Aging, Social Isolation of Seniors Discussed with Danish Leaders

As generations age, how do different countries and cultures plan and provide for them? Information and ideas about senior support and preventing social isolation spanned the Atlantic when a group of 12 health care leaders from Denmark spent the afternoon at the Palo Alto Medical Foundation’s Druker Center for Health Systems Innovation on October 10, 2012.  

Danish and American physicians, executives and directors from large health systems, government, universities, senior centers, hospitals and hospices joined for the four-hour exchange at the Innovation Center. The goal of the visit was to share knowledge of and opinions about the diverse challenges of aging populations in Denmark and the United States. From the many dynamic conversations underway at any given time, it appeared that that goal was met or exceeded.


Paul Tang, M.D., vice president and chief innovation and technology officer, Palo Alto Medical Foundation

Paul Tang, M.D., vice president and chief innovation and technology officer for PAMF’s Innovation Center presented on the health care system in the United States, including the changes required to adapt for the Affordable Care Act of 2010 and accommodate the needs of the enormous and growing aging population.

“Already about 13 percent of the U.S. population are seniors, the vast majority of whom are covered by Medicare,” Dr. Tang said. “The U.S. faces several challenges somewhat unique in the world: a fee-for-service care delivery model, the lack of universal health care, and health information systems that are not connected or, in some places, nonexistent.”

“In Denmark, 16 percent of our people are 65 or older,” explained Mikkel Bülow Skovborg, Research Attaché, Danish Ministry of Science, Innovation and Higher Education, outlined the health care system and focus on care for the elderly in Denmark. “We have a highly structured and well-funded system to provide long-term care at home for our elders. We haven’t built a nursing home in our country since 1987.”

Comparing Senior Support in the United States and Denmark

In Denmark, a high percentage of the gross domestic product is spent on social services and a lower percentage on health care. All health care policies are set on a national level but are implementing regionally via hospitals, clinics, rehabilitation centers and other health service centers. The municipal level tends to home care and preventive care services. Because of this comprehensive system, people rarely if ever “fall through the cracks.” There is a continuum of care with coordinated services.

Danish seniors have access to a wide range of services provided at the local, regional and national level, by people whose specific job it is to care for the elderly and support their ability to live in the community. A number of meeting attendees, however, observed that the high-level benefits, free at the point of delivery, may create a level of dependence on the system that enables families to “check-out” of their important caregiver roles. This relates particularly to their role in providing emotional support, the absence of which may contribute to isolation.

By contrast, the United States spends a low percentage of its gross domestic product on social services and a high percentage is spent on health care. The burden of care is on the family, not the government – basically, a private sector approach in which every person or family must research available options. The system is more fragmented, with some communities and cultures more adapted to solutions for elder care than others.

The attendees were divided into several groups, each of which discussed a different query and then reported out to the entire group at the end of the afternoon. Lively, engaging discussions covered these questions:

  • What are the drivers of isolation?
  • How does isolation impact aging?
  • Who has the responsibility for tackling social isolation of seniors?
  • What solutions to social isolation are being implemented?
  • What are your “dream” solutions?

The discussions yielded a variety of perspectives and suggestions for the need to:

  • Reduce health care and senior care costs. For example, in the United Stages, five percent of the people use 50 percent of the care.
  • Reduce hospitalizations through overall improved health
  • Become more community-centered, with more multigenerational composition, and nurture the spirit of volunteerism
  • Improve transportation systems that effectively alleviate isolation, and use IT systems that support natural human interfaces
  • Focus on seniors as people, not patients
  • Embrace and support advanced care planning, beginning at an earlier age


“Seniors seek to maintain their independence and to live out their lives in the community,” Dr. Tang said. “We are committed to keep the dialog about successful aging going.”

Learn more about the Innovation Center at the Palo Alto Medical Foundation.

Danish Leaders to Visit PAMF’s Druker Center for Innovation

Contingent to Explore Successful Aging Ideas

On Wednesday, October 10, 2012, from noon to 5 p.m., the Palo Alto Medical Foundation’s Druker Center for Health Systems Innovation is hosting a delegation of 15 leaders from Denmark who work in diverse capacities to address current challenges in health care, particularly with issues relevant to aging. Attendees include C-level executives and directors from large health systems, universities and private corporations in Denmark.

The focus of the visit is to exchange information and knowledge around challenges related to aging, from the diverse perspectives and approaches of Denmark and the United States.

The population of Denmark is 5.5 million, comparable to the San Francisco Bay Area’s more than six million residents (Alameda, Contra Costa, San Francisco, San Mateo and Santa Clara counties). Life expectancy for women is 81 years and men 77 years. According to the United States Census Bureau, American life expectancy is only slightly lower: women averaging 80 years and men 75 years.

“We feel that advancing cross-cultural leadership engagement in exchanges of shared knowledge will allow us to broaden the scope of our thinking as we work to address the needs of our fast growing and increasingly vulnerable, older adult population,” said Paul Tang, M.D., vice president and chief innovation and technology officer for PAMF’s Innovation Center.

The event has the endorsement of Liz Kniss, Chair of the Santa Clara County Board of Supervisors. Scott Strickland, Kniss’ Senior Policy Analyst, will kick off the event with a welcome on her behalf.

After a meet-and-greet lunch, there will be a presentation by Mikkel Bülow Skovborg, Research Attaché, Danish Ministry of Science, Innovation and Higher Education, who will outline the health care system and focus on care for the elderly in Denmark.

Addressing elder care and aging in the United States will be PAMF’s Paul Tang, M.D, and Albert Chan, M.D., PAMF chief medical information officer, and medical director for the Innovation Center.

The speakers will introduce issues and potential solutions to social isolation among seniors, and then the group will break into teams for a series of workshops, culminating in a panel discussion to share the different perspectives.

Guests for this special gathering also include leaders from the public sector, other hospital systems, senior centers, foundations and nonprofits. 

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PAMF Innovation Center Announces Winners of linkAges Developer Challenge

The David Druker Center for Health Systems Innovation at the Palo Alto Medical Foundation (PAMF) is excited to announce the winners of its recent linkAges™ Developer Challenge, in conjunction with Health 2.0. The Developer Challenge is part of PAMF’s Successful Aging Initiative, which is creating a community-based ecosystem that will support seniors to live vibrant, independent lives in the community.

Today, the vast majority of the rapidly growing senior population in the United States express the desire to age independently, in place, in their homes and communities. However, many face an array of challenges to doing so, including increasingly complex health issues, social isolation, and difficulty accessing resources that support their ability to age in place.

PAMF’s innovative solution is to create an ecosystem, called linkAges, that interconnects seniors, caregivers, social services and professional healthcare teams, and provides tools that empower seniors and caregivers to gain access to resources specific to their personal context, goals and preferences.

The LinkAges Developer Challenge is focused on one of the linkAges ecosystem components, “signal detection.” Signal detection provides a means of unobtrusively tracking a senior’s health and well-being, with the capability of alerting caregivers or the professional health care team of potential health risks.

Paul Tang, M.D., chief innovation and technology officer, Druker Center for Health Systems Innovation, Palo Alto Medical Foundation

“We wanted to advance our signal detection capabilities of linkAges as quickly as possible,” said Paul Tang, M.D., chief innovation and technology officer for the Druker Center for Health Systems Innovation. “Located in the heart of Silicon Valley, we sought to harness the tremendous talents of the area’s innovative developers in the creation of these new capabilities. More than 75 developers spent an entire weekend in April 2012 working on the opportunity and presented us with 20 potential solutions. Several of these teams went on to develop prototypes during the next three months. From these applicants, we selected a winner to enter our accelerator to co-develop their prototype into a viable product to apply in a pilot linkAges community. We are delighted with the result of this partnership between a health care provider and a start-up technology innovator.”

Overall linkAges Developer Challenge Winner: Team Meter Made (Now incorporated as Vevity Inc.)

  • Proposed and demonstrated a solution turning patterns of data from a variety of home monitoring devices into alerting intelligence on an individual’s status

Runner-up linkAges Developer Challenge Winner: Team Agility4Life

  • Proposed and demonstrated a solution tracking walking speed, which can predict deteriorations in a senior’s well-being

PAMF’s David Druker Center for Health Systems Innovation is pleased to formally present Meter Made (Vevity Inc.) as the linkages Developer Challenge winner during the Health 2.0 Fall Conference in San Francisco, Calif., on Monday, October 8 at 2:25 p.m. PDT.

Learn more about:

Druker Center for Health System Innovation

Vevity Inc.

Media Contact:

Martin Entwistle
Executive Director Druker Center for Health Systems Innovation
Palo Alto Medical Foundation


Erin Macartney
Public Affairs
Palo Alto Medical Foundation

IOM Report: Lowering Costs and Improving Quality of Care

PAMF’s Dr. Paul Tang Member of the Institute of Medicine’s Learning Health Care System Committee

The increasing complexity and escalating costs of health care in the United States threaten the nation’s economic stability and undermine progress in improving Americans’ health. Medical care lags behind many other industries in its ability to meet needs, offer choice, and become safer and more affordable to those it serves.

Paul Tang, M.D.

On September, 6, 2012, the Institute of Medicine (IOM) released its latest report, Best Care at Lower Cost: The Path to Continuously Learning Health Care in America, which details ways to bring about better quality care at lower cost by harnessing existing knowledge and technologies. The report calls for a transformation of the health care system into one that continuously improves, and it describes the specific steps that should be taken by all participants — including care providers, hospital and clinic managers, health insurers, policymakers, clinical researchers, and patients and their families — to achieve this improved system.

“This report provides a framework for creating a health care delivery system in America that continuously learns and continuously improves.  It leverages something America already does very well – innovation – and applies that to health care,” according to Paul Tang, M.D., M.S., internist and vice president, chief innovation and technology officer at the Palo Alto Medical Foundation (PAMF) and the PAMF Innovation Center.

Dr. Tang is an elected member of the IOM and has participated on a number of IOM studies, including a patient-safety study he chaired, which published two reports: Patient Safety: A New Standard for Care, and Key Capabilities of an Electronic Health Record System.

Further information on the report from the IOM

Hundreds in Silicon Valley Turn Out for PAMF Innovation Event on Senior Health

The  Palo Alto Medical Foundation’s (PAMF) David Druker Center for Health Systems Innovation  launched its linkAges™ Successful Aging Program with a community education and developer event on April 14 and 15, 2012. PAMF’s linkAges initiative is pioneering new ways to support seniors in the community to live a meaningful life and to age in place. When the Innovation Center invited the community to share its ideas on developing new ways to help seniors age successfully, the response was overwhelmingly positive. The event had a waiting list within days of the announcement, and more than 300 members and leaders in the community, high tech, government and developers attended the free event, which was hosted by PAMF and Health 2.0 at Silicon Valley’s Computer History Museum. The event was also carried live on Twitter via the #linkAges hashtag, with people participating virtually throughout theUnited States.

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PAMF’s Innovation Center Challenges High Tech to Help Seniors Age Successfully

New linkAges program launches April 14 in Mountain View

The Palo Alto Medical Foundation’s (PAMF) David Druker Center for Health Systems Innovation is inviting the Silicon Valley community to combine its unique talents in developing new ways to help seniors age successfully.

“More than anywhere else in the country, Silicon Valley is perfectly positioned to apply innovative thinking to the universal challenges of aging,” according to Paul Tang, M.D., chief innovation and technology officer for PAMF. “We live in the heart of technological innovation and have a proud history of excellent health care and supportive community organizations. We can be a national model for how the community supports aging and living well.”

“Successful aging is about much more than health care,” Dr. Tang said. “It requires a supportive ecosystem of social connections and resources to assist in a variety of daily-living activities. We call this community ecosystem linkAges – linking across generations.  We believe it takes a village – a combination of caregivers and community social services working together with professional healthcare teams to create a partnership that supports a vibrant and fulfilling senior community.” Read More