Healthcare 2040: The Future of Aging and Thriving in Community

Speaker 1 (00:13):
Welcome everyone to healthcare 2040. This is a series that matter produces together with Baxter. I'm Steven Collins. I'm the CEO of matter. We are a healthcare technology incubator and innovation hub with a mission to accelerate the pace of change of healthcare. And we do three things in service of our mission. The first we incubate startups, we launched about seven years ago and we've worked with more than 700 companies ranging from very early to growth stage startups. And we have a suite of services to help them at every stage of their development. Second, we work with large organizations, such as health systems and life sciences companies and payers to strengthen their innovation capacity. We help them find value in emerging technologies, unlock the full potential of their internal innovators and create a more human-centered healthcare experience through system level collaborations. And third we're in nexus for people who are passionate about healthcare innovation.

Speaker 1 (01:11):
We bring people together to be inspired, to learn, to connect with each other. And we produce a lot of programs, including large scale events for the broader community, as well as small forums that are exclusive to our members. Today's program is part of our healthcare 2040 series, where we look at what healthcare might look like in 20 years and how we're going to get there. We have a great collaboration with Baxter to produce this series. Baxter is based in Chicago and has evolved significantly, uh, over the last five to 10 years with a focus now on connected care and earlier diagnosis, workflow management and other tech enabled healthcare innovations. The topic of today's conversation is the future of aging and thriving in community. And we are fortunate to be joined by Gretchen brown and Mary O'Donnell. Uh, Gretchen is Stanford healthcare's associate chief nursing information informatics officer.

Speaker 1 (02:12):
Uh, she's had a number of nursing leadership roles over her last, uh, 13 years at Stanford, um, with a current focus around balancing the need for technology while enhancing the experience for Stanford's healthcare teams and their patients and their families. Uh, Mary is president of the RF foundation for aging, which is a private foundation dedicated to improving the quality of life for older people. Uh, Mary joined the foundation in 2009 and she assumed her current, uh, leadership role in 2020, uh, moderating the conversation today is Dr. Carlos UIA, who is the vice president of medical affairs at Baxter. Uh, Dr. UIA provides medical oversight for evidence generation and dissemination activities, and he offers guidance in product development and pipeline and digital health strategies. So Mary is going to kick us off with an overview of the aging landscape and how we talk about it and, uh, key considerations as we look forward. Mary, thank you so much for joining us and looking forward to your introductory presentation.

Speaker 2 (03:19):
Oh, thank you, Steven. Thank you for the invitation. I'm really looking forward to the conversation that we're gonna have today around the future of aging and thriving in community. And I really applaud matter and Baxter for their forward looking lens in trying to push all of us to think about what healthcare 2040 might look like. Um, so clicking onto the next slide. I wanna first help you understand my perspective a little bit. So I'm gonna say just briefly a few words about the organization that I have the honor of leading, as Steven said, I'm president of R R F foundation for aging. We are a national grant making organization. We're based here in Chicago and we've had an enduring commitment to, uh, older adults, uh, actually for more than 40 years, we've been dedicated to improving the quality of life of all of us as we age and, uh, in terms of our, uh, strategic direction.

Speaker 2 (04:23):
The next slide shows that our Strat strategic plan centers, the foundation's grant making on four priority areas. These are sort of the four pillars of our work, um, care, economic security and later life housing and social and intergenerational connectedness. We believe at the foundation that these issues are fundamental to allowing all of us to age where we want to and how we want to. And of course, many of these are interconnected and, uh, as topics relate closely to social determinants of health, um, I'm now on the next slide, going to begin moving into some context around age demographics. Um, this is one of my, uh, favorite charts. You know, those of us who are, are looking at these things regularly, there are a lot of different demographic projections that we can look at, but this one here shows in terms of the us population, the percent of the us population by age group.

Speaker 2 (05:29):
And it takes us over a course of, uh, nearly a hundred years, looking back from 1950 and zooming ahead to 2060, which will of course be slightly beyond our target of the 2040 lens that we're using for today's conversation. But I thought it was useful because when we, for instance, think back to 1950, when John D MacArthur established an endowed fund, that would become the RF foundation for aging, which is actually where the endowment for the foundation I lead comes from our population looked pretty different down there at that, uh, 1950, um, visual. We see that, uh, originally of course at that timeframe, the population was somewhat pyramid shaped, um, with a large percentage of the population as children and young adults. And then as time went on, it began growing, um, and growing and moving more, pardon me less as a pyramid and more as a rectangular of course, as the baby boom generation shifted through its demographics.

Speaker 2 (06:40):
But we know of course that our aging services and healthcare pace with these changes in the demographics that we're seeing on the next slide. I wanna share with you, um, a different consideration here, and this relates to, again, aging demographics, primarily in the us and the impact of the increasing health span that we're seeing across the life course, demographers are projecting what we're calling a rectangular of the survival curve and a compression of morbidity with actually more of the life cycle being spent in health and less time spent in morbidity. We know that that's not the case for all older people and for all, um, and for, uh, the whole population. But we do know that generally speaking people are living longer and healthier lives. And the consequence of these dynamics is that age at death is projected to increase, um, and, uh, variability decreases.

Speaker 2 (07:50):
So deaths are compressed toward ages closer and closer to the maximum lifespan. And that of, uh, this is just a hypothetical, uh, depiction, but it is something for us all to think about as we think about not just increasing lifespan, but increasing healthspan the final demographic slide that I'll share with you relates more toward a global lens. The previous two were reflective mostly of the us population, but for those of in the, of you in the audience who are interested in a global landscape, um, we want to know, I want you to be aware, of course, that we're seeing similar demographic trends. When we look globally at the population of young children and older adults, again, using that timeframe of looking back at 1950 and projecting ahead, in this case to, uh, 2050, we see that in 1950, the percentage of young children under the age of five across the globe was much larger than the percentage of older people over the age of 65.

Speaker 2 (08:55):
That is, uh, in 2020, just a couple years ago, those lines started to switch with the percentage of older adults beginning to outpace the percentage of young children in terms of global demographics. And in 2040, as we look ahead, we'll see that global projections suggest that the proportions will have nearly reversed themselves entirely with older adults taking over the same percentage breakdown that younger children had in 1950, at least back at least with a global lens. So in other words, the tides are turning, uh, so what does this mean? What does this mean for the future of aging? What can we do collectively to drive the future of aging to one, in which all of us can thrive as we age and create a picture of aging in 2040, that we all want to embrace. That's something that I think a lot about. And in many presentations, this is where the speaker might say.

Speaker 2 (10:01):
So we must prepare for a demographic shift that will result in a silver tsunami that will upend our collective good. Um, I, myself am one of a growing caravan of people who feel that, that phrase silver tsunami is pretty darn bad <laugh> and should be banished. Um, because what it does is it depicts that a growing number of older people, which is actually a really positive thing. It's, it's, it's truly miraculous is instead some kind of natural disaster about to drown us all. Um, I'm gonna say a little more about that in a moment, but I'm here to tell you that instead, I really feel there is so much good that can and will be possible by 2040. When we look at our aging landscape, the image you see in front of you is reflective of what we are starting to see. Now it's a landscape of older people that is becoming increasingly diverse with a wide set of skills, experiences, views, and contributions to our families, our communities, our workplaces, and our country.

Speaker 2 (11:12):
I feel that these, um, this diversity can and should be harnessed as we create a future that supports all of us as we age, in fact, at RF foundation for aging, our vision is that all older people, and we mean all older people will be valued and respected as participants and contributors to community life. And I firmly believe that that vision can become a reality. And the optimistic side of me believes that that vision can even become a reality by 2040 on the next slide. I'll share a teaser for why I think that that's possible. What can we do today to bring about this vision? I'm gonna talk for the remainder of my time, about three things, one shifting the narrative two, uh, advancing effective community based solutions and three harnessing innovations that use technology as a practical tool. Um, moving on to just say briefly about the first, uh, shifting the narrative.

Speaker 2 (12:16):
This I, I, uh, teased about a moment ago, but I wanna emphasize here that language is critical. The words we use reflect and even influence how we think those consciously and unconsciously. And so when we change our vocabulary, even in subtle, but significant ways, we can change how we think and how we start to undo age biases and other sorts of, um, isms that we're confronting as a society. So there are a number of phrases that just to put 'em out there, I think should be avoided as they carry an unconscious age bias that I always want people to be aware of. I already mentioned in the public sphere that we're trying to do away with the phrase silver tsunami, um, and, uh, and all that, that implies as something we need to run away from and avoid, uh, with this shifting age demographic. I also wanna say that we are, uh, less and less talking about the phrase aging in place, uh, which brings up sort of more of a stagnant kind of constraint, um, connotation.

Speaker 2 (13:30):
And instead talking more as the program for today suggests about aging and as we thrive, um, I'll, I'll say in the next, uh, if you could click here, Casey, one of the things that is shifting that is shifting the narrative on a national level that I'd love everybody to be aware of. If you're not already is initiative called reframing aging, which is countering ageism by shifting how we talk about aging, it's a national initiative that RF foundation for aging has been proud to support on a national level with research that was done by frameworks Institute and has empirically shown us how, what we say matters and how, what we, how we can begin to shift, uh, talking and thinking into actual programs and policies that support all of us as we age. Happy to talk more about that later. And I also wanna, if you could click ahead here, Casey, talk about new research that many of you are likely aware of that has come out of, uh, from Becca levy around breaking the age code.

Speaker 2 (14:37):
Uh, I'll just highlight briefly that, uh, her work reflects a growing body of research that is showing that how we view aging actually has profound impact on our health outcomes. So our perceptions of aging and that internalized ageism that many of us may feel, um, are actually correlated to our own health as we age and can have, uh, positive or negative impacts on our health outcomes in later life. Um, really fascinating work to look into on the next slide. I'll just touch briefly, cause I know we wanna get into our panel discussion on, uh, a second strategy that we can all begin to embrace today. As we look ahead to the sort of vision we want for 2040 and that's advancing effective community based solutions. So, um, I don't wanna be Pollyanna-ish and try to gloss over the fact that challenges do exist in later life.

Speaker 2 (15:37):
We know there are unique health challenges, socioeconomic challenges, and other difficulties that accompany the aging process, older people, particularly older people of color. And those from historically marginalized groups faced hardships that we can't glaze over. Um, but I do think that we need to be realistic about the fact that there are innovative, effective community based solutions that are underway right now to address those challenges and that we need to keep front of mind moving forward. For instance, in the housing sphere, we know that baby boomers are not interested in moving into nursing homes or even traditional assisted living facilities. So we're starting to see that the housing landscape is shifting and needs to keep pace. Um, I'm also here to tell you that, um, there is a final strategy that I know we'll be talking about more in our time today. Um, strategy number three, relates to, uh, in innovation and harnessing innovation by using technology as a practical tool to improve the quality of life of older people.

Speaker 2 (16:49):
And of course, those of you in the matter community are thinking about these innovations on a daily basis. We know for instance, that older adults in 2040 will be much more tech savvy than they even are today. And we know as well that even today there have been great strides in terms of harnessing the digital divide for older people. So we need to find new and innovative ways to use technology that can help achieve healthy aging, successful aging and help older adults live independently or independently, uh, in the community as long as possible. We know for instance, that staff shortages are a reality now, um, and, uh, will likely continue to be so in the future. So this is where technology can help fill gaps where we, but we also need to be mindful of where technology needs to perhaps be supplemented by or grounded within the personal touch.

Speaker 2 (17:49):
Um, that whole age tech side of our society is booming. Um, and I'm sure I will get into more of this today as well. So in closing, just to the introduction, I wanna share this photo of you. This is an older couple that, um, I look at with some frequency when I'm at the office, I feel that they reflect in their faces. If you can, zero in on them here, the optimism, resilience, and joy that I hope to have in my own face as I continue to age, um, we know that both of them likely are facing difficulties in later life needing to navigate new health challenges, needing to navigate shifts in their social circles. But, um, I'm, I like to think that if we look at the face of aging by 2040, we'd be at a place where both our communities and our health system and our policy related ecosystem in our country has been set up to allow them to thrive in later life.

Speaker 2 (18:56):
Um, I think that the big question of course is how do we collectively harness the demographic shift, those, those charts and scales and projections that I shared earlier, how do we harness that shift, propel ourselves into a version of 2040? That for all of us, for our loved ones for our communities is what we want as we age. Um, I think none of us are, are looking to age passively, but to thrive. Um, it's up to me, it's up to you, it's up to all of us and I think together we can do it. So that's where I'll close and look forward to the, to the discussion as we've Reed through the rest of our time today.

Speaker 1 (19:38):
Uh, Mary, thank you so much, uh, really helpful perspective on the trends, um, on the way to think about, uh, aging and the way to talk about, uh, aging, I'm looking forward to the rest of the conversation, um, looking, uh, Gretchen thank you, uh, for joining us as well. And Carlos, uh, thank you as always. And, um, we'll turn over to you now to, uh, lead the conversation.

Speaker 3 (20:04):
Thank you, Steve. And thank you, Mary for that great presentation. Uh, very, very, very interesting, lots of good information, Mary, before we talked with Gretchen and technology, um, you know, I wanna mention that this concept of increasing the health span, um, it's very, very important. So tell me, you know, with all the data that you presented, how should people be thinking about what age means, what will be the definition? What, what's your recommendation as people start to conceptualize this new view of aging?

Speaker 2 (20:36):
Right. Well, so much going on, you know, those are the sort of meta questions that many of us think about when we come together every day, long conferences. So I'll, I'll say that just briefly, I think more and more we're thinking about the importance of moving beyond sort of a chronological age of, you know, which traditionally might have been 65 or 62 60, you know, and more looking at the person in environment and what their life Spann, uh, age relates to and how that connects with the health span. Of course. So, um, I think that there are many people who are experiencing advanced aging, which is one side of it. So if you look at an older person who have made, who might have faced health disparities in their life, or lack of access to care, they are aging at a more advanced rate than others or an older adult who might be homeless and living on the experiencing homelessness and living on the street might be 55, but present very much like a 75 year old. So I think that that, um, sort of what is defined by as an older adult is one of those shifts that we're starting to take, uh, a closer look at as well and not have necessarily arbitrary cutoffs, but look at more what the person in their lifespan is experiencing.

Speaker 3 (21:54):
Thank you, Mary Gretchen, I'm gonna turn it over to you and, you know, new, new vision about aging. What do you think the role of technology will be in supporting aging and in particular, how do you think the, the patient experience or the customer experience, you know, the, um, major population will, will look like in the future?

Speaker 4 (22:15):
Um, well, I like Mary's comment that, you know, age is not a number, you know, I realize was Mary's talking, I am aging, right? Mm-hmm <affirmative> and I, I think it, it's not just necessarily about the technology, it's how you solve the underlying problem or workflow you're trying to solve. Right? You don't wanna come forward with a tech solution and put it in place. You wanna solve a workflow problem, and a workflow problem can be access or access to, you know, a meaningful conversation with, uh, caregiver or a care provider. And how do you do that? How do you do that? So that wherever the patient is in their technology savviness, whether they're 22 or 82, how do you do that easily? So, so that they can leverage these new tools that we're all seeing, you know, 30 years ago, we didn't all have iPhones now we do. Right. And I think that is an exciting example of a tool that will offer solutions to patients, providers, caregivers at whatever age. So I, I think we have to solve that sort of fundamental ease of issues so that the access can be level set

Speaker 2 (23:31):
Mm-hmm <affirmative>

Speaker 3 (23:32):
And, and Gretchen, you know, one of the things that we have for Mary today and wanted to follow up, um, was about the agent population. You know, we, we have this tendency to think of them as passive receivers of something, right. But now the invitation, which I think is a very powerful one, is, you know, they're actually active participants and contributors in the community. Um, how can technology help the aging population, all of us, you know, be active participants and contributors to the community.

Speaker 4 (24:03):
Um, I, I think, you know, I used sort of my personal life as an example, you know, during COVID we had an elderly couple as a neighbor and, you know, we asked them, you know, would you like us to pick up something at the store? So they weren't going out. And we did that, but what I realized really is if, you know, I would've had access to their dietician's recommendations, I could have been more proactive, like rethinking in the community. What could a caregiver be? And how could you sort of leverage technology to meet that need? I think in the hospital, you know, the hospital, the sniff, it's all gonna become part of the community. It should, it it's a near stage in somebody's sort of experience, but it will all be part of their community that they will have to manage through. And how do you keep that common thread? How do you bring the technology to them? I think that's an interesting perspective for tech companies to really think about, not about the location, where you're delivering care, but really what the patient or person needs. If I need large font and I have that activated on my phone, well, why can't I have that in the hospital or the sniff and why don't they know that? So sort of what, what you can maximize in these tools, wherever the community is for the patient. I think that will be exciting.

Speaker 3 (25:34):
Perfect. Mary, can you think of, you know, areas, um, that are sort of ripe for innovation for the aging, uh, population, you know, in, as you go out and about in the community, what are sort of the things that are salient points where you think technology can play a key role?

Speaker 2 (25:53):
Yes. Well, you know, I've appreciated Gretchen your, your, your consistent use of the, of the word tool. And I think that that's really what it needs to be, right. Technology is a tool in an ideal world, a practical tool that can be a solution to address a need, not, not the other way around where we're thinking first of, of, of the, the technology itself, but more, what is the, what is the tool or the issue we're trying to address? So, Carlos, you know, we think a lot here at RF foundation for aging about, um, uh, things like social isolation and loneliness or, or social connectedness is one of our priority areas where we've seen, um, that technology can be a really powerful tool to bring people together. Um, and of course during the pandemic, all of us, people of all ages, of course, were realizing in new ways how, uh, much technology had the potential to bring us together.

Speaker 2 (26:48):
Um, that was certainly true for older adults, um, in connecting generations, loved ones across the country, uh, you know, um, and, uh, trying to address social isolation and loneliness. We also see that technology can be a really practical tool when it comes to caregiving. Um, as, uh, as Gretchen said, um, you know, there's so much that can be done in terms of, uh, ensuring that older adults have the resources that they need and the support that they need, but also that the people caring for them are able to, uh, be, uh, be assisted or supported and, and often technology can really play a meaningful role there. Um, and we do see, I know that less, less directly tied to the healthcare space, but certainly in housing there's much to be done, uh, with technology and bringing, um, different forms of support in to support people in, in whether it be assisted living facilities or independent community settings or communities in their own home. Um, which of course is where most older people want to be able to stay as long as possible. So I would say those, the sort of social isolation and loneliness, um, caregiving, housing, uh, those are some areas that we see ripe for opportunity, uh, with use of technology.

Speaker 3 (28:05):
Yeah. And I think one comment that I wanted to make on caregiving is that, you know, we have a tendency to, to think of the aging population receiving care, but, or, or, you know, in need of caregivers, but in, there are many examples where they actually become the caregivers of the younger,

Speaker 2 (28:21):
Absolutely

Speaker 3 (28:22):
Know how do make that connection.

Speaker 2 (28:23):
And oftentimes then the caregivers, the older adult caregivers own health can begin to, can begin to suffer if they're not getting the support that they need. So we really do need to look at the, the whole ecosystem.

Speaker 4 (28:35):
Yeah. And I think COVID with technology showed us that we, um, can bring offerings that we never have before at the quantities interpretation, psychiatric services. You know, I, I think it caught all of us in the hospital community off guard when psychiatry went from 0% virtual visits to almost 95%. Yeah. And certainly not an answer for every patient, but getting sort of that first, um, uh, meeting with a psychiatrist and, and funneled to the right specialist. Like that is a good story, uh, that came unfortunately out of COVID, but really taught us that this connectedness and this, um, technology around the video platforms could really be leveraged. Um, I think we'll still sort of have to fight the challenge of the, um, perception, say for interpretation that, um, patients who need interpreters, don't often pick a video visit as their first, um, choice, but, but actually with a video, you know, option the, the speed of getting the meeting, uh, or appointment may be faster. I think there's really opportunities. And we still have some ways to go to sort of level level set that expectation. But I, I think COVID taught us some good lessons that we hopefully will continue. Mm-hmm

Speaker 3 (30:02):
<affirmative> Gretchen, and I'm gonna ask a follow up question, but I wanna make sure that I wanna remind the audience that they can, uh, type their questions on the chat. And, and I will be happy to, um, introduce 'em on the conversation. I haven't seen any questions come through, so I just wanna remind the audience or, you know, or maybe the matter team, if I'm missing something, please let me know. But I don't think I have any questions. Sorry. So Gretchen, I wanted to follow up, um, you know, very interesting to the thought, you know, I'm gonna say pre COVID. Um, there was this, um, sense that the older population wouldn't want the telemedicine, you know, remote that, Hey, you know, grew up in a where the personal touch was extremely, extremely important. However, the, the experience has shown otherwise, can you share maybe a stand force journey and, and how it actually has played out with the older population and their willingness to adopt new technologies and telehealth and so on, so forth.

Speaker 4 (30:58):
Yeah, I, and I think this is, um, where generationally, we will become more comfortable, but at Stanford, we did a study with a partner pocket RN that, um, was a virtual, um, virtual visit platform for nurses from Stanford. And what the study showed us is 60% of the patients were over 60 and most more importantly, the patients wanted us to meet them where they were some wanted proactive checks. Yes. Call me every Wednesday and Friday. Some wanted it as a lifeline. If they had a question or a problem. The interesting thing is, well, maybe it wasn't too interesting to anybody who has children's, but no, nobody got really ill Monday through Friday during clinic hours. It was after hours at, you know, 11:00 PM on a Friday where, what we found with these group of older individuals, where they were much more willing to reach out to a virtual nurse who was connected with their clinic rather than go to an urgent care or an emergency department.

Speaker 4 (32:08):
Right. And, and we also learned that 80% of the questions were general. They weren't 20% specific to that service line. So it really allowed us to leverage a larger pool of nurses to support those patients staying in their home. I, I thought it was also an interesting perspective for the aging care, you know, caregiver like a nurse, like I have spent, you know, years in, in hospital experience. And as I am aging out of maybe working, um, on a 12 hour shift on a nursing unit, I would never have thought of this ambulatory workflow, but this is sort of an exciting way for me to share my expertise and my knowledge as a generalist. I know my way around our EHR. I know my way around in AVS because I've, I've, you know, reviewed those multiple times with patients. I can look at the care plan for my patient, and maybe that's an interesting opportunity for our aging healthcare, not just nurses, but other clinicians and specialists. So it's a way to really, um, keep, uh, that knowledge within our enterprise, but maybe, you know, an opportunity to really leverage a resource across the United States, you know, and I think that comes with some regulatory things we have to solve too, but a very different way to make sure we're supporting patients staying in their home or wherever they want to stay.

Speaker 3 (33:38):
Right. Thank you, Gretchen. And, and yes, I I've seen the question now. It looks like I had a different window open. Um, I was surprised I hadn't seen questions, so yeah, it looks like Adam was sort of alluding to the same thing I was asking, you know, he call it the bias against technologies that requires human touch. I think Gretchen, you were talking about it, Mary, how, what have you heard regarding that topic? Sort of like these, you know, allegedly biased against, uh, technology that requires human touch? Is that playing out like that or not? What are your thoughts?

Speaker 2 (34:08):
Well, I do think, I do think that Adam's correct. I have, I mean, I think that bias is real. Um, you know, bias comes up in so many forms there often is, is assumptions, um, or biases against older adults thinking that they wouldn't be comfortable with technology. That's one bias that we're seeing, um, uh, proving to be untrue, not, not across the board, but that many older people are quite comfortable indeed, um, using their tablet or using a smartphone and especially after, after going through the pandemic. So that's one bias, but, um, the bias against technology that requires human touch, I think is, um, is, is something where, uh, if, if we can begin to at least overcome it by focusing once again on what the solution or the opportunity is that the, uh, technology is, is enabling. So I think that, um, whether it's older people, themselves that are being encountered by a case worker or resident service coordinator or others, physicians, nurses, those that they're interacting with, if they can see that, yes, this is something that's going to help me or my loved one, they'll be all in on it.

Speaker 2 (35:23):
And I think that if you are finding ways to not have that, uh, have not, not have the technology or the tool be, um, the only mechanism, but a way a mechanism that helps you extend the personal touch, um, that will help overcome the resistance that we sometimes feel. So I think it often is like so many things in life, uh, of both and where we need to not focus on how technology might replace the human touch, but how it can help extend the human touch. And then I think we'll begin to eat away at some of those biases.

Speaker 3 (35:59):
Right. Mary, I see a question here from gal, um, you know, as we think about our audience and, and innovators on the call, um, you know, this is a very interesting question about technology levering, leveraging the wisdom of older adults. Do we have any adult, any example, sorry that, that you can describe in which sort of, I'm gonna say broader input from the older population is being utilized to develop technology. I know Mary, maybe I'll start with you or sure.

Speaker 2 (36:28):
Well, I loved, you know, just not on the spot Gretchen, but I did love that you said, you know, as we're all aging, that, that, you know, tapping the expertise and experience that you've gathered from your career, finding ways to continue to, to use that. Um, I think in a community based setting, we also have seen a lot of ways for older adults to share their wisdom and experience oftentimes in intergenerational ways or with, with people of younger generations. So one of the re remarkable and very effective evidence based programs that exist in this sphere of aging is something called experience core, which uses older adults as, um, trained volunteers to help, uh, younger people who are reading below grade levels. So it sort of uses them as, as, uh, tutors and mentors to elementary age children who are struggling with reading. And of course, during the COVID, uh, the height of the COVID pandemic when schools were shut down, this is typically a school based intervention, um, that needed to shift and pivot, like all things were.

Speaker 2 (37:31):
So, um, that's one that had very successful rates of, uh, retention in terms of the older adult volunteers in being able to then have those services, uh, be delivered remotely through zoom and other platforms. So, um, I think that in like many other cases, we're seeing ways where things that might have been successful without a technology component now have been able to incorporate a technology component to make them, um, just as effective. And sometimes even more when we look also at the ability to bring things to scale and, um, have them disseminated to wider audiences. Um, I think one more note about older adults in their wisdom is that we always, always, always need to remember to ensure that, um, older adults are involved in the design of the technology that ultimately will be either engaging them or, or assisting them with some aspect of their life. So particularly with this population, we need to not lose sight of user design and the importance of that, that in the development phase.

Speaker 4 (38:37):
Yeah. I, I think, you know, for right or wrong, if you agree or not, but apple has really doubled down on the customer experience. And I, I think about their accessibility tools that are embedded, you know, embedded in their phones. And I don't think that's really about ageism. I think that's about what is a tool that's helpful and how do I make it easier for that user to use? They're all about the customer experience. If you take nothing else away from them, whether you love apple or not. But I think Amazon is another one, like they're really leaning into this space and their concept of scale and the customer experience and the ease of use. I think they're gonna bring interesting things to health and healthcare and tech. And I think whether you, you know, buy into it or not, but it's just the concepts that are really interesting, that they do very much think about the customer experience and how will the older adult or the younger generation, how will they interface with those offerings?

Speaker 4 (39:41):
I think that will influence and shape how we bring technology to the older population, you know, tools in the house to monitor you, um, you know, Pluto thought we'd be monitoring your blood pressure, your, you know, glucose, your, your weight, all of that, and electronically uploading it to the cloud, you know, 20 years ago. And I think in 20 more years, what we're gonna be doing with all of that will be amazing. It will push our ideas about our data and who has access and what we do with it. But I think conceptually sort of thinking about that ease of use, um, accessibility, I think those are interesting concepts, whether you're young or old.

Speaker 3 (40:26):
Yeah. Gretchen, you, you said one of the, sort of like magic words in the technology and innovation right. Environment, which is data and what is sort of, as we think about aging population, sort of the attitude towards sharing data, um, you know, some people are very, very concerned. I don't want you to know anything about my life. Others are not, do we, do we have a sense as to, as to where, you know, attitudes and, and perception on the use of data and share data, or that is today?

Speaker 4 (40:58):
I think, and Mary I'll, I'll just take a stab at it. And then, you know, I'll turn it over to you. I, I think, you know, this is sort of different. I'm not sure if it's really based on age. I think different people have different perspectives about allowing others to use their data. Um, you know, as we work on workflows within the hospital or the ambulatory environment, we have lots of data. We all say that, but it's how you look at that data to really inform what you're going to sort of leverage or do next. I think that's where data helps us, but I think the jury's out how people feel comfortable. And I always, you know, I use my kids as the perspective. I, I have three boys they're all in their twenties and one loses his wallet regularly and it just doesn't bother him.

Speaker 4 (41:45):
He just goes and gets another driver's license and, you know, gets a new you new debit card. And it's, it's no issue never been compromised. Then I have another son who is militant about where his wallet is and has been compromised, like I think six times on his credit card. So I, I don't, I don't know, I think whether you're young or old, I think if people have feelings about that, um, you know, when we move into these larger companies, um, that are outside of healthcare, I think our health data, it's gonna cause people to think about that and, and what what's gonna happen to the information about, um, their care and their health and how that may have implications on jobs, on, you know, insurance. I think people will think more about that. Mm-hmm <affirmative>

Speaker 2 (42:38):
Yeah, I would, I agree, Gretchen, I think that everyone's views on, on data are, are changing and shifting. And I think it is perhaps less of an issue about a particular age or age cohort, and more about individual views. I have to think that, um, by 2040 will be in a regular data sharing sort of mode. I think there's some inevitability for that. So I think what that makes me then ponder is how do we ensure that the right source of protections are in place? Um, and, and certainly when we think about an older population or any population that has with, at some level of vulnerability, we wanna make sure that we're perhaps having additional protections in place. So things like, you know, older adults are, again, I don't wanna have rose covered glasses. There are issues with elder abuse, financial exploitation that have made, uh, older people rightfully so in some cases, more, um, concerned about, uh, about their own security and, and, and information sharing. We know that sometimes as, as, uh, cognitive changes begin to set in, um, there are additional, uh, types of protections that need to be put in place to make sure that nobody is being exploited. But I do think that by 2040, there's gonna be no way getting around it. So let's use the next 20 years to make sure that we're doing putting the right protections in place and safety mechanisms for that smooth sharing of information.

Speaker 4 (44:06):
I do. Mary, I'm curious, just to ask Mary a question, you know, around oncology and cancer research. I think what I'm hearing from patients is they really wanna be part of the solution and are willing to open up their health information for the greater good mm-hmm, <affirmative>, that's a big shift. I'm just curious if you've had conversations.

Speaker 2 (44:28):
Yeah. That resonates with, with also what I'm, I'm hearing Gretchen and similar to, you know, our previous parts of our conversation when we, when we discussed the importance of, of talking about technology to what end. And I think that if you, if you raise, certainly here's a new technology based solution or tool that will help you do X, Y, Z, that's gonna be more effective in getting buy-in and, uh, participation. Similarly, when we think about data sharing or research participation, if we, if we frame it around your willingness to share or contribute to this, um, to this base of information is going to then help us do X, Y, Z. I think like any others, older people are gonna be much more tapped into the sense of collective good. We know that generativity is something that is very key to older people's, uh, later life stages.

Speaker 2 (45:18):
If we just think about that life course and cycle, and it's very developmentally on par for older people to then want to start to think about their legacy and what they're leaving behind and how they're giving back, which is why I also love the question about tapping, um, wisdom of older people here, even in Chicago, where, where we're based at least where, where, uh, I'm sitting along with Carlos is, uh, a great program called ageless innovators that trying to, to kind of tap into how older and younger people are both giving both co-mentoring each other in, uh, in the workspace, uh, which is a whole nother way to look at things. Um, as we move ahead to 2040 looking at how both all generations can have something to give and something to learn.

Speaker 3 (46:06):
Yeah. I think that's a good point, Mary. I, you know, we have both Sabrina and Gail on the, on the chat talking about, you know, the respect for the elderly, the knowledge, the uniqueness that they bring. And, and I mean, I think that's also very worth emphasizing, you know, like that, that's something that we should not forget and, and leave aside. Um, and, you know, Jean brought up a good point and I think Gretchen you touch on it. Like the example with cancer care is, you know, how do we connect, like sort of like the health information infrastructure, the communities, you know, what sort of advocacy should we be thinking of in terms of whether it is reimbursement return of, you know, what is it that we need to be thinking of sort of to create that infrastructure, that broader community age, you know, like a very macro level for something like that, to be able to happen?

Speaker 4 (46:58):
Well, we've heard a lot about the universal patient identifier. I, I hope I'll see that soon. I think that will help us connect sort of the experiences that people move through with their healthcare. Um, I, I think reimbursement as these lo these companies like Amazon get into healthcare, um, you know, the scale, how they'll be providing devices that can be leveraged in the home, I think will drive down cost. I think those type of companies will push because of the scale, the reimbursement, the insurance questions and, and conversations. Um, and I think, you know, academic medical centers like Stanford will benefit from that of being able to leverage those tools as a cheaper opportunity for patients to really stay in their home for our, um, you know, nurse coordinators to monitor those complex patients. You know, it's not unusual for us to do a heart lung and kidney transplant.

Speaker 4 (48:05):
And, you know, we expect these patients to go back out into their communities and, you know, it's not without a second thought, <laugh> that our providers let them go home. Um, but you know, that would be frightening as a spouse or a loved one or a caregiver to take someone home and feel responsible for that. So how can I leverage tools? How can I afford the tools? How can I connect the tools? I think those will be very important. And, and those conversations hopefully will drive down cost, um, link with insurances and make that easier for patients to, to do just that.

Speaker 3 (48:45):
Yeah, absolutely. And, you know, there is this common theme, right? Again, and, and I think Mary, you said the stage for this perfectly where, where the agent population is hardly become active participants of the community. Um, and, and I think we're, we're, I'm seeing some of those comments on the chat, right. And, and how can technology help become active participants somebody's mentioning, um, even to continue to work, right? Some people want to get back into absolutely, um, the, the workforce, but they don't wanna work, you know, 40 hours or with Monday to Friday. So any examples where technology sort of helping the other population remain engaged as a workforce, but not necessarily, you know, in a Monday to Friday eight to five type of approach.

Speaker 2 (49:30):
Yes. Well, I'm happy to, to take a first crack at that Gretchen and, and share that, I think yet, again, this is one of those areas where the pandemic, despite its tragedy did have some silver linings in that we realized that workforce issues can be thought about in new and different and innovative ways. So, uh, remote work is something that, uh, you know, we, we came to terms with and saw can be very successful. I think that also meant that then we, uh, began to think collectively about how, uh, older individuals or those who might not, as you said, wanna be working at their desk from Fri from Monday through Friday nine to five, could still be contributing to the workspace. So there are, um, some really exciting developments going on of finding ways to tap the older adult population, um, for their expertise and knowledge.

Speaker 2 (50:22):
I think really smart HR people have been into this already. And knowing that if you're having a worker shortages or difficulty hiring, which we know many are now, if you can be a little bit more creative in thinking about what you are able to offer, um, that can be really beneficial for your company. It might mean thinking a little bit different about benefits, you know, in terms, instead of thinking that only, you know, maternity of paternity leave is on your list, you might need to broaden it to family leave and thinking more about releasing people for caregiving needs or others. But I think that the smart and savvy executives and their HR, um, colleagues are indeed realizing that this is an untapped resource that, uh, might have been viewed as sort of being nice to incorporate. And now it's becoming increasingly necessary to find ways to incorporate that. And that technology is, is, is one way that we can do that.

Speaker 4 (51:22):
Yeah. And, and I'll just said, you know, I talked a little bit about the virtual nursing platform and sort of that being an exciting opportunity. Um, I, I think that we'll see that grow. We'll see reimbursement for that, not just from a physician or an a P P telehealth visit. I think you're gonna see the explosion of sort of nursing, because what I think we all know is that patients need to be touched. Now, you, you, you can reach out and touch them in a variety of different ways. And it, you know, it keeps the in basket managed for the physicians. It keeps demand down for the clinic. It keeps patients out of the emergency department when they don't know the answer to a question that's probably in their EHR that somebody could look at. Um, I think it, I think you'll see an explosion of that.

Speaker 4 (52:14):
We saw through COVID like Mary said the E I C U, but it wasn't just physicians. It was respiratory therapists that extended their view. It was nursing that was older, older nurses who couldn't be in the clinical space any longer were mentoring and helping younger ICU nurses that we're seeing five patients at a time. Right. But I think we learned lessons through that, that there's real opportunities to be available as an experienced nurse in these environments that are having staffing shortages. Right. Whether it's COVID, whether it's something else. Um, I think you're gonna see, uh, companies leveraging that. Um, there's a lot of expertise in the, the aging adult, you know, aging nursing force. And I put myself in that, in that field. Um, but you know, we all traditionally had looked around for opportunities, right? Clinical advice line, um, maybe working for a transfer center or something like that.

Speaker 4 (53:14):
But I think the virtual platform will open up options, like never before and keep nurses like myself connected with work, which will again, help with isolation. Um, and I, I also sort of always put my parents in that sort of scenario, too. The lessons I've learned, um, being part of, sort of the virtual nursing, um, experience through Stanford healthcare, I'm much more, uh, proactive about getting on as a proxy for my parents. Right. And now I'm, I'm much more a part of their care, and I don't know why it was surprising to their doctor, that they had a daughter who was a nurse and wanted to help. Right. And so now they see my messages when my dad's a little confused about the directions. So I think, you know, it will cause a ripple effect for both the caregivers and the care, you know, the people who need the care, but on both sides.

Speaker 3 (54:14):
Yeah. And Gretchen, I, I wanted to, cause there was a question around patient monitoring and remote patient monitoring at home. I think everything that you said applies to that as well, this is not only an inpatient acute care sort of approach. I mean, that really applies through the continuum of care. Once you have the technology that is gonna support, you know, both inpatient care, as well as, as remote and home care.

Speaker 4 (54:38):
I, I think, you know, that immediateness of a virtual visit like that, that's the element, right? Mm-hmm, <affirmative>, it's not, well, gosh, you know, it's seven o'clock on Friday. I don't know what to do. I'm gonna send the message to my doctor, or I'm gonna go to the urgent care tomorrow. That availability of immediate answer. I, I think that will be a game changer, no matter how old you are when you're at home with, you know, a complex or even a simple medical question that you just don't know where to go to.

Speaker 3 (55:14):
Yeah, no, that's a good point. And, and today we know, or maybe not today, but a few years ago that immediate response was ER dependent. And it was only in the emergency room where you could get it and, and hence all the challenge that we had. But now as we open urgent cares and now telehealth and so on, so forth, I think we're, we're really, technology's allowing us to expand that way.

Speaker 4 (55:36):
Yeah.

Speaker 3 (55:37):
Well, thank you very much, Mary and Gretchen. Um, we're coming up to time. I see just Steve, just pop up right on time, as we just said that boom, she shows up. So I wanna thank you very, very much. This was very, very good. Um, I appreciate a lot of very, very, uh, good thoughtful conversation. Thank you for those on the Q and a chat that, um, as their questions have participated. And uh, now I'm gonna turn it over to Steve to, uh, wave us. Goodbye.

Speaker 1 (56:06):
Thank you. Uh, so much Carlos and Gretchen and Mary. Thank you. Um, so much for your insights and for, um, spending your time with us. Thank you all for, uh, joining us if the number of, uh, questions that, uh, popped up are any indication of how engaging you found the conversation. I think we, uh, it's a sign that we did a really good job with this discussion and for everyone, I hope you enjoy the rest of your day. Thank you so much for joining us.