Technology for People with Cognitive Disabilities: the Promise, Pitfalls… · 2014-03-26 · the...

Technology for People with Cognitive Disabilities:

the Promise, Pitfalls, & Push for

Rodney Bell, Principal ASSET Consulting

Innovative Technologies Summit Mar 2014

mailto:[email protected]

2 © ASSET Consulting, 2014

Your Take-Aways

Lots of tech for people with I/DD

Big wave of tech challenges us

All can learn to ride tech wave

People with I/DD have a right to technology


Tech is Here for People with I/DD

Smart Mobiles

Assistive Apps

ResidentialSupports

Point-of-Care

Web


… and Changing Everything

ProvidersOrganization

PracticeOperations

Consumer LivesIndependence

SocializationWork & Play

GovernanceWaivers

ReimbursementEthics


The Promise and Pitfall

Abandonment


When Technology Doesn't Work

That'll fix ya !


Techies get a comeuppance

Heavenor Hell?

marketer

salesman


… with a peek at Heaven & Hell

HellHeaven

"Hell looks fun, we'll go there "


Looks Can Be Deceiving

Where's the

Party?SALES DEMO !


Provider IT no longer optional

I/DD, Client Mgmt, EMR …

Web services, Cloud, BYOD

Individual planningPerson-centered Outcome-oriented Cost-based


Provider IT no longer optional

I/DD, Client Mgmt, EMR …

Web services, Cloud, BYOD

Individual planningPerson-centered Outcome-oriented Cost-based

Cost to develop ready technology

Not commercial OH waiver pilot


Point-of-Care IT Cuts Errors, Time

Web services, Cloud IT

Medication administration


Point-of-Care IT Cuts Errors, Time

Web services, Cloud IT

Medication administration

BYOD, Malware configure, firewall, …


Web – also for people w I/DD

SimpleInterfaces

Entertainment

Communication

Skype


Web – also for people w I/DD

Simpler Interface

Accessible PC

Email, Browsing

Social Media

Entertainment

Communication

Skype

no Internet What?

Get it


Let's Get Social

Facebook


Let's Get Social

Fred Hobbs, Imagine!Colorado"Using Social Media ... Regardless of ... Disability"

Online harm coach

supervise

http://www.slideshare.net/ImagineColorado/using-social-media-to-connect-communicate-and-network-regardless-of-abilitydisability


Independence with Residential Support

Remote Monitoring, Supervision, Communication


Independence with Residential Support

Changes! prepare pilotmanage


EliteCare

Imagine

Advanced Smart Homes Do It All

Sense Activity

Track People

Control Building

Calls, Alerts

Complete IT

Family Portal


Mobiles/Apps Assist Wherever

Communication

Task Prompts

Plan, Remind

WayFinding

Health Monitor

LifeLog

http://www.friendshipcircle.org/blog/2011/03/02/10-websites-to-find-special-needs-apps-for-the-ipad-iphone/


Mobiles/Apps Assist Wherever

Communication

Task Prompts

Plan, Remind

WayFinding

Health Monitor

LifeLog

Not curated reviews

try outstart cheap

http://www.friendshipcircle.org/blog/2011/03/02/10-websites-to-find-special-needs-apps-for-the-ipad-iphone/


Plan Your Day; Talk With Others

Plan, remind activity

Augmentative Communication


Plan Your Day; Talk With Others

Plan, remind activity

Augmentative Communication

Usable? train, coach


Help for Daily Activities

Pick your task

for Step-by-step


Help for Daily Activities

Pick your task

for Step-by-step

Task-specific prioritize


Desktop & Web Help at Home

Plan & Prompt

Simple Desktop

Communicate

Manage Health


Desktop & Web Help at Home

Plan & Prompt

Simple Desktop

Communicate

Manage Health

PC Admin tech supportiPad


Mobiles Show the Way

DirectionPrompts

ReportLocation,

Status

Locate,Inform


Mobiles Show the Way

DirectionPrompts

ReportLocation,

Status

Locate,Inform

No one to help phone call

Theft GPS finds


Do a Job with Work Supports

Task prompts Monitor & prompt


Do a Job with Work Supports

Task prompts Monitor & prompt

Task-specific justify

R&D pilot


Tech is for Families too

Residential

Info Portals

Alerts/reports

Web

Social Media

Video Calls

Email


Tech is for Families too

Residential

Info Portals

Alerts/reports

Web

Social Media

Video Calls

Email

Rare ask for it

Usable? simpler app

coach


Coming Soon to Prime-time

Augmented Reality

Indoor WayFinder

Location Services

Wearables


Wearables Attract Investment

http://vandrico.com/database


WEARABLES

Fitness

Activity, position,

Context, location

Health

Medical devices

Physiological

Safety

Falling


Someday R&D Will Reach Us

Brain Prosthesis

Autism

Robots

Virtual Reality

Personal Robots


Technology Futures

Virtual realitySocial gaming

Simple web browsingComputer games

At home,day activities

Recreation

Multi-person track’gPredict risks

Monitor & alertStaff checksSafety

Wearable monitors Predict declines

Med Admin supportMonitor, Tele-health

Nurse checksHealth

‘Translations’iPhone/iPad appsAACCommunication

Automatedat Point-of-CarePaper records Documentation

Track plan careBig Data

Field use, “Cloud”Costing

Office useEnterprise IT

Urban SystemsFactory coach

Way-findersPersonal coach

SupervisedWork, community

Connected LifeLogsocial media, video callPhone, in-personSocial Life

Adaptive promptsApps plan/remind ...Staff promptsCognition

Robot, smart camera Smart Homes +Staff, call buttonHome (ADLs)

FutureEmergingTraditional


Really ?


To Keep Pace with Technology …

“It takes all the running you can do, to keep in the same place. … to get somewhere else, you must run at least twice as fast”

Through the Looking Glass Lewis Carroll

Elenore Abbott

RedQueenEffect


Big Wave of New Technology

seandavey.com


Internet users


Mobile phone use


Devices Connected to Internet

World Economic Forum

http://www3.weforum.org/docs/WEF_ITTC_PersonalDataNewAsset_Report_2011.pdf


Connected Wearables


Healthcare Devices


Machine to Machine Connections


Technology is Fast Improving

Personal Devices

Connectivity

The Cloud

Automation

Tracking

Software & Data

User Interfaces


What's Driving Tech Change

-> Exponential increases in computing

Economics and miniaturization


Moore's Law: Doubling rates

Transistors per chip – 18 months

World Data Storage – 12 monthsTransmission bandwidth – 9 months


Leads to other improvement

Cost, power, size halved every 18 months


Enabled by $10B Fab Plants

Intel Ronler Acres, Oregon - expanding


and 450 mm wafers

with 14 nanometer process


Makes Tech Affordable for All

$10 Smart phone?


with Astounding Potential

Time magazine

Computers >> Brain … Singularity


Unbalanced Pace of Change

>>>

>>


Why Tech Adoption Takes Time

Stakeholders

Time

Complexity -Interface …

Pitfalls

Manage the project, coordinate stakeholders


Tech Doesn't Just Happen … Yet

Manage Tech Adoption to Get Benefits


Best Practices for Tech Adoption

Tech is strategic

Integrate w/ facility & practice

Manage risks

Smart process

Prepare for change

Support & Improve

USER CENTEREDUSER CENTERED


Technology Hype vs. Maturity

Gartner Hype Cycle – 2013


Hype Cycle for Disability Tech

Web

Social media

Remote monitor

BCI

Office IT

AugmentedReality

IndoorWayfind

UrbanNavigate

Pt-of-Care IT

PersonalRobots

TherapyRobots

Cognitive Assist

SmartHome

Wearables

Predictive Models

WorkSupport

Daily AssistTherapy VR


Where will you board the tech wave?

Know your risk aversion, tech competence

Techsavvy

Risk adverse

Adaptive

Resilient

Early Adopter

Typical


Can You Ride the Tech Wave ?

ANCOR Links, NADSP Frontline Initiative

http://www.ancor.org/sites/default/files/pdf/2011_11-12_links.pdf

http://www.nysacra.org/nysacra/pdf/FI_Technology.pdf


Overwhelmed by the Leading Edge?

Don't try a wave too big for you

surfertoday.com


Had a bad experience with Tech?

Work your way up to big waves


Wonder what to avoid?

… rides that won’t make it


Concerned About Tech Risks?

Avoid danger in the waves


Does Your Project Seem Too Big?

Teamwork can drive a big boat


Tech too much to do alone?

Get a little help from your friends


Not Sure How To Do Tech ?

Learn from other riders …


Trouble Managing Tech Adoption?

Right size your projects


Is Your Tech Too Weak ?

Get a more powerful board


Wonder where to start?

Find an easy wave


Consumers Struggling with Tech?

Beginners can use help


Tech Too Hard for Some People?

The Right Size Wave is Fun


Has Tech Left Someone Behind?

Some waves everyone can ride


Overtaken by Trailing Edge of Tech?Andy Johnson-Laird, Wescon, 1979

Don't be left out. Start paddling !


Soon You'll be an Expert Surfer


New Tech Challenges Governance

Reimbursement ?

Internet/web ?!

iPad v AAC



Reimbursement ?

Internet/web ?!

iPad v AAC

general PC DME

many apps comm

$ $$$

cool disabled



Reimbursement ?

DSP labor v Remote monitor

$$$ $Invasive PrivateGroup home Apartment

Waiver RM services

Share savings with providers

CMS receptive


Make Tech > 2% of Reimbursement

UIC Study of HCBS waivers

http://www.ncbi.nlm.nih.gov/pubmed/23360405



Tech Monetization ?

thru 3rd party beneficiaries

e.g., Social Impact Bonds

Regs/policy inhibit change

Revisit ethics

http://harvardmagazine.com/2013/07/social-impact-bonds


Tech Enables More Autonomy

PrivacyGroup Living

Independent LivingStaff Keeps Safe

Community InclusionCare Settings

FriendsCare-givers

Right of AssociationControl Contacts


Want Good Help for Change?

Next Conference: October 9, 2014

Coleman Institute

http://www.colemaninstitute.org/community-news-category-list/235-upcoming-conference-14th-annual-coleman-institute-national-conference-on-cognitive-disability-and-technology-and-coleman-institute-and-ancor-technology-showcase


State of the States Informs Policy

Fiscal Effort by Disability - US

per $1000 of aggregate personal income

http://www.stateofthestates.org/



Fiscal Effort by Disability - NC

per $1000 of aggregate personal income




I/DD Fiscal Effort Trend - NC




I/DD Fiscal Effort Trend - US




Candidates for Remote Monitoring ?



The Push for Equal Rights


Why Push for Equal Rights ?

28 million

Entitled to inclusion

Tech inaccessible

But necessary

Funding access

Benefits society


The Push for Equal Rights

150+ organizations endorsed :

AAIDD, The Arc, ANCOR, SABE, SLN, …

Colorado legislature resolution

Dr. Braddock's article

"The Rights of People With Cognitive Disabilities to Technology and Information Access"

AAIDD Inclusion 1:2, p.95

Copies of Declaration & Article here

Endorse @ www.colemaninstitute.org

http://aaidd.org/

http://www.thearc.org/

http://www.ancor.org/

http://www.sabeusa.org/

http://siblingleadership.org/

http://colemaninstitute.org/documents/INCL 1 2 Braddock.pdf

http://www.colemaninstitute.org/declaration


References

Strategies for Equal Technology Access, Bell

HCBS Waivers: a nationwide study , Rizzolo et al

ANCOR LINKS, Bell“Top Ten Guidelines for Adopting New Technology“Riding the Technology Waves” “Making Technological Investments" p16

Presentations, BellEmerging Technology, ARRM Tech Showcase, 2012Smart Homes, Coleman Institute Conference 2008

http://www.colemaninstitute.org/declaration-updates-category-list/237-declaration-update-by-rodney-bell

http://www.ncbi.nlm.nih.gov/pubmed/23360405

http://newsmanager.commpartners.com/ancor/issues/2013-01-19/12.html

http://www.ancor.org/sites/default/files/pdf/2011_11-12_links.pdf

http://www.ancor.org/sites/default/files/links_2010_03.pdf

http://www.arrm.org/training/ongoing/docs/RodneyBell.pdf

http://www.colemaninstitute.org/images/documents/conferences/2008/smarthouse_rb.pps

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