Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet

An array of technology-based interventions has increasingly become available to support family caregivers, primarily focusing on health and well-being, social isolation, financial, and psychological support. More recently the emergence of new technologies such as mobile and cloud, robotics, connected sensors, virtual/augmented/mixed reality, voice, and the evermore ubiquitous tools supported by advanced data analytics, coupled with the integration of multiple technologies through platform solutions, have opened a new era of technology-enabled interventions that can empower and support family caregivers. This paper proposes a conceptual framework for identifying and addressing the challenges that may need to be overcome to effectively apply technology-enabled solutions for family caregivers. The paper identifies a number of challenges that either moderate or mediate the full use of technologies for the benefit of caregivers. The challenges include issues related to equity, inclusion, and access; ethical concerns related to privacy and security; political and regulatory factors affecting interoperability and lack of standards; inclusive/human-centric design and issues; and inherent economic and distribution channel difficulties. The paper concludes with a summary of research questions and issues that form a framework for global research priorities.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet

Technology currently plays a significant role in the lives of older adults: it assists older adults in remaining independent and safe in their home, reducing the burden of family caregiving, improving socialization and engagement, and offering a dramatic increase in access to information and resources. Employed to its fullest, technology has the potential to improve the quality of life and health of older adults by preventing illness and improving the management of chronic disease through improving access to care, efficiency of care, and reducing costs of care. While technology offers innovative methods of support for family caregivers and professional caregivers alike, the most exciting element of these advances in technology is how it is changing the lives of...

Telecommunication technologies have been used to bring healthcare expertise to the point of care since the 19th century. In 1878, The Lancet reported the use of the telephone to reduce unnecessary physician visits and, in 1910, a tele-stethoscope had already been described.¹ During the mid-20th century, NASA (National Aeronautics and Space Administration) used remote monitoring systems to measure astronauts’ physiological functions. The Space Technology Applied to Rural Papago Advanced Health Care project further developed this field with the Papago Indians in the southwestern U.S.² However, the greatest strides in remote monitoring technologies for telehealth have occurred over the last 10 years, with a growing evidence base showing their effectiveness in the management of chronic disease.

BACKGROUND In response to the significant stressors on health care delivery created by COVID-19, CITRIS Health and partner organizations developed 2 telehealth solutions through a rapid co-design process: Lighthouse and ACTIVATE. These programs were developed to support providers serving underserved and vulnerable populations who lack the tools and resources to support patients with chronic illness or who are isolated. These challenges were exacerbated by the COVID-19 pandemic, which increased the need for resources to support vulnerable patients who could not come into a clinic in person or were isolated and lacked access to services. ACTIVATE and Lighthouse apply 2 different telehealth strategies to reach vulnerable populations. OBJECTIVE This paper presents lessons learned from the design, development, and implementation of 2 innovative telehealth programs developed to improve health care delivery, access to care, digital literacy, and patient outcomes: ACTIVATE and Lighthouse. METHODS ACTIVATE is a comprehensive digital health pathway for community health centers that care for those who are medically underserved. ACTIVATE is an innovative, evidence-based, and sustainable telehealth program, designed to benefit vulnerable populations in rural and agricultural communities in the California Central Valley who experience significant health disparities. Lighthouse focuses on connecting older adults in congregate affordable housing, which are settings where residents are particularly vulnerable to isolation, the lack of health care resources, and limited to no access to the internet. Lighthouse provides digital literacy training as well as access to broadband internet with the goal of increasing communication, engagement, and access to health care. RESULTS This presentation will discuss successful design and implementation strategies as well as organizational and policy barriers to program operations. CONCLUSIONS In addition to reviewing program and implementation outcomes, strategies for replication and sustainability will be discussed. Although developed in response to COVID-19, the ultimate success of Lighthouse and ACTIVATE is dependent upon its successful scaling beyond the pandemic.