Tuned-in health care possible as we age

Let's say I'm 83 years old. I'm not that old — but let's assume I am just for the purposes of this column. Let's assume you're in your 80s, too.

Where would we like to live? It's a relatively easy question for both of us, I suspect. We'd like to be comfortably situated in our own homes. I know I'd like to be independently observing my personal morning rituals and managing my own activities of daily living.

If either of us were chronically ill or physically frail and had a need for constant medical attention, living independently might not be possible.

That's what I used to think. An article in a recent issue of the Atlantic (www.theatlantic.com) altered my view.

Here's the story. It's about Ellen, who is an 82-year-old widow living in Anaheim, Calif. "One Wednesday morning last year she got on the scale, as she does every morning, and it read 146 pounds — wasn't that a little high? Ellen felt vaguely troubled as she poured herself a bowl of oat bran."

As Ellen ate her cereal, the phone rang, and a friendly voice from the health clinic where Ellen was a patient expressed concern about Ellen's weight — which "had jumped 3 pounds from the previous day."

The friendly voice knew about Ellen's weight gain because Ellen's scale had transmitted the information through a wireless connection.

Because Ellen had a history of congestive heart failure, a 3-pound weight gain in a 24-hour period was a potentially dangerous situation. There was likely to be fluid build-up that would complicate her already-existing medical issues. She needed treatment immediately.

So now you may be thinking that the friendly voice — not a mechanized one by the way, but a real person — probably told her to come into the clinic. Or maybe the voice said, "Call 911 and get to an emergency room."


The friendly voice said, 'We're sending a car to pick you up," which they did. Ellen's health provider gave her no-fee transportation from her home to the health clinic over the next few weeks, as well as appropriate medical treatment, until her health situation stabilized.

Had this not occurred, Ellen might have languished. Perhaps she would have eaten less because she was afraid she was gaining too much weight. She may have experienced a life-threatening cardiac event. She could have ended up in the hospital for days or weeks undergoing painful — and expensive — treatment.

The California-based clinic system that supported Ellen in this way is appropriately named CareMore (www.caremore.org) and it specializes in patient-centered approaches that also seem to avert huge medical costs.

This is impressive health care. According to the Atlantic article, CareMore has a hospitalization rate 24 percent below average and hospital stays are 38 percent shorter. Overall costs are 18 percent lower than average. And the surveyed satisfaction rate is well above 90 percent. (And remember, 80-year-olds can be hard to please.)

When I'm in my 80s, that's the kind of health care I want: coordinated, integrated, tuned in to my personal needs and preferences. You too?

Whatever you may think about the Affordable Care Act President Obama signed into law in 2010, these are the kinds of innovative approaches included in it. These ideas effectively combine common sense with technology — or as some system-watchers put it, "It's about improving the quality of our country's health care, but at a reduced cost.

It's really about you and me at 83.

Sharon Johnson is an associate professor in health and human sciences at Oregon State University and on the faculty of the OSU Extension. Email her at s.johnson@oregonstate.edu or call 541-776-7371, Ext. 210.

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