Real World Health Care Blog

Tag Archives: seniors

The Future of Healthcare Transportation? May Just Be Subscription-Based Ride Share

Meeting the health-care demands of the elderly community is already a challenging job, but patients who miss appointments add to that challenge. Unlike 20 years ago, today there are more independent seniors who live remotely from immediate family. At the same time, more surgical procedures are now done with patients going home the same day. Relying on friends and family members to get to and from the health care facility just doesn’t work anymore and seniors are being left to fend for their own care.

Jeffrey Ericson, CEO and Founder, RubyRide

Jeffrey Ericson, CEO and Founder, RubyRide

As physicians and caregivers, we need to change our mindset on how care is going to be provided and look at the future of healthcare. There is a recognized need for high quality extended post-surgical care beyond the hospital recovery unit. Enter a PostOp Concierge service.

To alleviate the stress of having to ask family and friends for help, the only subscription-based car and driver service in the United States, called RubyRide, has been launched in partnership with board certified anesthesiologist, Dr. Karl Frindrich, MD. The service, which is being piloted in Phoenix, Arizona, hopes to partner with senior centers and healthcare facilities around the country to extend the service area.

So what is PostOp Concierge and what benefit would a service such as this provide to the senior community?

PostOp Concierge supports all patient transportation and service needs for pre-operation as well as post-operation. In addition, all drivers are extensively background checked to ensure a safe environment from a ride, recovery and healing process standpoint. Staff has to be CPR, ADA, and First Aid trained.

As an extension, there is a Home Safe Program™ encouraging a safer home environment by making sure all passage ways, bedrooms, bathrooms and kitchen are free of obstruction and well lit. Trained providers can help interpret post-operative instructions to make them clearer, decreasing non-vital phone calls to the surgeon’s office. When patients do need help with medical problems such as nausea, vomiting or excessive pain, the patient quickly reaches the right person in the doctor’s office to get the help they need. This combination of services is intended to create a safer environment for the patient, as well as reassuring them that they are progressing as expected for the procedure.

Some patients resort to asking family or friends to deliver them to the surgical procedure as well as back home. According to Dr. Frindrich, the minimum time needed to take a patient to and from a procedure is approximately four to six hours, including round-trip drive time, pre-operative procedures, the surgical procedure, and recovery. With today’s busier lives, the patient needs a driver care service he or she can rely on. Patients not only have someone to ride along with them to and from a procedure for emotional support, but physicians do not have to worry about how they are going to transfer the post-op patient home.

The future of the senior medical industry is headed in the ‘concierge’ direction. Communities need to embrace new models of care that are both safe and affordable options providing that continued piece of mind. After all, we are all going to be seniors one day and we only hope that the level of care and attention makes sense.

Jeff Ericson is the CEO and Founder of RubyRide, a membership-based transportation provider that specializes in scheduled, local, regular trips on a recurring revenue model.




6 Reasons Seniors Need Social Media for Wellness

When you consider that some seniors were around before the advent of television, it is no wonder that they may be resistant to new technology and especially social media. For many seniors, computers are intimidating, but it is critical for family members and the healthcare community to encourage seniors to get involved in social media.

Asif Khan, CEO, Caremerge

Asif Khan, CEO, Caremerge

A recent article in the Harvard Business Review points to several studies that show social interactions could lead to a smarter, stronger brain. This is traditionally a huge focus in senior living communities, where social interactions are encouraged to promote overall wellness among their residents. Thanks to technology, these social interactions can now happen online.

Here are six reasons seniors should use social media.

  1. Keep in touch with family. As the body slows down, visiting old friends and even family can be difficult. Social media overcomes geography, helping seniors keep in touch with kids and grandkids. They can receive videos and photos and have live conversations with the push of a button.
  2. Find old friends. Ever wonder what happened to your Army buddy or high school sweetheart? One of the most amazing parts of social media sites like Facebook is that you can find people from your past and reconnect. This can be a thrilling experience for someone in a senior living community.
  3. Make new friend. When a 25-year-old in a major city complains that it is hard to meet new people, imagine how an 85-year-old in a senior living community feels. Limited mobility makes isolation a big problem for seniors. Traditional social media can certainly help find old friends. However, finding new friends on the same old sites is not practical for the aging. What seniors want is a simpler solution that lets them connect with other like-minded people right within their own local community. New social media sites geared toward seniors make it possible for seniors to broaden their horizons and find people with similar interests in their local community. The face-to-face interaction available through these sites helps seniors create an “active” lifestyle within their own environment.
  4. Keep working. Sixty-five is no longer the retirement age for most seniors, and while a daily commute into the nearest city may no longer be a viable option, digital and online opportunities for work are expanding at a rapid pace. Social media networking tools keep seniors from being forced into retirement. Moreover, senior living providers can easily post local jobs along with many volunteer positions so that seniors can continue to live an impactful and purposeful life.
  5. Learn and research. Having an endless library at your fingertips is a luxury that seniors did not have growing up. When most seniors take the leap and begin to use the Internet and search sites like Google, they are astonished at how much there is to learn. Learning keeps the brain active, which is critical to health and wellness. And active learning can lead to new hobbies or even business ideas.
  6. Help with gifting. For seniors who have grandkids, being a good gift giver is a core responsibility. Elder consumers can follow their favorite brands on Facebook and other sites and be alerted to sales and promotions. They can also see what is “new and hot” among the younger generation to help them come up with great gift ideas their grandchildren would love.

What are some other ways seniors can use social media to improve their health and wellness? Give us your ideas in the comments section.

Asif Khan is founder and CEO of Caremerge. The company forges meaningful connections between providers, families and seniors seeking to improve communication in today’s complex healthcare environment.

Elder Care: Living Independently Thanks to Coordinated, Compassionate Care

Vera Brown of Churchville, Pa., was like many elderly Americans. She had multiple health issues including decreased mobility, degenerative joint disease, progressive dementia and aphasia from a stroke. But unlike some in her situation, she was able to live comfortably in her own home until her death in October, thanks to LIFE St. Mary. LIFE is a Program of All-Inclusive Care for the Elderly (PACE®), a unique model of care that helps people live safely at home with assistance from a team of compassionate healthcare experts.

A LIFE St. Mary nurse works with a patient

A LIFE St. Mary nurse works with a patient

Elder care can be expensive and frustrating. Nursing homes and other long-term care facilities can quickly eat up a person’s life savings as well as destroy their feelings of independence. But keeping the elder at home means family members or other caregivers need to drive to multiple doctor appointments, stay informed about medical issues, keep track of medications, and more—not to mention the worry that goes along with leaving their loved one at home during the day.

LIFE St. Mary offers 24/7 support and a range of services for elders and their caregivers: medical and in-home care; medications; transportation; physical, speech and occupational therapy; social work services; nutritional counseling and home-delivered meals; hearing, foot and dental care; adult day care; and caregiver respite. The hub of the program is the LIFE Center, a central location where doctors, nurses and other healthcare professionals offer treatment and monitor changes in participants’ health. Here, participants also receive nutritious meals and join in on a variety of activities to keep active and make new friends.

St. Mary Medical Center started LIFE five years ago to address the needs of the growing population of older adults in the Bucks County, Pa. area,” explains Erin Williams, manager, Outreach & Enrollment, LIFE. “The program is part of St. Mary’s commitment to improving the quality of life for everyone in our community, including elderly residents who need assistance to remain independent in their own homes.”

For Vera Brown, that assistance arrived at her front door three days a week, in the form of a LIFE van, which picked her up and took her to the LIFE Center. There, she received meals, therapeutic recreation, routine physical therapy and a full range of medical services. Vera’s LIFE team—her doctor, nurse, social worker, physical therapist, and home care nurse—collaborate to ensure that the care provided met her needs, and regularly updated her daughter to discuss her mother’s care plans. All of Vera’s medications came directly to the LIFE Center and were sent home with her. This saved her daughter the time of making trips or phone calls to the pharmacy, or coordinating doctor’s visits.

In addition to reducing headaches and hassles for family caregivers, LIFE helps to manage healthcare utilization and costs.

“The program costs about 30 percent less than nursing home care in Pennsylvania,” says Williams. “Program participants pay one monthly fee that covers all services, no matter how many of those services they use or how often. There are no copays or deductibles—even for medical equipment, prescriptions and transportation—so participants know exactly what their healthcare costs will be every month, with no surprises.”

Ms. Williams notes that LIFE’s coordinated care model is also helping St. Mary Medical Center reduce costs relating to unnecessary hospital and nursing home stays, medication errors, redundant tests and unnecessary labs. She says by reducing unnecessary hospital stays, “we’re saving a lot of healthcare dollars.”

“Holistic, patient-centered care can be difficult when elderly people stay in their home,” concludes Williams. “But with LIFE St. Mary, all care—including specialist care—is centrally coordinated, making it much easier for patients to access the care they need. Plus, we see our participants on a regular basis, so we can tailor services to each patient’s medical, psychological and social needs.”

“LIFE St. Mary is a wonderful program and a Godsend to aging and disabled individuals and their families,” says Marie Brown-Etris, daughter of Vera Brown. “For my mom, it was like they were an extended family who treated her with nothing but kindness through smiles, touches, hugs and kind words. The compassion and understanding for the people they serve is palpable.”

Are you a caregiver for an elderly family member or friend? Have you been able to take advantage of a PACE program like LIFE St. Mary? Tell us about your situation in the Comments.

Keeping Minds of Seniors Sharp: Some Answers Emerge

As a member of the Atari Generation, I remember my parents telling me to limit my time playing video games. Well guess what? Now I can tell them that if they want to improve their ability to fight cognitive decline, they should increase their time playing video games – at least when it comes to the games from A well-designed study published in PLoS One found cognitive benefits for seniors. No, this is not a paid advertisement. None of the funding for the study came from Lumosity. The study was funded by the government of Spain.

David Sheon

David Sheon

Let’s back up a bit. America is aging. As the massive number of baby boomers reach their twilight years, we’re well served to think through the implications of a couple of statistics mentioned on the recent 60 Minutes story, Living to 90 and Beyond. The fascinating story finds compelling evidence that as we age, drinking a glass of any alcohol a day, consuming coffee, and gaining weight (but not to the point of obesity) all increase the chances of living past 90.

The story also mentions that by about 2050, the number of Americans over age 90 is projected to quadruple. It also reports that the risk of developing dementia doubles every 5 years starting at the age of 65.

Although more research needs to be done before we can say that games for your brain delay dementia, we can say that Lumosity improves the ability of seniors to stay attentive and alert thanks to the Spanish-funded study by Julia Mayas et al.

Recently, research on aging has begun to examine cognitive “plasticity” in seniors and its capacity to counteract cognitive decline. The aim of the Spanish-funded study was to investigate whether older adults could benefit from brain training with video games, with additional distractions, like randomly generated noises created by the researchers, to assess distraction and alertness.

For example, participants were presented with a sequence of numbers on the screen that they labelled as “odd” or “even” while ignoring irrelevant sounds such as drilling, rain, or hammering, just before being shown the number. In most trials the sound was consistent, while in a small proportion of the trials, interspersed at random, the standard sound was replaced by a random sound not presented earlier in the task. Other studies have shown that random sounds seemed to startle and take study volunteers off task, if only for a second or two.

The researchers hypothesized that if video game training improves auditory attentional functions as it does visual attention or executive functions, then older adults in the study who used Lumosity for training would show reduced distraction and maintain their level of alertness or prevent its decline.

Forty healthy adult volunteers aged 57 to 77 years were randomly assigned to either the experimental or the control group. The study was completed by 15 of the 20 participants of the experimental group and 12 of the 20 members of the control group. All participants had normal hearing and normal or corrected-to-normal vision. In addition to the random noise task, all participants completed a battery of cognitive tests to be sure that participants in both groups had similar capabilities.

Each participant assigned to use the computer video games had 20 sessions of game training. They practiced 10 video games selected from Lumosity’s commercially available package. The games practiced were specifically designed to train a variety of mental abilities, including speed of processing and mental rotation, working memory, concentration, and mental calculation.

Points were awarded to participants based on their performance and on the time taken to complete the games. To make sure the data wasn’t biased, participants were not allowed to play any other video game during the study. None of the participants reported any previous experience with video games. The control group did not receive video games training but participated in three group meetings during this time in which they socialized with each other but didn’t try the games.

All participants were measured for the ability to cope with distractions and stay alert before and after the study. On both accounts, those who used the video games improved compared to those who did not do the video games.

The ability to ignore irrelevant sounds improved after video game training by about 12 milliseconds, while those in the control group saw no improvement.

Similar pre- and post-training comparisons showed a 26 millisecond increase of alertness in the experimental group with no significant difference in the control.

One thing that makes this study stand out is its ability to transfer findings from the computer games to real-world improvements.

According to the study authors, “practicing video games of this type may offer some protective factor against the effects of aging and may potentially be recommended to older individuals, alongside other interventions found to improve mental functions. These include, for example, a long-term physically active lifestyle (improving executive control and speed of processing), aerobic exercise (improving cognition by increasing the volume of grey and white matter in frontal and temporal sites), or social networking and innovative solutions to connect people in a multimodal way with family members, friends and caretakers.”

So I guess that like when my parents told me to put down the joystick and play outside, I get to remind them to do the same. Just don’t be quick to dismiss video games as part of the equation to a healthier mind in our senior years.

Do you use Lumosity or any other brain training program? Have you noticed it helping you? We’d love to hear about it.

Get Your Flu Shot Now to Stay Healthier Later

So you think you’re too busy to get your flu shot? It’s easy to put off, but taking the time to do it sooner rather than later could prevent you from getting sick while helping to protect those you care about – during the holidays and beyond. That’s why the U.S. Department of Health and Human Services (HHS), the Centers for Disease Control and Prevention (CDC), state and local health departments as well as other health agencies are raising visibility around National Influenza Vaccination Week (NIVW), from Dec. 8-14.

Paul DeMiglio

Paul DeMiglio

With the flu season beginning in the fall and not peaking until January-February, it’s certainly not too late to get your influenza shot. In fact, the CDC’s Advisory Committee on Immunization Practices recommends that everyone 6 months of age or older receive it, including:

  • Children
  • Seniors 65 and older
  • Pregnant women
  • American Indians and Alaska Natives
  • Those with underlying health conditions like asthma
  • Those living with conditions including chronic lung disease, heart disease, HIV/AIDS, cancer and diabetes

Although the effectiveness of flu vaccination varies each year, the CDC reports that recent studies demonstrate the evidence-based public health benefits. The Mayo Clinic agrees, calling flu shots your best defense against the flu, enabling “your body to develop the antibodies necessary to ward off influenza viruses.”

“The single best way to protect against the flu is to get vaccinated each year,” said CDC’s Anne Schuchat, M.D., Director, National Center for Immunization and Respiratory Diseases. “Today, flu vaccines are available in more convenient locations than ever. The few minutes it takes to get a flu vaccine can save you from experiencing several unproductive days due to influenza. The most common side effects are mild and short-lasting, especially when compared to symptoms of influenza infection.  Flu vaccine cannot cause flu illness.”

Despite evidence that the influenza vaccine is an effective tool, some still fear that getting their shot might put them at risk for experiencing severe side effects. No more than one or two cases per million people vaccinated acquire Guillain-Barré syndrome, an outcome much lower than the risk of developing severe complications from influenza. From 1976-2006, in fact, estimates show that far more people died from flu-associated deaths in the U.S. (3,000-49,000) than from negative reactions to the vaccines that protect against influenza.

To build awareness and support of NIVW and encourage people to get their shots, the CDC is making a rich variety of online tools and resources available to a wide spectrum of patients, educators and providers, such as:

Partnering with Reckitt Benckiser, Inc., the makers of LYSOL® Brand Products, the CDC is also spotlighting the Ounce of Prevention Campaign, which seeks to empower consumers and professionals with practical tips and information around effective hand hygiene and cleaning habits to prevent infectious diseases like the flu.

Click here to see if the vaccine is available in your area. To find a nearby location to get the vaccine, check out HHS’s “Flu Vaccine Finder” on, enter your ZIP code and share the widget to let your family members, colleagues and friends know where they can go too. HHS also provides a series of informative YouTube videos that cover prevention strategies, share tips for identifying symptoms and provide recommended treatment practices.

You can also make a powerful statement by taking the pledge to get vaccinated for the 2013-14 season, commit to taking a friend with you and in the process spread the word by clicking here. To get the latest updates on flu vaccination efforts, follow the CDC on Twitter (@CDCFlu and @CDCgov) and “like” them on Facebook.

Now tell us if you’ve gotten your flu shot. Where did you go? How long did it take? What ways could providers and health care stakeholders more effectively remind patients to get vaccinated?

Striking the Right Balance for Better Patient Outcomes

A recent article in Health Affairs reports that ChenMed – which serves low-to-moderate income elderly patients primarily through the Medicare Advantage program – is achieving better health outcomes for Medicare-eligible seniors, including those living with five or more major and chronic health conditions.  Dozens of Chen and JenCare Neighborhood Medical Centers are helping tens of thousands of seniors live better, longer: 


Dr. Christopher Chen, ChenMed CEO

  • Total hospital days per 1,000 patients at ChenMed in 2011 were 1,058 for the Miami area in comparison with 1,712 total US hospital days per 1,000 patients in the same year (Centers for Medicare and Medicaid Services Office of the Actuary).
  • Just one year prior, according to Dartmouth Atlas of Health Care, the Miami Hospital Referral Region was above the 90th percentile in inpatient hospital days.

Why is ChenMed so successful?

Dr. Christopher Chen, CEO of the organization, says its patient care model integrates cutting-edge medical expertise in a way that empowers physicians to ensure patients receive personalized attention and optimal care.

“People always ask, ‘What is your secret?’ There really is no secret,” he says. “It comes down to having the right incentives, the right physician and staff culture, and the right philosophy of care. My goal at the end of the day is to be cost-effective through improvement of outcomes by changing the philosophy of care. We care about results.”

The group practice’s popularity also attests to its effective one-stop-shop approach to patient-centered care through multi-specialty services. Smaller physician panel sizes of 350-450 patients spur intensive health coaching and preventive care, and prescriptions are given to patients during their visits at all Chenand JenCare Neighborhood Medical Centers.

This aspect of ChenMed’s model makes the biggest difference in boosting medication adherence, followed by strong one-on-one doctor-patient relationships that help to change habits for the better. Receiving meds within 3-5 minutes of ordering drugs not only means patients don’t have to wait for the treatment they need, but that they receive their medications while having face-to-face interactions with their primary care doctors.

“In our model we aren’t looking for high-income patients,” Dr. Chen says. “People ask, ‘Are you saying that patients like you because you give more attention to them and provide more access to doctors than those who pay for concierge service?’ I would say yes.”

ChenMed continuously employs top specialists from a variety of fields to conveniently provide fully integrated medical services to patients.  It effectively combines services like acupuncture into its portfolio of care, and improves outcomes and patient experience with customized end-to-end technologies enhancing its daily operations. For example, all the medical assistants and staff are equipped with iPads and can offer physician support tailored to each patient. This fuels collaboration, enabling doctors to work side by side with patients and providing a significant convenience to all parties as a result.

Primary care physicians at Chen and JenCare Neighborhood Medical Centers also meet three times a week, engaging in thoughtful ongoing discussions that generate numerous enhancements to care and delivery for better outcomes.

“We discuss whether a hospitalization could be improved through better outpatient care. We ask, ‘What can we do to improve patient outcomes while the patient is in the hospital?’ We innovate to improve outcomes and can achieve great things for patients because of our small panel sizes. These meetings have saved many lives and continue to do so,” explains Dr. Chen.

When interviewing prospective doctors to work at ChenMed, they are asked whether they like spending time with patients and whether they love the complexity of medicine. If they say no to either of those questions, then this group is probably not the best place for them, Dr. Chen says, underscoring that:

“We want you to practice medicine the way you thought you would when you graduated from medical school. It’s not about how many patients you see, how many procedures you do, or how much you bill. You should want to be a doctor to make people feel better.” 

ChenMed, through its Primary Management Resources subsidiary, also provides behind-the-scenes consulting services to enhance medical practice operations nationwide.  Physicians interested in end-to-end solutions that streamline operations while enhancing patient health outcomes and the patient experience should contact ChenMed at (305) 628-6117 or go to