Seriously Simple, and Smart, Ways to Plan Ahead for Long-Term Care
Why do you need to plan ahead for long-term care? If you have no clue how to answer this and you are planning for retirement, you could be in for a major financial surprise. Long-term care is expensive and most everyone needs it at some point, so it’s important to take these long-term care planning tips to heart before you finalize your retirement plans.
Be Aware of Medicare Limitations
If you’re looking forward to retirement, you may think you don’t need to plan for long-term care because Medicare will cover it. This is a huge mistake, however, because Medicare offers basically no coverage when it comes to paying for a nursing home, an assisted living home, or in-home care. That’s because this kind of care is considered custodial, rather than medical, and therefore is not included in the coverage that most seniors receive from Medicare. With long-term care, you are more likely to need help with daily tasks such as bathing or dressing, and this is why more involved care is necessary. Medicaid might cover some costs if you’re eligible, or you may be entitled to assistance from the VA if you have served in the military or are an eligible dependent. If neither of these is an option, you will need to come up with other ways to plan for care. However, try not to stress yet. If you are planning well ahead of time, you have some ways to prepare yourself for long-term care.
Make Healthier Changes to Your Life
There’s really no surefire way to prevent the need for long-term care. According to statistics, you may need long-term care at some point in your adult lifetime. You can, however, try to beat the odds by making some simple changes to your life and home. Falls can be a source of debilitating injuries as you get older. Those tricky stairs could lead to a serious fall in the future, so take steps to help yourself age in place at your own home. If you do have steps or stairs, have some secure railings installed on either side to provide support and reduce your risk of falling. You’ll also want to think about fall-proofing your bathroom as time goes on, by installing grab bars in slippery areas. Another simple change you can make is to add better lighting throughout your home. You can swap out to brighter bulbs or add fixtures to ensure areas are lit evenly. Finally, don’t underestimate the impact lifestyle choices can have on your long-term health. Regular exercise and diet can reduce your risk for serious conditions such as dementia and Alzheimer’s disease and give you a chance for a more independent life.
Research All Your Options for Paying for Care
Paying for long-term care can be a real financial burden, especially if the need comes up unexpectedly. Most American seriously underestimate long-term care expenses, which can run upwards of $100,000 per year if you need to stay in a nursing home. However, you have a decided advantage by choosing to plan ahead. For one, you can research just how much care could cost you, as well as how exactly you can pay for it. If you are in your 50s, for example, you may be able to snag long-term care insurance for much lower monthly payments than someone who is only a few years older than you. When long-term care insurance is not feasible, there are other financial avenues you can include in your long-term care plans. You could pre-pay, plan to receive care from a loved one, or you can get roommates to offset housing costs and allow you to tuck away more funds for care.
Planning for long-term care doesn’t have to be a headache. If you start planning early and going over all your options now, you will have more options to choose from and end up with less stress in the future if you do need some form of long-term care. So, don’t forget to add long-term care to your list of essential retirement planning steps.
eMEDICS.org has just completed its homecaremarketplace platform and invites medical professionals such as RAI evaluators or specialized nurses to register on www.YFORM.org to offer their services at home.
Several organizations have showed interests using this platform if the number of registered resources is sufficient.
Housekeepers can also register for housekeeping and meal services. Registration is completely free. Service providers can indicate their availability and their hourly rate in order to receive the right requests.
The eMEDICS.org social network, eHSN (eMEDICS Health Social Network) is being finalized. The YFORM platform should be able to integrate with eHSN but also with coreERP, software used by medical organizations, to bring these organizations closer to the medical professionals and patients.
The Swiss spend more from their own pockets for health care than any other nation, according to a survey for the price comparison website Comparis. Providers of supplementary health insurance are the biggest beneficiaries.
The Comparis survey found that out of CHF80 billion (USD 82 billion) health expenditure in 2016, the Swiss paid CHF24 billion themselves.
Since 2012, expenditure covered directly by households has continued to rise, it says. This includes CHF5.5 billion for retirement home care, CHF2.8 billion in dentists’ bills and 1.6 billion for medicines.
Whereas insurance companies’ revenue from supplementary healthcare premiums has continued to rise, pay-outs under supplementary schemes have risen only moderately. Between 2008 and 2016, revenue from premiums rose by CHF865 million to CHF6.6 billion, whereas health cost reimbursements to clients rose only CHF353 million to CHF4.7 billion, the survey found. The sector therefore made a healthy profit.
Basic health insurance is mandatory in Switzerland. Private companies must all offer the same basic coverage and are not allowed to make a profit on it. Their profits come from the supplementary schemes.
Economist Pius Gyger, the author of the Comparis report, says the needs of the population go well beyond basic health care coverage, and a high number of Swiss are prepared to pay for supplementary schemes.
But Comparis health insurance expert Felix Schneuwly says insurers need to be innovative, otherwise they may start to lose this lucrative market.
Switzerland Telemedicine Market is Expected to Reach Over CHF 500 Million by 2022: Research Forecast
Telemedicine services will be more reliant on cloud-based compared to the web-based as the data or details of every patient is stored on the cloud while treatment. Artificial intelligence will be the future trend in the Tele-Medicine. There will also be more emphasis placed on the use of connected devices which can be continuously monitored at Tele-Medicine Center and required action can be taken. There is a scope that virtual hospitals might come into the picture which will be a central hub and where the patients could be treated via telemedicine.
Companies will enhance their services in order to compete in the market. Medgate will develop more follow-up services for stroke and epilepsy in coming years. Clinical robots are expected to be popular technology in the telemedicine market in future as they will help the specialists to visit their patients regardless of the location. Moreover, the specialists will be able to connect with the patient and X-ray or laboratory reports simultaneously. Personalized telemedicine applications can be made in future for both the patient and the doctor, which will be customized according to the requirements of the customers. Moreover, there will be better integration of EHR software
Radiology has been used effectively in the telemedicine market and fields such as dermatology, mental health and stroke care are also being used heavily. In future, other fields might explore telemedicine further such as psychiatry, neurology and others. Moreover, psychological ailments will become a big challenge for Swiss healthcare which will further increase the demand for tele-psychology.
Switzerland Telemedicine market is expected to register positive CAGR of around 12.4% during the period 2018-2022 in terms of revenue. Providing better data security and adopting different marketing techniques to creating awareness is expected to have positive impact on the overall telemedicine market.
eMEDICS.org, a YFORM Ltd company, is pleased to announce IT consultancy work with WHO, the World Health Organization. This is part of the Framework Convention on Tobacco Control (WHO FCTC). eMEDICS.org will be involved in a pilot project in seven countries to measure compliance with smoke-free legislation and bans on tobacco advertising, promotion and sponsorship (TAPS), using mobile technology. The use of conventional and crowd sourcing surveys will be deployed to conduct the surveys using a special Mobile App that has been developed for the project enabling offline capabilities. Building capacity of implementing agencies and training data collectors on data collection, data monitoring and preliminary analyses are the keys deliverables of that project.
eMEDICS.org coreERP v1.7 turnkey solution has been successfully completed for the Swiss market. The EMR (Electronic Medical Record / Medical requests) and RAI evaluation processes (RAI MDS and Household assessments) are now fully functional. When the medical staff assess RAI MDS evaluations, performance scales (ADL, IADL, CPS and DRS) as well as the GAD alarms, are automatically generated (on the fly). This helps streamline the decision making. Mental Health PHQ-9 / GAD-07 is being implemented and shall be available in the coming weeks.
We invite Swiss home-care organizations to contact us at firstname.lastname@example.org or +41 75 416 4140 to participate to our pilot projects. Your organization would take advantage of a substantial gain of productivity in your day to day business (ex: use of Electronic Patient record, fill-in RAI evaluations online, document generation on the fly, such as OPAS…). In exchange, free licenses and support will be provided by eMEDICS.org team in order to meet your expectations and business needs.
coreERP solution is now responsive using the same code for mobile and web, reducing by half any development cost. The solution could also be used in the field while we’re still adjusting the offline capabilities. It has been optimized to run on any type of IT infrastructure. Our framework is open-source which makes our first class solution available to large but also small to medium home-care organizations. Our solution combines quality and competitive pricing over time with a drastic cut in maintenance and operations.
1) Pilots and projects updates:
We’re already in discussion with a couple of home-care organizations to start pilot projects.
We’re also meeting AVASAD this month, to discuss a potential collaboration.
At this stage, we only invite Swiss home-care organizations that are interested by such a solution to contact us for free demos and licenses.
The generic international InterRAI solution is scheduled to be supported by Q4 2018. European and North American home-care organizations could still contact us to book a demo and reserve free coreERP licenses.
2) Infrastructure update:
coreERP has been tested on shared hosted environments such as InfoManiak and the solution works perfectly fine. This is a huge achievement, allowing small/medium/large home-care associations to significantly reduce their infrastructure expenses and operational costs.
InfoManiak infrastructure platform provides a state-of-the-art back-up solution: your data is backed-up daily on a second data center and previous versions could be restored in one click. This is crucial especially when dealing with high sensitive patient data information.
It is now GDPR compliant (European General Data Protection Regulation) which makes it the best choice to host our Health oriented software for European organizations.
coreERP is also being tested in other countries (OVH and HostGator) and on-premise (LAMPP and WAMPP servers).
3) eMEDICS.org Process automation update:
OPAS computations are fully functional providing the LiMA and OPAS estimates on the fly.
Approbation workflows are ongoing and should be ready in the coming weeks.
The advanced business process automation based on RAI assessments, has been refined and is functional. An updated version including end-to-end automation (from the assessment or the medical request to invoicing) shall be available by Q2, 2018.
4) Other updates:
Multilingual module is now available and any language could be supported by filling-in a single source file. coreERP could handle any new language in a week.
Activity reports and time sheets are 50% completed.
As planning of the visits may require extensive computation, we’ve decided to incorporate coreERP with existing solutions instead of implementing the whole solution ourselves. Several partnerships are currently being discussed.
eMEDICS.org Health Care Network (EHC Network): our EHC Network implementation is progressing and will be opened to all physicians, clinics, pharmacies, Home care organizations, hospitals and insurance companies (with the preservation of medical data of patients), and patients themselves, facilitating the exchange of medical information by Q4 2019. A catalog of forms will be available to medical organizations, which will allow them to set better diagnosis and share data with the patients (patients could also provide health measurements over time).
The considerable hype around blockchain is starting to be tempered by enterprises earning practical experience and identifying worthwhile use cases for the technology.
Most of the buzz around blockchain in healthcare has focused on EHRs, interoperability and security, but a new potential for value-based care, precision medicine and a patient-driven healthcare system are emerging as more clear and present opportunities for the distributed digital ledger technology.
While we don’t expect the hope for data interoperability and security to fade away, hospital executives who want to stay abreast of what’s really happening with blockchain will also need to understand these new considerations.
Blockchain and the move to value-based care
A variety of possible use-cases for blockchain are coming into focus for healthcare, ranging from clinical to financial to administrative.
“Traditional healthcare fee-for-service payment systems are overly complex and expensive from an administrative perspective. On average, payment administration accounts for about 14 percent of healthcare spending. Blockchain applications can definitely reduce the waste,” said Corey Todaro, chief product officer at Hashed Health, which leads a consortium of healthcare companies focused on accelerating innovation using blockchain.
Beyond fee-for-service, blockchain as a technical architecture can enable value-based payments to take off and thrive, some experts said.
“Blockchain can enable a smart payment system to match the distributed care teams that will take responsibility for episode- and disease-centered payment models,” Todaro added.
Claims adjudication and billing management is ripe for a blockchain-based system that can provide realistic solutions for minimizing medical billing-related fraud; this is a highly relevant use-case given the amount of fraudulent activities around improper medical billing and reimbursements across the payer industry, said Tapan Mehta, market development executive in the healthcare practice at DMI, a mobile technology and services company.
“For example, in a situation where a health plan and patient are dealing with a contract, the blockchain could automatically verify and authorize information, as well as the contractual processes, eliminating the back-and-forth between multiple parties,” Mehta said. “This would increase transparency and efficiency, leading to lower administration costs, faster claims processing and less money lost.”
Precision medicine and a patient-driven healthcare system
Blockchain-based systems could help drive unprecedented collaboration between participants and researchers around innovation within medical research, particularly in the fields of precision or personalized medicine.
Maria Palombini, director of emerging communities and initiatives development at the IEEE Standards Association, said that blockchain can enable the patient-driven healthcare system.
“The lack of interoperability among data systems in a personal health network is a detriment on patient care,” she said. “Informed patients know that data is critical to enhancing their care and safety. This is beyond safety from data hacks, this is the ability for their healthcare providers to have access to information that will help them better treat the patient.”
There has been a trend in educating patients to manage their health to embrace wellness and prevention, and that may also include the data that is generated out of this practice, she added.
The best type of patient is an informed patient. If blockchain can deliver a patient-managed EHR system, the business of healthcare will be about delivering service and treatment to better health and not owning the patient’s health, Palombini said.
Precision medicine in clinical trials presents another big opportunity for blockchain innovation, Mehta said.
“According to IgeaHub, it is estimated that about 40 percent of clinical trials go unreported,” he said. “In fact, a majority of pharmaceutical research related to clinical trials is completed in silos, thereby making collaboration across an organization’s internal team impossible. This creates crucial safety issues for patients and knowledge gaps for healthcare stakeholders and policymakers.”
The contribution of wearables
Wearables and internet of things devices can also be integrated into the health IT ecosystem via blockchain.
“Health wearables are currently hoarding critical information for clinical research, outcomes of treatments, and disease prevention and management,” Palombini said. “However, in its current state, the information often sits in a repository where raw data may be inaccessible and never has the ability to be shared for other uses.”
If validated, this health data could be secured, shared and verified on a blockchain and the function of the health wearable takes on a whole new role, with, for example, clinical trial patient recruitment, clinical research and treatment of disease.
Indeed, patient-mediated health data exchange holds a big opportunity for blockchain innovation in healthcare. Blockchain can empower patients and data owners to control access to their healthcare data by using the blockchain as a system of record for patient consent and health data transfer activity.
“Today, patients have little access to their health data and cannot easily share with researchers or providers,” said Shahram Ebadollahi, chief science officer at IBM Watson Health. “Giving patients the opportunity to share their data securely, for research purposes or across their healthcare providers, creates opportunities for major advancements in healthcare. Blockchain technology is designed to make this a reality.”
As more and more patients gain that kind of control over their own data it will flow more efficiently across the system to create something a lot closer to a longitudinal view than what exists now and that, in turn, can enable more accurate data, better access to new treatment options and ultimately improved outcomes, Ebadollahi said.
Yes, this is where electronic health records come back into the blockchain picture.
Blockchain and EHRs
One big question is how might blockchain affect the evolution of the electronic health record? Blockchain can enhance EHRs in many ways, presuming healthcare CIOs and other executives want to move in that direction.
“Blockchain will help connect electronic health records across providers, to enable the full view of a patient’s health data, if patients provide the consent to do so,” Ebadollahi said. “This would be through a patient-mediated health data exchange.”
Currently, EHRs focus on clinical data. The fastest growing type of information is exogenous data, from mobile devices and medical devices and including genomics, Ebadollahi added, and blockchain can help connect these disparate sources to the more traditional clinical data.
The electronic health record, in fact, is generated from many different sources – hospitals, doctors offices, labs and more – each acting as the owner of the data. The fragmented network tying things together can be viewed as more about maintaining the business of patient care.
“If we look at the truly disruptive and emerging trend in blockchain and healthcare, the EHR will be created, maintained and distributed by the patient,” said IEEE’s Palombini. “Therefore, no longer multiple health records owned and operated by Healthcare Inc. Instead, it will be one record with multiple compartments containing data that was extracted as a service by one of these entities and given back to the person to add to their health record.”
These entities will no longer own a patient’s health record; they will merely contribute to the data in it as a rendered service, she added. Blockchain could flip the ownership and maintenance of the EHR completely upside down. It could empower patients to choose with whom, how much, and when they want to share their information, and not be beholden to any health system, she said.
Dave Watson Chief Operating Officer of SSI Group said that EHRs and blockchain working together have a long way to go.
“First, EHR vendors have so many pressing enhancements to deliver, and second, without clear and compelling use-cases, why would EHR vendors move blockchain up in the development queue?” Watson pressed. “They may entertain some proofs of concept or simply make positioning statements so they don’t appear to not be on the bandwagon, but that’s not a viable deployment of the technology.”
Blockchain and security
Another area in healthcare where blockchain could have a profound impact, like with EHRs, is cybersecurity. Blockchain can fundamentally change the way healthcare CISOs and infosec teams think about securing data.
“Blockchain offers a new combat strategy because it is not simply a security system, it is a technology that compels every enterprise professional to rethink their business operations in a digital universe,” Palombini said. “Blockchain is not a patch. It’s a whole new approach to distributing, managing and verifying information in a tamper-proof, decentralized system.”
All transactions are time-stamped and replicated in every block visible to permissioned users but can never be altered, only appended. The decentralized nature of the blockchain provides the ability to distribute anonymized, encrypted data that can be verified by credentialed users.
“This can provide traceability for all health data access, with transparency to auditors,” said IBM’s Ebadollahi. “Blockchain can provide integrity of data by maintaining indelible hashes of the data, so that any alterations of the data are detected.”
The distributed digital ledger technology can also can maintain keys for access to data, adding another level of security by working in concert with other systems to produce immutable audit logs, thereby making illegitimate access more difficult, Hashed Health’s Todaro said.
The largest opportunity is rethinking the movement of data in the healthcare ecosystem. Todaro explained that blockchain enables the development of light-data transactional models in which partners can get expanded utility without having to do large-scale data transfers or availability, both of which are sources of cybersecurity risk.
“One might argue that it may not be blockchain the technology that is oversold, but the amount of work to fix existing taxonomies, protocols and policies to fully maximize blockchain may be undersold.”
Maria Palombini, IEEE Standards Association
Hype outpacing reality?
In the end, one might wonder whether blockchain is all it’s cracked up to be. Evangelists sure make blockchain sound like a panacea for all of healthcare’s woes. But is it? Or is there more hype than promise?
Today, the challenge in truly driving innovation in the healthcare system is the inability to obtain and share clean patient health data while maintaining data privacy. The current crop of data management systems are not designed to evenly negotiate the ability to share data while retaining privacy, so the default has been to safe-harbor the data and let data-sharing fall to the wayside.
“The lack of data-sharing has become a true impediment to advancing innovation in drug development and healthcare,” Palombini said. “The true value healthcare providers offer is not the service or product but the data they provide. The data is the key to innovation in finding treatments, disease prevention and more.”
The very nature of blockchain – to distribute information with anonymity in an encrypted and tamper-proof environment – provides the platform to overcome this critical barrier of data-sharing and privacy, Palombini said.
As history has shown time and again, however, technology for technology’s sake cannot fix all problems.
“One might argue that it may not be blockchain the technology that is oversold, but the amount of work to fix existing taxonomies, protocols and policies to fully maximize blockchain may be undersold,” Palombini said.
“It’s important to remember we are just at the beginning of blockchain’s potential in health, so it will take some time before its benefits are fully realized.”
Shahram Ebadollahi, IBM Watson Health
An evolutionary journey
Palombini said that there are already more than 100 blockchains in existence across multiple vertical industry sectors.
“It’s important to remember we are just at the beginning of blockchain’s potential in health, so it will take some time before its benefits are fully realized,” IBM’s Ebadollahi said. “But it’s potential should not be underestimated.”
In the next five to 10 years, patient consent and data exchange backed by blockchain could fundamentally change the way healthcare services are provided by making patient longitudinal data readily available and opening the door to new treatments, new care delivery models and better coordination of care, IBM’s Ebadollahi explained. He pointed to blockchain underlying precision medicine and wellness programs outside the health systems as potentially having a large impact on outcomes.
And the matters of blockchain’s inherent limitations with respect to scalability, confidentiality and governance still need to be ironed out, SSI Group’s Watson said.
Working through those thorny issues will be an evolutionary journey for blockchain-based healthcare applications. Trust and governance are key as the interval between proof-of-concept production-quality technologies gets shorter. And building blockchain networks will require a lot of heavy lifting by software vendors and hospitals alike.
Making your home safe for a loved one with Alzheimer’s By Lydia Chan
When a loved one is diagnosed with Alzheimer’s disease, home safety takes on a whole new meaning. You may go for years satisfied that you’ve made your home environment safe by keeping sharp objects put away and cabinet doors closed.
Alzheimer’s changes the game radically: almost overnight you’re forced to see your home through very different eyes. Objects that may have occupied the same space for decades suddenly pose a lethal threat. It can be very easy to overlook something if you’re not very careful. For instance, if you’re not used to keeping your doors locked 24 hours a day, an Alzheimer’s patient can easily slip out and wander away.
Keeping a loved one with Alzheimer’s safe is a round-the-clock responsibility. It can be stressful and frustrating, forcing you to call on reserves of patience you didn’t know you had. You need to continually assess their capabilities and acuity, making any adaptations that a sudden change in their condition may require.
Keep a checklist
Making a checklist can help you maintain a safe environment. It should cover every room in your home, include instructions if there’s an emergency, and be revised or added to depending on your loved one’s situation. If you feel the need, request a home safety evaluation to make sure you’ve accounted for everything. Many healthcare professionals and social workers are fully qualified to help you with this important task.
Safe and secure
About 60 percent of the Alzheimer’s population wander off and get lost; one-third of those who aren’t found within 24 hours don’t survive. The first thing you should do is make certain that there are solid, reliable locks on all exterior doors and windows. If possible, put in an alarm system so you’re alerted the instant a window or door is unlocked. And conceal a house key somewhere in your yard in case you’re inadvertently locked out of the house.
Falls are another major safety concern if your loved one has Alzheimer’s. That makes your stairways very dangerous. Each should have a handrail running from the top all the way to the bottom step. Install safety strips on each stair to improve traction and help prevent slippage. If your family member needs help getting up and down stairs, make sure there’s a safety gate blocking the top and bottom (if your gates are worn or hand-me-downs, consider buying new ones).
Clear the clutter
Clutter is a big problem for people who suffer from dementia. Studies have shown that scattered objects only add to their confusion, and impair their ability to make sense of their surroundings. Clutter is a major cause of falls. An Alzheimer’s patient may have trouble navigating even familiar surroundings, so it’s important to keep everything picked up and off the floor. Avoid using extension cords if at all possible, and make sure that the grates on all floor vents are secure and even with the floor.
Medication, alcohol and more
A person who’s cognitively impaired can confuse a dangerous substance for something that’s perfectly harmless. Alcohol and cleaning fluids should be securely locked away in a cabinet and all medication should be kept in a safe place. Your loved one’s prescriptions should be clearly marked. Request a child-proof top if necessary.
A tense situation
Alzheimer’s disease affects about 5.4 million Americans, about 5.2 million of which are 65 and older. It can be your grandparent, your cousin, your sibling or even your parent who faces the diagnosis. Eventually, those with Alzheimer’s require round-the-clock care, and for many families, that means taking the loved one into their own home. Following a home safety checklist can help you control what can be a tense and frustrating situation.
A visit to the hospital typically ends in a doctor prescribing a particular set of medications, the details of which are printed on a physical form and handed to the patient. The patient must then take the form and submit it to a pharmacist.
Looking to overturn this traditional model, South Korea has set out to start digitizing prescription forms and make them accessible via mobile devices.
The Korea Internet & Security Agency said Tuesday that it has signed a Memorandum of Understanding with Seoul National University Hospital and Samsung Medical Center to create and implement a new service that digitizes prescription forms.
Under the agreement, the two hospitals will deploy a new system that lets patients receive and access prescriptions via their mobile devices, offering them convenience and an organized digital database of their prescription records that can be used for future personalized medicine services, KISA said.
The system will be adopted by the two hospitals within the first half of 2018, according to the Seoul-based internet technology agency.
In addition, implementing mobile-based prescriptions will save 2 million pieces of paper per year and allow pharmacies to retain their prescription records in an organized way without physical hurdles, it added.
KISA did not state whether it would expand its prescription digitization project to additional hospitals.