inviting me and giving visibility to the important issues of Global Aging and what I have frequently referred to in this blog as "gray technologies."
The title of my talk was "Technological Innovation and the Future of Aging"--you can click here to find a free download of the audio cast of the speech--in which I focused on Oregon's opportunity to lead in the development of new technologies, services, and jobs that promote independent living for our graying population. I shared some of the research prototypes and findings that Intel, Oregon Health & Science University (OHSU), and the Oregon Center for Aging and Technology (ORCATECH) have developed from our more than ten years of exploration into home-based technologies that can help people to age-in-place with good health, social engagement, purposefulness, dignity, and choice.
I promised attendees (and the many radio and TV listeners who have been writing to me ever since!) that I would post some links where you can find more information. To that end, here are a few that I referred to in my talk...
ORACTECH, the Oregon Center for Aging and Technology at www.orcatech.org, is a passion-driven, grass-roots center founded in Oregon Health & Science University to help coordinate statewide collaborations around independent living technologies amongst universities, companies large and small, non-profits, and government agencies. The funding to get this started came from Intel's $3 million dollar donation to OHSU and a prestigious NIH Roybal Center Grant awarded to ORCATECH director, Dr. Jeff Kaye and his collaborators. You can join the mailing list by emailing firstname.lastname@example.org or, if you are local to Portland, come join "upcoming events" announced on the web page.
CAST, the Center for Aging Services Technologies at www.agingtech.org, is a non-profit advocacy organization I helped to develop with the American Association of Homes & Services for the Aging who recently changed their name to LeadingAge. CAST is a national (or actually, now international) version of ORCATECH, designed to bring together providers, university researchers, technology companies, and others to help ignite a wide array of innovative technologies and services to help seniors to age-in-place from the "home" of their choice. Be sure to view the free CAST vision video shown to Congress and the last White House Conference on Aging.
The TRIL Center, or Technology Research for Independent Living, at www.trilcentre.org based near Dublin, Ireland, is Intel's largest investment in independent living technology research with a $30M joint investment with the Irish government. TRIL includes our multidisciplinary Intel team and three universities in collaboration with St. James Hospital in Dublin to invent and test out these home health and independent living technologies. You can learn more about the falls work there at the TRIL Center site, as well as go here to read more about the Shimmer "matchbox-sized wireless computer" I described in the talk.
ETAC, the Everyday Technologies for Alzheimer's Care initiative, a collaborative program between Intel and the national office of the Alzheimer's Association, has published information here about the grants that we have funded since 2004. This was one of our first programs to start funding university research on independent living technologies and has produced a great international community of dedicated researchers and entrepreneurs focused on Alzheimer's care specifically.
Care Innovations, at www.careinnovations.com, is the name of the newly formed joint venture between Intel and GE to produce disease management, independent living, and assistive technologies for the home. Full disclosure: I run healthcare policy for Care Innovations (in addition to my Intel role). I didn't feature our products at the City Club talk because my focus was on the R&D infrastructure that Oregon has built, not a commercial for our products. But I don't want to leave the impression that everything is stuck in research...Care Innovations (and many other companies) is diligently working to get these kinds of aging-in-place solutions to market worldwide!
And realizing now that I had to fly through my recommendations to the state of Oregon at the end of that lecture (I warned everyone that, without PowerPoint, there was no predicting what I might say!), I want to highlight some of the main points I tried to make last week. My overall thesis was that Oregon has some enormous advantages in trying to become an international leader of independent living technologies and jobs. Just as we have with Wave Energy and Biotech, our state needs to bluntly ask ourselves as Oregonians what future industries we could really lead in? I argue that Oregon is already a big fish in the small pond of independent living R&D and that we should put forth a state plan to go after this opportunity.
So, why Oregon? What are our particular strengths?
1) We have a head start: We can build upon the foundational technologies, data, and know-how of ORCATECH, OHSU, Intel and many others in our state who are recognized leaders internationally in this emerging field. Today, we already host numerous Minister of Health and other visitors in our labs, as other countries and states come to see what Oregon is doing. Now we need to make sure our own state knows the assets we have!
2) We have our own fiscal challenges: Oregon itself is already in the top ten of states with the highest percentage of an aging population, and we likely face cuts to our Home and Community Based services as we, like so many other states, try to balance a budget in the midst of a recession. We need independent living and home health technologies just to drive up quality and drive down costs of the care for seniors--and people of all ages--in our own backyard.
3) We have flexibility. Though many of my friends and colleagues in the long term care industry in our state would like to see even more flexibility, we need to realize that we have more regulatory/licensure freedom to pilot and develop new care models for seniors than do many other states. Less red tape for us means faster innovation cycles and learnings than many other states can produce!
4) We know high tech. There is a large information technology presence here in Oregon to draw upon--not just Intel but many other technology companies who have intellectual property, innovation methodologies, and entrepreneurs to bring to the challenge of addressing Global Aging.
5) We are the right size. I believe we are the right size and geography of a state to develop independent living technologies and the care models to use them. It is hard to imagine a state as large as California or as small as Delaware doing this. With our four million citizens living in a mix of rural and urban environments across the state, it is conceivable and achievable to build a state-wide strategy and infrastructure to enable aging-in-place.
6) We can collaborate with Asia. Oregon is already seen as a "gateway to the Pacific Rim" with a wide range of trade and research collaborations going on with Asian countries. Having just keynoted to the APEC (Asia Pacific Economic Cooperation) meeting just weeks ago in D.C., I can tell you that the need and market for independent living solutions in Asia is significant given the longevity in many of the countries there. If done right, our state plan for Global Aging should foster collaboration and export of our Oregon technologies and services to some of these countries.
7) We have national political leaders for aging issues. It is rare as I make visits to Congress that members know much about gerontology, but when I visit the Oregon delegation, they often end up teaching me more than I do them! Senator Wyden has a background in gerontology, as does Congressman Peter DeFazio, and both have shown a commitment to aging and health reform issues in their political careers. I believe we should be leveraging their understanding and leadership on aging issues to make Oregon the center of the independent living technology universe!
8) We are committed to healthcare reform. I had the pleasure of hearing last week's "Think Out Loud" radio segment on OPB that was exploring healthcare reform in the state of Oregon. Dr. Bruce Goldberg, head of the Oregon Health Authority, was clear (and I couldn't agree more!) that we need to transform our culture and infrastructure to do health reform right. At the end of the day, aging-in-place is not about technology but about transforming our culture of care for seniors, and the technology is simply a tool to help do that. But if we are a state prepared to be at the forefront of acute care/hospital/insurance reform, let's make sure we do the same for long term care!
9) We have a legacy to uphold. Last but not least, innovating aging is in our blood...is in our history...as a state. Oregon is widely credited as the state who invented end-of-life or hospice care, which became a national standard and movement. Similarly, we are known for pioneering the concept of "assisted living" which is, of course, now common-place and taken-for-granted. In many ways, the rest of the country is just waiting for Oregon to invent "what's next?" for the care of seniors, so let's not disappoint them!
We should make no mistake as a state to think that we can rest on our laurels or that we will just end up becoming the leader of independent living technologies without investment or a plan. Other states are competing to create these technologies and jobs; I have worked with officials in New York, Minnesota, California, and Florida who are trying to get their act together on this front. I am biased as an Oregonian to want to make sure it happens here, but at the end of the day, may the most organized and proactive state win!
So what would my calls to action be for Oregon? What should we be doing to capitalize upon this opportunity?
1. I call upon Governor Kitzhaber to put together a commission to develop a state Global Aging response plan. Let's bring together industry, community, and academic experts to identify how we can use independent living technologies to care for our own elders and families and also evaluate new business and job opportunities in this segment. I will certainly volunteer my time to participate!
2. Let's commission an inventory of Oregon's assets on aging-in-place...let's show what we've got and what we are missing in terms of building out an R&D and new business incubation infrastructure for independent living technologies and services.
3. We need to identify, with our nursing and medical schools, what new kinds of careworkers and curriculums are needed to enable aging-in-place care for seniors (and people of all ages). If Oregon can develop the models for training and credentialing community workers and volunteers who can use these new technologies to do care delivery in the home, community, and electronically, then we will be the likely creator of the first national call center for electronic care & support for elders. With that asset, we would be a fierce competitor nationwide!
4. Let's make sure that our current and future technology infrastructure investments--for broadband, for Electronic Health Records, for insurance exchanges--are being designed and built to support aging-in-place and to carry data/transactions from hospital to home. If all we do is connect and coordinate care in hospitals and clinics, then we will fail to achieve the kind of health reform required to make us fiscally, morally, and medically strong.
5. We need to build upon ORCATECH to develop the nation's first 10,000 household cohort of seniors who can help test and prove the value of these aging-in-place technologies and care models. Today, we have about 300 households in the Portland metro area who are outfitted with these kinds of systems, but we need 10,000 homes across the state to deliver the statistical and economic data that proves which systems are most valuable, usable, and useful. If we build this kind of large-scale R&D infrastructure, it will be very difficult for any other state to supplant our position as a leader in this sector.
6. Like many other states are exploring, let's develop a policy framework for seniors in our state that makes aging-in-place a right. If we set that as an overarching policy goal, then it will help to guide our activities and priorities for the full range of services--meals, medication assistance, transportation, social support, mental health, healthcare, etc.--that are needed to give people a high quality of life at an affordable cost from a place of their choice.
7. Let's set an audacious goal--a 2020 vision--to move 50% of care in Oregon out of institutions and into homes and the community in 10 years. We may not achieve 50% or it may happen faster than 10 years, but if we set a goal that everyone knows and can aim for, then we will achieve great progress towards an aging-in-place agenda!
In closing, I want to reiterate a message I have played over and over again in the pages of these blog entries: we need to prepare for Global Aging much as we do Global Warming. Just as our state (and our nation), are competing to try to become a leader in Green Tech industries to address Global Warming, so too, we should be competing to become a leader in Gray Tech industries for Global Aging. The issues and needs are no less urgent or pervasive; the opportunities for economic growth for the state are no less promising. And if we are truly a state committed to healthcare reform, then let's make sure that commitment includes long term care as we figure out how to improve cost, quality, and access for people of all ages.