Tuesday, November 27, 2012

TEDMED and the Great Challenges of Geriatrics

TEDMED started a big project this year : the "Great Challenges in Health & Medicine." These 20 Challenges are "complex, persistent problems that have medical and non-medical causes, impact millions of lives, and affect the well-being of all of America."

I'll admit I was mildly surprised when I realized that not a single one of these worthy issues is specifically about the health care of aging Americans. (See the list below for yourself, and note the absence of the words "Medicare" "aging" "senior" "elderly" "geriatrics" or even "older adult." The closest they come is "dementia," which is almost exclusively a problem of older adults.)

And there I was thinking that fixing Medicare was the most high priority challenge of the next several years.

As in, figuring out how to provide compassionate, coordinated, and effective healthcare to older adults, at a cost that we all -- patients, caregivers, clinicians, society -- can bear and sustain. And this in a time of projected primary care clinician shortages, with a particular shortage of providers trained to meet the unique health care needs of frail and vulnerable elders.

No matter. There is still much common ground that geriatricians can find with the Great Challenges, as all (except childhood obesity) are relevant to better care of frail and vulnerable elders.

Why TEDMED should consider the frail and vulnerable elderly


Because for many Challenges, the typical elder presents a common, and usually more complex, version of the challenge. After all, the elderly have a disproportionately high illness burden and usually suffer from multi-morbidity. This means that they:


Also, as the healthcare needs of older Americans will be driving most of the nation's healthcare spending over the next 30 years, this group desperately needs Healthcare Costs and Payment Systems Addressed.

Last but not least, when the above issues don't go well, millions of elders and caregivers suffer, as do some of the clinicians trying to help them. And hundreds of billions of dollars are spent.

In other words, the knotty problems of health care are knottiest when it comes to frail older people. This is a large population that could really benefit from the creative problem-solving of the TEDMED community.

Plus the nation's finances somewhat hang in the balance.

(But no pressure TEDMED!)

How the geriatrics community can participate in TEDMED's Great Challenges


The next TEDMED conference costs $4950 (scholarships available) and requires a successful application to attend.

Fortunately, the Great Challenges are a more accessible affair. The idea is to foster an "open, ongoing dialogue" in order to "move toward a broad-based understanding of each challenge." Each Challenge has a website and a team (a "multi-disciplinary group of leaders in their fields") leading the discussion. Questions and comments can be posted on each Challenge's website. Use of Twitter and other social media is encouraged. Virtual panel discussions are already underway, featuring the teams conversing with each other and fielding questions from an online audience. (Read more about it all here.)

If you have an interest or passion for any of these Great Challenges, I'd encourage you to participate. Bonus points from me if you bring a special focus on the elderly.

And what will be the outcome of all this discussing and exploring of knotty problems?

Hard to say. TEDMED states that the mission is "not to solve these complex problems." Rather, the idea is to "move toward a broad-based understanding of each challenge," which then will "set the stage for truly effective action."

I myself am a bit antsy for effective action that actually changes things down here where the rubber meets the road. Will TEDMED's Great Challenges project eventually lead to specific and scalable improvements in the care of geriatric patients?

Who knows. It certainly can't hurt (unless it only leads to glamorous high-tech interventions that work mainly for the digital natives, and the entrepreneurs eager to sell things to them).

Advocates for better geriatric care, jump in. Learn from the others joining this TEDMED project. And speak up for the needs of elders, their caregivers, and their clinicians.

The 20 TEDMED Great Challenges:

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