NEW YORK CITY, April 28 – Older adults with multiple chronic conditions and complex therapies are particularly vulnerable to breakdowns in care as they transition between care settings. Despite consistent positive outcomes, research based approaches to enhance transitions in care are not routinely integrated into clinical practice. On April 22, The New York Academy of Medicine’s (NYAM) Health Care Delivery Lecture series funded by George R. Seidenberg Memorial fund, addressed how to translate these research findings into effective “real-world” clinical practices at a panel discussion entitled “Transitions in Care for Older Adults.”

The Moderator, and Panelists:, , , and discussed translating the transitional care model into the clinical practice, the business case for the transitional care model and the widespread adoption of evidence-based transitional care and the policy implications.

“We need to address the problems that older people and people with multiple chronic illnesses have as they try to use this system. The system has been designed for the providers, not for the users, there for more of our care is in very neat silos, and the problem that the patients have, is trying to get from one silo to the other,” began Moderator Mary Jane Koren, MD, MPH, Assistant Vice President of The Commonwealth Fund.

Given the growing number of older adults with complex care needs, the gap between evidence-based practices and current approaches must be bridged. Panelist Kathryn Bowles, PhD, RN, University of Pennsylvania School of Nursing addressed the bridging process by asking what the transitions in care mean for the patient and the families and how technology such as tela-health programs and health information technology can help care for aging populations.

Panelist Mary Naylor, PhD, RN, the University of Pennsylvania School of Nursing provided an evidence base for the creation of health models and supporting the argument that care needs to be managed for people. In her experience of over 15 years in the field, she created a number of models that have worked. She discussed how to take this research into real practice, collecting the data and translating it into the public domain for use.

Panelist Randall Krakauer, MD, FACP, FACR, National Medical Director, Retiree Markets, Aetna, Inc., took the research tested evidence based model, and designed a program to work with the specific beneficiaries and the provider and still allow them to save money. While Panelist, Mark Pauly, PhD, Bendheim Professor and Professor of Health Care Systems, Business and Public Policy, Insurance and Risk Management, and Economics, Wharton School, the University of Pennsylvania, one of the leading health economists in the United States, discussed the transition from model to working program more in depth and addressed the issues of how this process, from the patient to the evidence, to the model, to the provider and what the policy implications are.

Aging is one of the central themes across NYAM with several projects taking place. In June, 2007 a partnership with the City Council, NYAM launched the Age-Friendly NYC initiative, guided by a protocol developed by the World Health Organization to assess the city’s age-friendliness in eight key areas from housing to transportation. In the spring a blueprint for improvement will be presented as recommendations for policy makers.

The Health Care Delivery Section at NYAM will host one more lectures this spring, “Future Health Care Workforce for Older Americans: The Institute of Medicine Panel Findings” on May 19.

The New York Academy of Medicine is an independent, non-partisan, non-profit institution whose mission is to enhance the health of the public. Its research, education, community engagement, and evidence-based advocacy seek to improve the health of people living in cities, especially disadvantaged and vulnerable populations. The impact of these initiatives reaches into neighborhoods in New York City, across the country, and around the world. It works with community based organizations, academic institutions, corporations, the media, and government to catalyze and contribute to changes that promote health.

Posted on 04/29/2008

Contact:
Malini Doddamani
Director of Communications
mdoddamani@nyam.org
212.822.7285