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Smart Homes: Visioning Elderland

New technology will change the experience of growing old both at home and in the community

One thorny question is how to pay for these new technologies. Much of the cost may fall on taxpayers. The recently enacted health care bill contains several provisions that may help quicken the adoption of aging-related technologies, including portable digital health care records and tele-medicine.

In the long term, though, technology could save money. As people age they often suffer from multiple chronic conditions, requiring a variety of medical specialists. Currently, Alwan says, few technologies help doctors coordinate patient care. That in turn leads to repeated procedures, unnecessary hospital readmissions and increased costs.

"Physician A doesn't know what physician B has prescribed for the same individual," Alwan said. "That causes medical errors."

The HITECH provision (Health Information Technology for Economic and Clinical Health) of the stimulus law calls for the creation and standardization of electronic health records. Medicare and Medicaid will give physicians and hospitals financial incentives to adopt electronic health records and share patients' information.

Developers of aging technology, encouraged by such prospects, hope that their inventions will be the next household musts. Each year, the American Association of Homes and Services for the Aging holds an exposition that attracts thousands to see the latest technologies. Alwan is most excited about the exercise coach robot, among the technologies to be unveiled at the Los Angeles expo in November.

A pilot project of the University of Southern California and Southern California Presbyterian Homes, the robot will provide older exercisers with coaching to encourage them to remain physically active. Eventually, if the concept of an electronic coach catches on, an easily replicated avatar will give instructions from a computer screen instead.

Even in 2029, however, health care will still involve face-to-face interactions between providers and patients.

"These shouldn't be considered replacements," Alwan says. The new aging technologies are a way "to increase the efficiency of available professional caregivers, and to provide additional support to the older adults and their caregivers."

Nushin Rashidian is a fellow of News21, a national foundation-supported initiative to promote innovation in journalism, at Columbia University Graduate School of Journalism. News21 fellow Connor Boals contributed reporting.

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