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Reinventing Quality Conference
               August 7, 2012
                 Greg Wellems
Imagine! SmartHomes




 Bob and Judy Charles    Charles Family SmartHome,
SmartHome, Boulder, CO         Longmont, CO
   People are living longer.
   Care is becoming increasingly complex.
   Increased focus on wellness promotion.
   Caregivers need more information.
   Workforce crisis.
   Transparency.
   Reimbursement policies.
   Funding streams will be more self-directed.
   Benefits of “The Cloud”.

                                      © Imagine! Consulting
   Improve Organizational Management
   Improve/Support Supports/Service
   Automate Notification and Prompting
   Improve Learning/Independence
   Improve Health/Wellness
   Increase Stakeholder Involvement
   Transparency
   Reduce Risk


                                     © Imagine! Consulting
Enterprise
               Applications




                Smart
               Supports
  Assistive                    Remote
Technologies                  Monitoring
   Education
    ◦ Software and Application
    ◦ Benefits of Technology
   Prioritization
    ◦ Analyze “pain” points
    ◦ Greatest Impact
   Planning
    ◦ Impacts on the Organization
   Implementation
    ◦ Project Management (DIGs)
   Maintenance and Support

                                    © Imagine! Consulting
   Enterprise Applications
    ◦ Enterprise Resource Planning (ERP)
    ◦ Customer Relationship Management (CRM)
    ◦ E-MAR, Learning Management, Document Imaging
   Remote Monitoring Applications
    ◦ 3rd Party Monitoring Services
    ◦ In-House Monitoring
   Assistive and Adaptive Technology
    ◦   Communication Systems
    ◦   Environmental Controls
    ◦   Learning/Prompting Systems
    ◦   Community Navigation/Support
    ◦   Apps/Apps/Apps

                                         © Imagine! Consulting
   Analyze “Pain” Points
    ◦   What Takes the Most Time?
    ◦   What Costs the Most Money?
    ◦   Where are the Workflow Bottlenecks?
    ◦   Where are You at Risk?
   Greatest Impact
    ◦ Simplify Current Workflows
    ◦ Change Static to Dynamic
         Increase Communication
         Reduce Risk by Reducing Errors/Judgment



                                                    © Imagine! Consulting
   Impact on the Organization – Culture Change
    ◦ Change in Current Practices
    ◦ Change in Personnel – Build Capacity
    ◦ IT Infrastructure/Support
      Equipment
      Support
        Help Desk – Track/Identify trends
      Education
    ◦ Cost
      Capital Expenditures
      Ongoing
      Return on Investment (ROI)



                                             © Imagine! Consulting
   Designed for the End User
   Replicate/Improve Current Workflow
   Does it Integrate with Other Systems?
   Does it Scale?
   Can you Customize?
    ◦   Security/User Roles
    ◦   Dashboards
    ◦   Report Functions
    ◦   Additional Data Fields
   Don’t Over Develop (Know When to Stop)

                                       © Imagine! Consulting
   Project Management
    ◦ Identify Project Team
      Use an experienced Project manager
      Representative of the Organization
    ◦ Adequately Staffed
      Free up content area experts to configure work flow
      Design for the end user
      Involve end user early in any implementation
    ◦ Create and Follow Project Plan
      Accountability and timelines
      Ensures clear communication


                                                © Imagine! Consulting
   Avoid Siloed Data
    ◦ Integration across Applications
    ◦ Dashboards for Business Intelligence
   Build in Internal Competencies
    ◦ Learning Management Systems
    ◦ Systematic Processes
   Analyze Trends
    ◦ Monitoring Metrics for Success
    ◦ Maintain Momentum and Interest




                                             © Imagine! Consulting
Imagine! SmartHomes




 Bob and Judy Charles    Charles Family SmartHome,
SmartHome, Boulder, CO         Longmont, CO
Individual
          Supports
Family Communication and Access
Operational – Management and Line Staff (DSP)
Support and Information
Environmental – Home Management and
Remote Monitoring Systems
Using RFID Information

                                    Just In
                                                Portal                     •Alerts & Notifications
                 Sensors            Time
    Staff                                        Use
                                     Log                         Staff     •Live View
   Members                                                      Members    •Care Zone Summary
                                                                           •Performance Metrics




                                                                           •   Live View
               Sensors         Alerts                           Support    •   Historic Trends
                                                                Network    •   Health information
Clients                                                                    •   Social information



                                                  CARE System
                                                                           •Global Perspective
                                                                Managers   •Client Overview
                                            Alert
                         Profiles
                                         Preferences                       •Employee Overview


    Managers
®

Medication Administration and prompting system
Intuitive User Interface improves efficiency and accuracy
Easily manage staff and medications records from a central
location or remotely
Improved compliance with Medication Administration
Improved communication between DSP and Nursing
75% reduction of medication administration errors
Reduces staff training by 18 hours per residence (houses who
support medically fragile individuals offers a greater
differential)
Integrated with Pharmacy to reduce transcription errors
Over three year period reduced 2 nursing FTE
Environmental
Control Units



                   The MEDIAssistant
                    Mobile is a portable
                    system that uses both
                    infrared transmission
                    and Insteon™ radio
                    transmission to
                    operate up to 24
                    devices.
   Motions Sensors
    Detect Falls/Proximity
   Security/ Health and Safety Sensors
    Doors/Windows - Alarms
   GPS- Community
   Remote Health Monitoring
   RFID – Specific Location
    Environmental Control
   Data – Trends
   Cameras
    PTZ – Fixed Units

                                     © Imagine! Consulting
Research Question
   Does living in the Bob and Judy Charles
    Smarthome enhance the quality of life for the
    residents?
   Quality of Life Indicators Studied
     Increased  service to customers
     Increased active participation with community

     Increased communication

     Increased independence

     Improved health

     Satisfaction with services provided through the
      SmartHome
Results -Choices and Decision
Making
   There was a large                    Choices & Decision Making 1
    increase in residents’                          (n=6)
    perception in control of               8
    their own lives.                       7

   5 resident’s mean                      6
                                   Number 5
    scores stayed the same         of       4
    or increased                   Resident
                                   s        3
       2 resident’s mean scores           2
        increased by one point             1
       1 resident’s mean scores           0
        increased by two points                 -5 -4 -3 -2 -1 0   1   2    3   4
       2 resident’s mean scores
        increased by 4 points                       Change in mean scores

   1 resident’s mean
    scores decreased by 3
Results -Service Coordination
   There was a decrease in             Service Coordination (n=7)
    getting what’s needed from               8

    service coordinator and                  7

    knowing service coordinator.             6

    This was not expected.         Number
                                             5


   3 resident’s mean scores       of
                                   Residen
                                             4

                                   ts
    stayed the same or increased             3


   4 resident’s mean scores                 2

                                             1
    decreased
       2 resident’s mean scores             0
                                                 -5   -4   -3    -2   -1   0    1      2   3   4
        decreased by 1 point                                    Change in mean score
       1 resident’s mean scores
        decreased by 3 points
       1 resident’s mean scores
        decreased by 5 points
Supports Intensity Scale – SIS
Overview
   Evaluate and measure the type, frequency and
    intensity of supports needed for an individual with a
    developmental disability in 85 areas covering the
    following domains:
       Home Living
       Community Living
       Lifelong Learning
       Employment
       Health and Safety
       Social
       Protection and Advocacy
       Medical
       Behavioral
   Collected directly from participants in a structured
    interview format.
   Part B: Community Living Activities
    ◦ Q1 – Getting from place to place throughout the
      community
   Identify - “low hanging fruit”
   Adopt Best in Breed Solutions
   Supportive Corporate Structure
   Seek Collaboration/Consulting
   Evaluation Process and Feedback Loop
   Fail Fast
   Advertise/Market Success
    ◦ Fundraising/Grant Writing




                                     © Imagine! Consulting
   Incorporating Consumer Technologies
    ◦ Technology Screening
    ◦ Individual Technology Plan
         Part of Individual Plan Process
    ◦   Data/Tracking Methodology
    ◦   Build Systems for Replication
    ◦   Job Expectations and Job Descriptions
    ◦   Staff Training/Staff Training/Staff Training
         Hiring and Recruitment
         Group Similar Technology
         Curriculum Development


                                                 © Imagine! Consulting
Fourth Annual
ANCOR Technology Summit
      November 3, 2012
     Westin Westminster Hotel
      Westminster, Colorado
            In conjunction with the
         Coleman Institute Conference
     on Cognitive Disability and Technology
               November 2, 2012




                  www.ancor.org
Greg   Wellems -Gwellems@imaginecolorado.org


SmartHome       - http://Imaginesmarthomes.org

FaceBook– http://www.facebook.com/pages/Imagine-
SmartHomes/86609388388

Twitter   - http://twitter.com/ImagineColorado

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Innovative Technologies in Services and Supports for Individuals with Disabilities

  • 1. Reinventing Quality Conference August 7, 2012 Greg Wellems
  • 2. Imagine! SmartHomes Bob and Judy Charles Charles Family SmartHome, SmartHome, Boulder, CO Longmont, CO
  • 3. People are living longer.  Care is becoming increasingly complex.  Increased focus on wellness promotion.  Caregivers need more information.  Workforce crisis.  Transparency.  Reimbursement policies.  Funding streams will be more self-directed.  Benefits of “The Cloud”. © Imagine! Consulting
  • 4. Improve Organizational Management  Improve/Support Supports/Service  Automate Notification and Prompting  Improve Learning/Independence  Improve Health/Wellness  Increase Stakeholder Involvement  Transparency  Reduce Risk © Imagine! Consulting
  • 5. Enterprise Applications Smart Supports Assistive Remote Technologies Monitoring
  • 6. Education ◦ Software and Application ◦ Benefits of Technology  Prioritization ◦ Analyze “pain” points ◦ Greatest Impact  Planning ◦ Impacts on the Organization  Implementation ◦ Project Management (DIGs)  Maintenance and Support © Imagine! Consulting
  • 7. Enterprise Applications ◦ Enterprise Resource Planning (ERP) ◦ Customer Relationship Management (CRM) ◦ E-MAR, Learning Management, Document Imaging  Remote Monitoring Applications ◦ 3rd Party Monitoring Services ◦ In-House Monitoring  Assistive and Adaptive Technology ◦ Communication Systems ◦ Environmental Controls ◦ Learning/Prompting Systems ◦ Community Navigation/Support ◦ Apps/Apps/Apps © Imagine! Consulting
  • 8. Analyze “Pain” Points ◦ What Takes the Most Time? ◦ What Costs the Most Money? ◦ Where are the Workflow Bottlenecks? ◦ Where are You at Risk?  Greatest Impact ◦ Simplify Current Workflows ◦ Change Static to Dynamic  Increase Communication  Reduce Risk by Reducing Errors/Judgment © Imagine! Consulting
  • 9. Impact on the Organization – Culture Change ◦ Change in Current Practices ◦ Change in Personnel – Build Capacity ◦ IT Infrastructure/Support  Equipment  Support  Help Desk – Track/Identify trends  Education ◦ Cost  Capital Expenditures  Ongoing  Return on Investment (ROI) © Imagine! Consulting
  • 10. Designed for the End User  Replicate/Improve Current Workflow  Does it Integrate with Other Systems?  Does it Scale?  Can you Customize? ◦ Security/User Roles ◦ Dashboards ◦ Report Functions ◦ Additional Data Fields  Don’t Over Develop (Know When to Stop) © Imagine! Consulting
  • 11. Project Management ◦ Identify Project Team  Use an experienced Project manager  Representative of the Organization ◦ Adequately Staffed  Free up content area experts to configure work flow  Design for the end user  Involve end user early in any implementation ◦ Create and Follow Project Plan  Accountability and timelines  Ensures clear communication © Imagine! Consulting
  • 12. Avoid Siloed Data ◦ Integration across Applications ◦ Dashboards for Business Intelligence  Build in Internal Competencies ◦ Learning Management Systems ◦ Systematic Processes  Analyze Trends ◦ Monitoring Metrics for Success ◦ Maintain Momentum and Interest © Imagine! Consulting
  • 13. Imagine! SmartHomes Bob and Judy Charles Charles Family SmartHome, SmartHome, Boulder, CO Longmont, CO
  • 14. Individual Supports Family Communication and Access Operational – Management and Line Staff (DSP) Support and Information Environmental – Home Management and Remote Monitoring Systems
  • 15.
  • 16. Using RFID Information Just In Portal •Alerts & Notifications Sensors Time Staff Use Log Staff •Live View Members Members •Care Zone Summary •Performance Metrics • Live View Sensors Alerts Support • Historic Trends Network • Health information Clients • Social information CARE System •Global Perspective Managers •Client Overview Alert Profiles Preferences •Employee Overview Managers
  • 17.
  • 18.
  • 19. ® Medication Administration and prompting system Intuitive User Interface improves efficiency and accuracy Easily manage staff and medications records from a central location or remotely Improved compliance with Medication Administration Improved communication between DSP and Nursing 75% reduction of medication administration errors Reduces staff training by 18 hours per residence (houses who support medically fragile individuals offers a greater differential) Integrated with Pharmacy to reduce transcription errors Over three year period reduced 2 nursing FTE
  • 20. Environmental Control Units  The MEDIAssistant Mobile is a portable system that uses both infrared transmission and Insteon™ radio transmission to operate up to 24 devices.
  • 21. Motions Sensors Detect Falls/Proximity  Security/ Health and Safety Sensors Doors/Windows - Alarms  GPS- Community  Remote Health Monitoring  RFID – Specific Location Environmental Control  Data – Trends  Cameras PTZ – Fixed Units © Imagine! Consulting
  • 22.
  • 23.
  • 24.
  • 25. Research Question  Does living in the Bob and Judy Charles Smarthome enhance the quality of life for the residents?  Quality of Life Indicators Studied  Increased service to customers  Increased active participation with community  Increased communication  Increased independence  Improved health  Satisfaction with services provided through the SmartHome
  • 26. Results -Choices and Decision Making  There was a large Choices & Decision Making 1 increase in residents’ (n=6) perception in control of 8 their own lives. 7  5 resident’s mean 6 Number 5 scores stayed the same of 4 or increased Resident s 3  2 resident’s mean scores 2 increased by one point 1  1 resident’s mean scores 0 increased by two points -5 -4 -3 -2 -1 0 1 2 3 4  2 resident’s mean scores increased by 4 points Change in mean scores  1 resident’s mean scores decreased by 3
  • 27. Results -Service Coordination  There was a decrease in Service Coordination (n=7) getting what’s needed from 8 service coordinator and 7 knowing service coordinator. 6 This was not expected. Number 5  3 resident’s mean scores of Residen 4 ts stayed the same or increased 3  4 resident’s mean scores 2 1 decreased  2 resident’s mean scores 0 -5 -4 -3 -2 -1 0 1 2 3 4 decreased by 1 point Change in mean score  1 resident’s mean scores decreased by 3 points  1 resident’s mean scores decreased by 5 points
  • 28. Supports Intensity Scale – SIS Overview  Evaluate and measure the type, frequency and intensity of supports needed for an individual with a developmental disability in 85 areas covering the following domains:  Home Living  Community Living  Lifelong Learning  Employment  Health and Safety  Social  Protection and Advocacy  Medical  Behavioral  Collected directly from participants in a structured interview format.
  • 29. Part B: Community Living Activities ◦ Q1 – Getting from place to place throughout the community
  • 30. Identify - “low hanging fruit”  Adopt Best in Breed Solutions  Supportive Corporate Structure  Seek Collaboration/Consulting  Evaluation Process and Feedback Loop  Fail Fast  Advertise/Market Success ◦ Fundraising/Grant Writing © Imagine! Consulting
  • 31. Incorporating Consumer Technologies ◦ Technology Screening ◦ Individual Technology Plan  Part of Individual Plan Process ◦ Data/Tracking Methodology ◦ Build Systems for Replication ◦ Job Expectations and Job Descriptions ◦ Staff Training/Staff Training/Staff Training  Hiring and Recruitment  Group Similar Technology  Curriculum Development © Imagine! Consulting
  • 32. Fourth Annual ANCOR Technology Summit November 3, 2012 Westin Westminster Hotel Westminster, Colorado In conjunction with the Coleman Institute Conference on Cognitive Disability and Technology November 2, 2012 www.ancor.org
  • 33. Greg Wellems -Gwellems@imaginecolorado.org SmartHome - http://Imaginesmarthomes.org FaceBook– http://www.facebook.com/pages/Imagine- SmartHomes/86609388388 Twitter - http://twitter.com/ImagineColorado

Editor's Notes

  1. . As noted in my introduction I work for a company called Imagine! in Colorado – we’ve been working on the incorporating of tech into our services for the past 15 years and developed a number of strategic partnerships. Over that time we’ve learned a great deal – had a some success and some failures but it’s been an incredible education.– part of that the education development of smart homes.
  2. The strategic process follows five specific steps.
  3. Enterprise resource planning, a system that is used to manage and coordinate all the resources, information, and functions of a business.This typically coordinates multiple applactionsCustomer Resource Management – Stakeholders – communication – services
  4. DocumentationStaff IssuesInformation Stagnant information
  5. IT support/systemsRelationship between IT and Operations
  6. As systems change will the software scale to meet those needs
  7. The CARE System collects information from disparate sources, to creates views of information relevant to each role within the support network. From staff members collect information from sensors (such as location and alert response), just in time log in of services provided, and their use of the web-based information portal. From clients we collect information about their movement throughout the environment, and also from alerts they generateManagers provide the system with definition by completing profiles of Clients, and setting appropriate alert and notification preferences. The CARE Station translates this data into information relevant to each role: actionable cues for staff members: Alerts and notifications social and health information for client contacts (the support network) Global perspective for managers
  8. Review bullet points. If possible, relate to situations previously described by the audience.This is a good place to refer to previously posted items on the flip chart or white board.
  9. These research questions were developed by Imagine! And Colorado WIN Partners in December of 2008.4 research areas were discussed. The research question that elicited the biggest interest to Imagine & WIN Partners was how to Enhance the quality of life for consumers. The following is a list of the areas WIN Partners addressed in our data collection and analysis. Increased service to customers – Increased active participation with community –Increased communication – Increased independence – Improved health – Satisfaction with services provided through the SmartHome-
  10. Measures the level of which resident has control in choosing , for example where to work and where to liveOverall, 5 out of 6 residents scores all increased, while only one resident had a decrease in score for Choices and Decision Making 1
  11. Measures the extent to which residents know and receive services form manager/case coordinator/staff. Higher scores indicate resident receives more services from staff that are coordinated effortsThree residents scores stayed the same, however four residents scores decreased. Two of which decreased by 1 mean average, while 2 other residents scores decreased by 3 and 5 mean averages, respectively
  12. Supports Intensity Scale (SIS): Identifies the type, frequency and duration of supports needed for an individual receiving services in order to complete particular tasks or participate in particular activities. This information is collected through an informal interview.SIS covers different domains, or categories, of support needed: Home Living ActivitiesCommunity Living ActivitiesLifelong Learning ActivitiesEmployment ActivitiesHealth and Safety ActivitiesSocial ActivitiesEach domain has 8 questions. For each question there are three answers that need to be addressed: 1. What type of support would be needed for that activity? 2. How frequently would that support be needed? 3. How much time in one given day would that support take?Responses to the questions are chosen from the rating key of the assessment.Type of support: “What type of support would be needed?”0=none1=monitoring2=verbal/gesture prompting3=partial physical assistance4=full physical supportFrequency: “How frequently would that support be needed?”0=none or less than monthly1=at least once a month but not once a week2=at least once a week but not once a day3=at least once a day but not once an hour4=hourly or more frequentlyDaily Support Time: “How much time in any given day would that support take?”0=none1=less than 30 minutes2=30 minutes to less than 2 hours3=2 hours to less than 4 hours4=4 hours or moreUses for SIS:Created for measuring and planning supports and services for person with intellectual disabilities. Can develop Individualized Services Plans and track and decrease or increase in support needs overtime.Plan for supports that will improve independence and quality of life. Supports refer to an array of resources and strategies including individuals, agencies, money or tangible assets, assistive devices or environments that enable people with developmental disabilities live in typical community settings. “Rather than mold individuals into pre-existing diagnostic categories and force them into existing models of service, the supports approach evaluates the specific needs of the individual and then suggests strategies, services and supports that will optimize individual functioning.”**SIS info/goals goes along with the basic tenants of the SmartHome and Imagine!. Like Sterling told me – “to rethink the way we have always thought.”
  13. Part B: Q1 – Getting from place to place throughout the communityHandheld GPS Device (UMPC) – Not rugged enough.Rae – Time 1: 7 (2,2,3), Time 2: 0 -**SmartHome staff know what factors resulted in this change?Chris – Time 1: 11 (3,4,4), Time 2: 0 – Possible result of the UMPC?Lana – Time 1: 8 (3,2,3), Time 2: 0 – SmartHome staff know what factors resulted in this change?***PICTURE OF TECH BEING USED – UPMC being used by Chris
  14. Low hanging fruit – pain points -