ChromeVis: Free Tool for Chrome Users With Low Vision


ChromeVis is a simple Chrome extension for users with low vision. ChromeVis is simple to use and has many customization options. To use ChromeVis highlight the text you want magnified and then click on the ChromeVis icon in the top right of your Chrome window. To customize the appearance of ChromeVis right click on its icon and select options. To download ChromeVis for free click here.

4 Ways iPads Are Changing the Lives of People With Disabilities


4 Ways iPads Are Changing the Lives of People With Disabilities

http://mashable.com/2011/07/25/ipads-disabilities/

Noah Rahman has moderate Cerebral Palsy affecting his communication, cognition and upper and lower body movement. When he turned two, his language, cognitive abilitity and fine motor skills were diagnosed by a developmental specialist as being at least 12 months behind. Then Noah got an iPad.
Four months later, his language and cognition were on par with his age level. His fine motor skills had made significant leaps.

Today, the three-year-old (pictured at right with his father) spends an hour or two on his iPad each day. He switches his apps between reading and writing in English, Arabic and Spanish. In the fall, he’ll enter a classroom of five-year-olds. “The iPad unlocked his motivation and his desire because it’s fun,” says his dad Sami Rahman, co-founder of SNApps4Kids, a community of parents, therapists and educators sharing their experiences using the iPad, iPod touch, iPhone and Android to help children with special needs.

SNApps4Kids taps into a burgeoning trend for people with disabilities. Touch devices — most notably the iPad — are revolutionizing the lives of children, adults and seniors with special needs. Rahman estimates some 40,000 apps have been developed for this demographic.

“Touch has made it exceptionally accessible — everyone has an iPad, everyone has an iPod,” says Michelle Diament, cofounder of Disability Scoop, a source for news relating to developmental disabilities. “If you’re someone with a disability, having something that other people are using makes you feel like part of the in-crowd.”

For people lacking motor skills, touch screens are more intuitive devices. There is no mouse, keyboard or pen intercepting their communication with the screen. Larger platforms, like iPads, are preferred over smaller iOS and Android devices for ease-of-use and, of course, the cool factor.
Here are four ways that touch devices are changing the lives of people with disabilities:

1. As a Communicator


Before the iPad and other similar devices, using touch-to-speak technology was incredibly expensive, costing around $8,000. Now, it only costs $499 for an iPad and $189.99 for a thorough touch-to-speak app like Proloquo2Go.
That relative affordability has made the technology more available for children and adults that can’t use their voice. With the simple touch of an iPad, a hungry non-verbal person can communicate exactly what he or she would like to eat. Those apps can then be customized with photos or features to suit an individual’s life and needs.
Another option is Assistive Chat, which predicts several sentence completion options. For the most severely disabled people, Yes|No is a simple app that allows individuals to voice their preference in yes-or-no responses.
“It gives dignity back to people who are more disabled,” says Vicki Windham, a special education teacher in the Clarkstown Central School District who trains people of all ages to make the most of their iPads. Windham reviews apps for people with a variety of special needs.
For hard-of-hearing iPad users, soundAmp R amplifies sound in a variety of situations. Users can also record lectures or presentations they want to listen to again later.

2. As a Therapeutic Device


SNApps4Kids co-founder Cristen Reat’s son Vincent was born with Down syndrome, which can also lead to low-muscle mass. While he can walk, Reat describes his son as a Buddha that prefers to sit still most of the time. Throughout his life, Vincent’s therapists and parents have tried to help him be more active. It was not until his physical therapist placed an iPad on a treadmill that Vincent was motivated to walk. He now stays on for nine and a half minutes, interacting with his iPad while he’s in motion.
In addition to increasing his gross motor ability to walk, Vincent’s iPad has helped his fine motor skills. For Vincent, computers and older technology required visual shifting — between a mouse or keyboard and the screen. On an iPad, Vincent can watch as one of his fingers writes directly on the screen to make selections.
Similarly, Noah Rahman has shown motor improvement. After playing the Elmo Loves ABCs app on his iPad, he can write the entire alphabet, requiring sophisticated finger isolation. As a three-year-old, this puts him well above his grade level. “First it was ‘do it for me,’ then it was ‘do it with me,’ now he does it by himself,” says Noah’s father.

3. As an Educational Tool


Years ago, one of Jeremy Brown’s autistic elementary school students picked up his iPhone off his desk and began navigating the iOS with ease. “It’s like a fish to water,” says Brown, a teacher for autistic elementary school students, of his students’ interactions with touch technology.
Brown is immersed in online discussions of technology and special education, moderating the Facebook group iTeach Special Education, collaborating on the podcast EdCeptional and coauthoring the blog Teaching All Students. While use of the iPad in classrooms is not yet approved in his school district, he believes the iPad is a great supplemental method of instruction, estimating 80% to 90% of his students with autism see great results when using iOS devices. Brown hopes his school district and others across the country will approve iPads in the classroom.
While no one advocates replacing traditional instruction, a number of apps do address academic subjects from math to language to reading and writing. In October 2010, Apple even featured an “Apps for Special Education” section in the App Store.
Brown encourages parents to separate their children’s recreational uses of the iPad from those in the classroom. Some students may watch YouTube videos on the school bus but while they’re at school they know Mr. Brown’s iPads are only for education.

4. As a Behavior Monitor


Behavior Tracker Pro is a popular app for parents, therapists and teachers to quantify the behavioral progress of children with special needs. In addition to taking notes, good and bad behaviors can be video recorded and later reviewed. The app automatically turns that input into visual graphs and charts.
High school teacher Vicki Windman notes that the iPad can also be a great way to strengthen and reinforce memory for seniors with Alzheimer’s or memory loss. Still, she warns that touch technology is not a miracle drug: “You’re not curing Alzheimer’s. Parents challenge me all the time — they want a cure. It’s no cure.”
That doesn’t mean it can’t help. Apps like Medication Reminder tell users when it’s time to take medication. Memory Practice, a memory strengthening app, was created for the developer’s mother shortly after she was diagnosed with Alzheimer’s. Windman’s father uses an app called Nudge, which gives him a persistent reminder every fifteen minutes to accomplish lapsed tasks on his to-do list.

Long-Roads Ahead


Despite these successes, SNApps4Kids cofounder Cristen Reat recommends a measured approach. “Just because you buy a device doesn’t mean it’s going to change anything,” she says.
Rahman agrees. He says that viewing the iPad as the solution is the backwards approach. “We are big advocates that the user needs to understand the objectives first before you pick the technology,” Rahman says. “We’re not just putting [our son] in front of an iPad and walking away. That’s the real key.”
Image courtesy of Sami Rahman.

BodyWave Technology

Interesting artilce that could offer future opportunities for brain-computer interface.


-----------------------------------------------------

BodyWave Technology

BodyWave technology from Freer Logic reads and reacts to brainwaves through
the extremities of the body. The sports armband device collects interactive
feedback for training purposes.

BodyWave reads brain activity through the human body via a uniquely
innovative arm band that houses brainwave sensors that attach to the arm or
wrist. BodyWave's patent pending design monitors the brain's physiologic
signal through the body. Dry sensors acquire brain signal and transfer it
wirelessly to a mobile device or PC. When BodyWave is used with Freer Logic's
3D computer simulations, it can teach stress control, increase attention, and
facilitate peak mental performance.

[I really think they use EMG signals rather than EEG signals - DJ]

Unique Logic and Technology (UL&T), uses BodyWave technology in their Play
Attention product which is advertised to increase student attention, teach
cognitive skills, and improve behavior.

Links:
Freer Logic
http://www.freerlogic.com/

Play Attentionhttp://www.playattention.com/

Surfing the flow of brain waves to help employees pay attentionhttp://www.theglobeandmail.com/news/technology/science/surfing-the-flow-of-brain-waves-to-help-employees-pay-attention/article2242244/

Experimental treatment gives hope to sufferers of post-traumatic stress disorderhttp://www.theglobeandmail.com/life/health/new-health/health-news/experimental-treatment-gives-hope-to-sufferers-of-post-traumatic-stress-disorder/article2187112/

Researchers explore how video game technology can treat brain disordershttp://www.theglobeandmail.com/life/health/new-health/conditions/autism/researchers-explore-how-video-game-technology-can-treat-brain-disorders/article1593091/

TextGrabber: Fast, Cheap, Accurate OCR app for iPhone


TextGrabber is a low cost OCR app for iPhone that quickly and accurately converts printed text into digital text that can be edited or read aloud using text-to-speech. Click here to download TextGrabber. The app is easy to use. Snap a photo of the text you want to read then crop the photo and finally read the text. TextGrabber only takes a few seconds to convert the printed text into a digital format. Once the text has been recognized you can have it read aloud to you using VoiceOver. TextGrabber can also translate captured text into many languages. One negative of TextGrabber is it does not have built in text-to-speech,  or Speak Selection, a new iOS 5 feature, does not work. In day-to-day use I found that TextGrabber and ZoomReader offer similar OCR speed and accuracy. To improve the accuracy turn on the flash while taking the picture. TextGrabber does not feature built in text-to-speech with highlighting while ZoomReader does not offer a cropping tool for removing unwanted text. To read more about ZoomReader click here. Click read more below to see screen shots and examples of TextGrabber in action,including a step- by -step depiction of TextGrabber converting a newspaper article.

Picture of Newspaper Article Taken with iPhone 4S camera.
Crop the Section You Want to Read
Press Read and Let it do its Work
Finish Product Ready to be Read by VoiceOver or Emailed.
Below is the text that was extracted. It is not perfect but is a par or better than most other OCR apps for iPhone.
^ Economic Slide Took A Detour at Capital Hill From Page Al group. Congress has never been place for paupers. From planta" tion owners in the pre-Civil War era to industrialists in the 1900s to ex-Wall Street financiers and Internet executives today, it has long been populated with"the rich, including scions of families like the Guggenheims, Hearsts. Kennedys and Rockefellers. But rarely has the divide ap- peared so wide, or the public con- trast so stark, between lawmak- ers and those they represent. The wealth gap may go largely unnoticed in good times. "But with the American public feeling all this economic pain, people just resent it more," said Alan J. Zio- browski, a professor at Georgia State who studied lawmakers' stock investments. There is broad debate about just why the wealth gap appears to be growing. For starters, the prohibitive costs of political cam- paigning may discourage the less affluent from even considering a candidacy. Beyond that, loose ethics controls, shrewd stock picks, profitable land deals, fa- vorable tax laws, inheritances and even marriages to wealthy spouses are all cited as possible explanations for the rising for- tunes on Capitol Hill. What is clear is that members of Congress are getting richer compared not only with the aver- age American worker, but also with other very rich Americans. While the median net worth of members of Congress jumped 15 percent from 2004 to 2010, the net worth of the richest 10 percent of Americans remained essentially Hat. For all Americans, median net worth dropped 8 percent, based on jnflation-adjusted data from Moody's Analytics. Going back further, the median wealth of House members grew some two and a half times be. tween 1984 and 2009 in inflation- adjusted dollars, while the wealth of'the average American family has actuaily declined slightly in that same time period, according Emmarie Huetteman and Derek Willts contributed rfmrtiw SJata cited by The Washington _'"an article published Mon- with millionaire status now the norm, the rarefied air in'the Capi- days is $100 million. lofty level appears to have surpassed by at least 10 members, led by Representative Issa, a California Repub- and former auto alarm mag- nate who is worth somewhere be- tween $195 million and $700 mil- lion. (Because federal law re- quires lawmakers to disclose their assets only in broad dollar ranges, more precise estimates are impossible.) Their wealth has created occa- sional political problems for Con- gress's richest. Mr. Issa, for instance, has faced outside scrutiny because of the overlap of his Congressional work and outside interests, in- eluding extensive investments with Wall Street firms like Merrill Lynch and Goldman Sachs, as well as land holdings in his San Diego district. In one case, he ob- tained some $800,000 in federal earmarks for a road-widening project running along his com- mercial property. Senator John Kerry, a Mas- sachusetts Democrat who is mar- ried to Teresa Heinz Kerry, set off an uproar last year when it was disclosed that he had docked his S7 million, 76-foot yacht not in his home state but in neighboring Rhode Island, which has no sales or use tax on pleasure boats. (Mr. Kerry, worth at least $181 million, voluntarily paid $400,000 in Mas- sachusetts taxes after criticism.) Representative Nancy Pelosi, the House Democratic leader, was challenged about her wealth, as much as $196 million, by a member of her own party a few weeks ago. Representative Laura Richardson, a California Demo- crat who is among the poorest members of Congress with as much as $464,000 in debt, at- tacked Ms. Pelosi at a closed- door Democratic caucus meeting for endorsing a Congressional pay freeze, according to a report in PoHtico that was confirmed by other members. Ms. Richardson angrily told M, n^i^n: ..i--
Article from New York Times

Cigna now approves Speech Generating Devices!

From Twitter feed of Comm Greenhouse:

Barriers to AAC keep falling! Thanks to Lew Golinker & other AAC advocates, CIGNA no longer considers SGDs experimental. 

http://www.cigna.com/assets/docs/health-care-professionals/coverage_positions/mm_0447_coveragepositioncriteria_autism_pervasive_developmental_disorders.pdf

State of the Science Conference for AAC-RERC--June 28th

The State of the Science Conference for the RERC on Communication Enhancement (AAC-RERC) will be held on Thursday, June 28, 2012, at the Baltimore Marriott Waterfront, 700 Aliceanna Street, Baltimore, MD. The AAC-RERC State of the Science Conference will be immediately followed by the RESNA conference (June 28-July 3), also at the Baltimore Marriott Waterfront.

Please save the date! More information will be posted soon at
http://aac-rerc.psu.edu/index.php/projects/show/id/14

Add Quick Text-to-Speech Button to Microsoft Word



Microsoft Word has a hidden text-to-speech button built in. To access add the text-to-speech button to the quick access tool bar click on the down arrow in the top left corner of the screen. Next click on more commands and then click on all commands from the drop down menu. Finally click on speak from the list and then press add. To use the text-to-speech feature select the text you wish to have read and click on the text-to-speech button you just added to the top left corner of the screen. The text will be read allowed instantly. Click the button again to stop the text-to-speech. Watch the video above to learn more. Click read more below for step by step instructions.








iOS 5 Tips: Use Assistive Touch to Replace a Broken Home Button, Lock Button or Volume Button


Assistive Touch is a new feature in iOS 5 that allows people with physical disabilities to better use their iOS device. To learn more about AssistiveTouch click here. To enable Assistive Touch go to Settings>General> Accessibility>Assistive Touch and then turn on Assistive Touch. A small round white button will then appear on your screen. When you touch the white button a list of commands will appear including a software home button, lock button and volume up and down button. You can now use these software buttons to replace your broken home button or any other broken buttons. You can drag the white button to different places on the screen for your convenience. Watch the video below to learn more.



iOS 5 Tip: Look Up Any Word


A new feature in iOS 5 allows you to get a definition of any word from any app. To get a definition of a word simply select the word by holding down on it for a couple of seconds and then tap define. A dictionary will appear with that word defined. When you are done tap done to return to your app.

iOS 5 Tips: Reader Eliminates Distractions



A new feature in iOS 5 called Reader makes reading articles on the web much easier. Many articles on the web are hard to read on the iPhone and iPod Touch's small screen. Reader also works on the iPad. To read the articles you must zoom in and deal with distractions such as advertisements. Reader solves this problem by taking out the advertisements and formatting the text perfectly. To activate Reader simply tap the Reader button in the address field. The address field is where you type the website address. After pressing the Reader button the article will appear perfectly formatted for your screen. To change the size of the text simply press the text size button in the top left of the screen then tap on the little A to make the text smaller and the big A to make the text bigger. When you are done reading the article simply tap done to continue to browse the web. Reader can enlarge the font substantially to assist people that have trouble reading small print. Click read more below to see more screen shots.






Zite Personalized Magazine--an app for iPad that allows you to subscribe to TOPICS

Zite Personalized Magazine

http://www.therapyapp411.com/2011/12/zite-personalized-magazine.html


This post also appears on SpeechTechie as part of Blog Awareness Month!

All month I have been singing the praises of blogs as a route to professional development and therapy planning, and I am ending with a bit of a twist- Zite Personalized Magazine (Free, iPad only for now) an app that allows you to subscribe not to blogs but to topics. Select topics of interest and Zite will pull in posts from various news sources (including blogs) that correspond with your selections.  Here's my Zite home page:



Zite works somewhat like music app Pandora in that you can then further customize your feeds by giving a thumbs-up or -down to articles that appear or request more from the author, source, or subtopic.  It is easy to share articles by email or send to Twitter, Facebook or other services, making Zite a great tool for participating in your Personal Learning and Sharing Network.


Zite is somewhat more of a leisurely experience than using Google Reader as you don't have a number of unread posts to contend with; just read what you want! Because Zite allows you to set up multiple profiles within the app, it could also be a tool for helping older students do research or explore topics of interest and work on comprehension and language strategies.

IBM '5 in 5' predicts no more passwords, mind-reading smartphones

The business and culture of our digital lives,
from the L.A. Times

December 19, 2011 | 10:22 am

Too good to be true? Today, yes. But researchers at tech companies such as IBM are working on bringing these ideas to fruition, which is why the 100-year-old tech giant is including these and other ideas in its sixth annual "5 in 5" report of five technologies "that have the potential to change the way people work, live and interact during the next five years."

6466943267_6bdba32e41_bMind-reading gadgets: IBM and other companies are working on devices that you can control with your mind. For example, rather than having to tap on a touch screen or through a series of buttons to place a phone call, someday you may need only to imagine calling someone and a mind-reading phone will make the connection, IBM said.

"If you just need to think about calling someone, it happens," IBM said of its prediction. "Or you can control the cursor on a computer screen just by thinking about where you want to move it."

Mind-reading technology, known as bioinformatics, has already shown up in simple forms from toy makers such as Mattel, and engineers at IBM and other companies "have designed headsets with advanced sensors to read electrical brain activity that can recognize facial expressions, excitement and concentration levels, and thoughts of a person without them physically taking any actions," the report said.

"Within five years we will begin to see early applications of this technology in the gaming and entertainment industry," IBM said. "Furthermore, doctors could use the technology to test brain patterns, possibly even assist in rehabilitation from strokes and to help in understanding brain disorders, such as autism."

No more passwords: Passwords will be left behind as devices instead grant you access by recognizing who you are, IBM is predicting.

"Your biological makeup is the key to your individual identity, and soon it will become the key to safeguarding it," IBM said. "Imagine you will be able to walk up to an ATM machine to securely withdraw money by simply speaking your name or looking into a tiny sensor that can recognize the unique patterns in the retina of your eye. Or by doing the same, you can check your account balance on your mobile phone or tablet."

A bit freaky right? An example of this sort of technology hitting the mainstream can already be seen in the facial recognition technology used in the "face unlock" feature found in the latest version of Google's Android operating system, known as Ice Cream Sandwich.

"Biometric data -- facial definitions, retinal scans and voice files -- will be composited through software to build your DNA-unique, online password," IBM said. "Referred to as multifactor biometrics, smarter systems will be able to use this information in real time to make sure whenever someone is attempting to access your information, it matches your unique biometric profile and the attempt is authorized."

Of course, this idea has and continues to raise privacy concerns as companies collect the biometric data needed to pull this sort of thing off.
"To be trusted, such systems should enable you to opt in or out of whatever information you choose to provide," IBM suggested.
People-powered homes: IBM projects that we will soon have the technology to generate the power needed for our homes ourselves.

"Anything that moves or produces heat has the potential to create energy that can be captured," IBM said. "Walking. Jogging. Bicycling. The heat from your computer. Even the water flowing through your pipes."
The ability to collect kinetic energy that is currently untapped is improving, the company said, pointing to its own team of scientists in Ireland who are "looking at ways to understand and minimize the environmental impact of converting ocean wave energy into electricity."

Mobile devices could fill the technology gap: Currently, the disparity between those with access to modern technologies is a wide one, particularly in emerging countries, though it is believed to be shrinking.
IBM is forecasting that over the next five years the gap will continue to lessen.

"In our global society, growth and wealth of economies are increasingly decided by the level of access to information," IBM said. "And in five years the gap between information haves and have-nots will narrow considerably due to advances in mobile technology."

The current, fast-growing adoption in India, an increasingly wealthy and powerful country, is an example of this already taking place, the company said, projecting that as many as 5.6 billion mobile devices could be sold worldwide over the next five years.

"As it becomes cheaper to own a mobile phone, people without a lot of spending power will be able to do much more than they can today," IBM said. ""In India, using speech technology and mobile devices, IBM enabled rural villagers who were illiterate to pass along information through recorded messages on their phones. With access to information that was not there before, villagers could check weather reports to help them decide when to fertilize crops, know when doctors were coming into town, and find the best prices for their crops or merchandise."

Junk mail extinction: Junk mail as we know it today will cease to exist in five years, IBM said.
But, if this prediction comes true, it won't be because companies are sending us less email. Instead, "unsolicited advertisements may feel so personalized and relevant it may seem spam is dead," IBM said. "At the same time, spam filters will be so precise you'll never be bothered by unwanted sales pitches again."
So how do IBM and its rivals envision a junk-mail-free future coming to pass? Real-time analytics will be used "to make sense and integrate data from across all the facets of your life such as your social networks and online preferences to present and recommend information that is only useful to you."

Google Dictionary Defines Any Word on the Web




Google Dictionary is a free extension available for Google Chrome. To download the extension click here. Once downloaded simply double click on any word on a web page to view its definition or hear the word read aloud. Google Dictionary is perfect for quickly looking up unfamiliar words. To learn about other Chrome extensions click here.

Sturdy Cases for the iPad

This is important information. You need to protect your iPad from damage if dropped or prevent it from getting wet.  Invest in a good case to protect your investment!

Sturdy Cases for the iPad

http://otswithapps.wordpress.com/2011/12/13/sturdy-cases-for-the-ipad/

Posted on by
I give recognition to the QIAT (Quality Indicators for Assistive Technology) list serv for this list of “Sturdy Cases for the iPad”. The topic came up on the list serv with posts generated by experienced AT professionals. It seemed appropriate to share the suggested cases for others benefit:
Otterbox Defender Case - This case is what we have been using in our school. Staff has evidenced an iPad with a Otterbox case being dropped from about chest height on a concrete floor and another iPad being thrown on the floor. Both devices survived without any damage to them at all! Available for iPad, iPad2, iPod Touch, iPhone devices.

Trident Kraken Case - Constructed from impact-resistant polycarbonate and double-enforced with a shock absorbing silicone inner-sleeve. Corners feature double-thick silicone for outstanding protection against drops and other impacts. Available in different colors for iPad2, iPhone, iPod Touch. About $50 for iPad case.
 Griffin Survivor case - This case is built for military duty grade protection and listed for extreme-duty. Sounds like it would work for some school situations! Comes in a few different colors for iPad2 and iPhone. Costs listed as $80 for iPad2.

Gumdrop case -  This company has a variety of cases among which is a Drop Tech series case as well as a Military Edition case that are for durable for rugged use. Available for iPad2 and iPhone. Cost ranges from $60-70 for the iPad case.

Thanks to the QIATer’s for their expertise and time to shared their information on cases on the list serv that I am sharing with you. This was valuable information to have when needing to purchase a “sturdy” case for the iPad for some of the students and individuals that we work with. As an OT this was a valuable list to have when considering dedicating a student with a device that you have invested a lot of money, time as well as ensuring the safety of the user.
Anyone have any additions or comments?
Carol

Early Intervention At Secondary School To Increase University Enrollments In Computing And Science

Globally, the STEM subjects (Science, Technology, Engineering, and Mathematics) are competing for enrolments in universities with an increasing range of options, to their detriment. The Australian Mathematical Science Institute revealed that basic mathematics was growing in popularity among secondary students to the detriment of intermediate or advanced studies. This has resulted in fewer universities offering higher mathematics courses, and subsequently there are reduced graduates in mathematics. Educators are therefore continuously looking for innovative ways to attract students to STEM university courses.

First, an examination of causes for the low interest in STEM university programs revealed the following: An October 2011 report from the Georgetown University's Centre on Education and the Workforce (CEW) reported that American science graduates viewed traditional science careers as "too socially isolating." In addition, a liberal-arts or business education was often regarded as more flexible in a fast-changing job market. Secondary students had the perception that computing and information technology careers were outsourced and not a career path at the local level. They had the belief that the only IT careers available were "backroom" jobs, such as data entry. The challenge, says Professor Ian Chubb, head of Australia's Office of the Chief Scientist, in his Health of Australian Science report (May 2012), is to make STEM subjects more attractive for students. As he points out, mathematics and science are studied in secondary school, but engineering and technology is not. Therefore students in secondary school are not receiving a "taste" for STEM subjects in a practical and applied context.

To address this situation, on an experimental basis, secondary schools in Australia are undertaking a pilot program in computer science and technology. In the state of Victoria, in southern Australia, secondary schools will trial the country's first computer science and technology subjects in Year 12, the last year of secondary school. The premise is that the pilot program will provide students with a taste for the subject, applied to real situations, in order to examine whether it produces increased interest and enrolments in related subjects at university level. The pilot is viewed as a form of early intervention.

Twelve secondary schools will take part in the pilot program. Hence, up to 120 secondary students will undertake the computing program developed by computer science and engineering academics at Melbourne University and Monash University in partnership with the Victorian Curriculum and Assessment Authority of the Victorian Department of Education and Early Childhood Development. Melbourne and Monash universities are conducting workshops for teachers and educators on the pilot program, as well as promoting the pilot to parents.

The pilot program is one subject added to the senior curriculum in the twelve Victorian state government schools. The subject is a modified version of the first year computer science syllabus of the two collaborating universities, taught in two modes: face-to-face classroom teaching in the targeted twelve secondary schools, and through online topics.

The pilot computer science subject is not teaching students how to use technology, because they already know this. The subject aims to extend their thinking to a level of academic rigor equivalent to senior secondary and pre-university standards. Hence, students will be able to create software and focus on specialized skills, such as complex analysis, sought by high tech employers, thereby exploring a multi-disciplinary approach to computer science and engineering. An introductory to the skills required at university level is expected to increase student confidence in the applied techniques.

Melbourne University graduates in both computer science and information communication technologies (ICT) courses have a 90% employment rate within six months of graduation. The high employment rate is also expected to enhance the program's rate of secondary schools transitioning to computer science and STEM courses at university.

The United States and the United Kingdom have had computer science programs in their secondary school curricula for twenty years and the subject is taken as part of the International Baccalaureate. However, Australia has lagged behind in the introduction of computing science and engineering subjects in secondary school. If the pilot proves to be successful, the subject will be included in the national schools secondary curriculum.

Great List of Apps to Support Literacy


Greg O'Connor has put together a great list of apps for literacy support on spectronicsinoz.com. To view the list click here. The list is broken into categories reading support, OCR, writing and notetaking support, mind mapping, organizational and study support and reference. Check out the list here.

India - Growing in Information Technology, Healthcare and Real Estate Sector

Online Florida auto insurance quotes: That car insurance rates differ from insurer to insurer is no longer news. Don't be surprised if you realize that an insurer somewhere charges a fraction of what you're paying for a comparable plan. If you have an existing plan, you could be the one who pays double the premium others pay for a comparable package. Here's how to ensure you don't pay more than your should.

Getting a good number of online Florida auto insurance quotes will only require a few minutes. This way, you will even lift your savings to a new height as you will be able to contrast rates and packages and be able to make truly informed decisions on what's best for your vehicle insurance. Add the ease of use and you will realize that there's no reason to get your quotes any other way.

Apart from the ease of online Florida auto insurance quotes, you'll also receive lower rates than if you buy elsewhere. Why this is the case is beyond the scope of this article.

With sites that return online Florida auto insurance quotes you won't have to flip through the Yellow Pages or call anyone. You can, with just one request, get assorted rates from up to five insurers on several of these insurance quotes websites. To ensure you get all the help you need, some even provide live chat facilities.

And the process is also very simple: An online form is presented to you in order to capture details that will help them determine your rate. Shortly after you will receive rates from a number of insurance companies that are licensed to provide auto insurance in Florida. When you're done with obtaining as many online Florida auto insurance quotes as you can from several sites, contrast them to pick the best price to value ratio.

Electro-Mechanical Technologies and Mechanical Maintenance Engineering

For many individuals, an office job provides an anathematic working environment. These individuals are likely to want to work with their hands, to exert significant physical effort during their daily travails, and to use their minds and bodies to solve problems on the job. Prior to the collapse of American steel and auto manufacturing in the 1980s, individuals who desired careers outside of the office-job norm found success in various labor professions, many involving manufacturing. It is a common stereotype that all labor jobs are unstable and outsourcable. This still rings true of manufacturing work; however, careers in electro-mechanical technologies and mechanical maintenance engineering require skilled American workers to perform challenging and diverse maintenance, repair, design, and management tasks.

Individuals interested in mechanical and electrical careers have several training options available to them. These education and career training programs range in length from 10 weeks to four semesters (or, two academic years). The training course that is most appropriate for an individual will typically depend upon what he or she can afford, what his or her schedule permits, and what length of time the individual wishes to devote to training.

Shorter courses of study are more likely to concentrate specifically on electro-mechanical technologies, which is the study and application of various electrical and mechanical principles, sans a liberal arts or general education component. Courses of study are separated into classroom lecture, which covers theories and principles of electrical and mechanical work; and laboratory exercises, which allow students to apply lecture principles to real-life situations.

Because these shorter courses of study are more direct, and usually lack the liberal arts education component, they can typically be completed in one academic year or less. Many training institutions offer classes on staggered day schedules, weekend schedules, or evening-only schedules, enabling students who must work full time to attend sessions. Other institutions offer full-day, accelerated schedules, which permit students to study without taking significant time off from the workforce. Many shorter-study training courses offer career placement assistance for students finishing the program, as well.

The class work offered in short-duration electro-mechanical technologies education tracks will vary, but most programs offer foundation classes in basic mechanical and electrical principles. Students are likely to take more advanced classes in HVAC and air conditioning technologies and applications; wiring and electrical applications, and sometimes, classes in mechanical motor work as well. Lab practicums enable students to work through classroom theories and scenarios. Better training programs often place emphasis on trouble-shooting and maintenance techniques, which are assets in the workplace.

Mechanical maintenance engineering courses of study are typically longer, taking two years or more to complete. (Two-year courses of study are also offered in electro-mechanical technologies at some schools.) Upon completion of a longer training program, the student is often granted an associates degree in engineering or electrical/mechanical studies. Many institutions offer degrees that are transferable to four-year colleges and universities; students might continue working in the field while training for bachelor's degrees in electrical or electronics engineering, physics, or applied science.

The two-year programs cover electrical and mechanical concepts in greater depth than is possible during shorter courses of study. Some programs focus extensively on advanced electrical and mechanical concepts, while others incorporate mathematics and applied physics course work into the curriculum. Still other programs add information science or computer applications classes; English or technical composition classes, or psychology and business classes to the degree requirements.

Many of the core degree lecture classes are accompanied by labs or practicums where students can refine their skills and learn how to apply them to the workplace. Topics covered in classes can vary and might include: electronics concepts such as voltage and amperage; the science and design of pumps and mechanical motors; pneumatics and compressors; the heating and cooling cycles; and the properties of different metals, chemicals, and elastomers.

Graduates of shorter certification programs or longer degree programs that focus on engineering are eligible for numerous jobs in the HVAC, electrical, and mechanical maintenance fields. Some students begin careers in HVAC, refrigeration, or air conditioning maintenance and repair. Others begin careers in electrical work, and some advance to positions such as electrical journeyman. Some students might specialize in electronics maintenance and repair, including television, small appliance, and computer work. Others still might work as assistant engineers, air-quality controllers, or facilities managers. Students with entrepreneurial drive and talent might wind up as owners of their own businesses.

With the correct training program, intellectual curiosity, and a good work ethic, a graduate of an electro-mechanical technologies or mechanical maintenance engineering program often finds that he or she has many career options.

Chemistry and Technology

Online Florida auto insurance quotes: That car insurance rates differ from insurer to insurer is no longer news. Don't be surprised if you realize that an insurer somewhere charges a fraction of what you're paying for a comparable plan. If you have an existing plan, you could be the one who pays double the premium others pay for a comparable package. Here's how to ensure you don't pay more than your should.

Getting a good number of online Florida auto insurance quotes will only require a few minutes. This way, you will even lift your savings to a new height as you will be able to contrast rates and packages and be able to make truly informed decisions on what's best for your vehicle insurance. Add the ease of use and you will realize that there's no reason to get your quotes any other way.

Apart from the ease of online Florida auto insurance quotes, you'll also receive lower rates than if you buy elsewhere. Why this is the case is beyond the scope of this article.

With sites that return online Florida auto insurance quotes you won't have to flip through the Yellow Pages or call anyone. You can, with just one request, get assorted rates from up to five insurers on several of these insurance quotes websites. To ensure you get all the help you need, some even provide live chat facilities.

And the process is also very simple: An online form is presented to you in order to capture details that will help them determine your rate. Shortly after you will receive rates from a number of insurance companies that are licensed to provide auto insurance in Florida. When you're done with obtaining as many online Florida auto insurance quotes as you can from several sites, contrast them to pick the best price to value ratio.

iBooks Update Adds Useful New Features


Apple recently updated its iBooks app to add more add more features and make reading easier. One of features adds a night time reading theme to make reading in the dark easier on you eyes. The new update also add several new fonts and makes highlighting and taking notes easier. Yet another new feature allows you to read your book in full screen mode. iBooks is available here for iPad, iPhone and iPod Touch. 

National Institute of Standards and Technology (NIST)

By 1900, only 124 years after declaring independence, the United States had grown and expanded into one of the most prosperous and influential countries in the world. The economy was strong, driven by the power of steel locomotives, steam engines, electricity, and the beginning of automated manufacturing. But the burgeoning economic productivity, along with the complexity of 20th century machinery, created problems when different manufacturers had to work together. Disagreements arose over the units of measurement and how to apply them. For example, one company's "gallon" might not be the same as another company's. Without standards, the parts or containers made by one company did not fit another company's items, resulting in chaos.

On March 3, 1901, the U.S. government chartered the National Bureau of Standards to remedy this problem. Beginning with a staff of 1 2, the new bureau quickly went to work, improving the standards of length and mass measurements, and establishing new standards of temperature, time, and light. Time was especially important, as it synchronizes the activities of so many people. How do railroads, radio and television networks, and other time-conscious organizations know what time it is - and keep the same time? The bureau has provided time signals from a radio station, WWV, since 1 923. Governing this timekeeping is an atomic clock so precise that it will not gain or lose a second in 60 million years!

The National Bureau of Standards changed its name to the National Institute of Standards and Technology in 1988. Today, the NIST has facilities in Gaitherburg, Maryland, and Boulder, Colorado, and employs about 2,800 scientists, engineers, and staff. The NIST continues to improve measurement technology and standards, helping promote economic and technological progress. Laboratories at the NIST include the Building and Fire Research Laboratory, the Center for Nanoscale Science and Technology, the Information Technology Laboratory, the Manufacturing Engineering Laboratory, the Physics Laboratory, and others.

Science and Technology - Definition by Real Life Examples

Online Florida auto insurance quotes: That car insurance rates differ from insurer to insurer is no longer news. Don't be surprised if you realize that an insurer somewhere charges a fraction of what you're paying for a comparable plan. If you have an existing plan, you could be the one who pays double the premium others pay for a comparable package. Here's how to ensure you don't pay more than your should.

Getting a good number of online Florida auto insurance quotes will only require a few minutes. This way, you will even lift your savings to a new height as you will be able to contrast rates and packages and be able to make truly informed decisions on what's best for your vehicle insurance. Add the ease of use and you will realize that there's no reason to get your quotes any other way.

Apart from the ease of online Florida auto insurance quotes, you'll also receive lower rates than if you buy elsewhere. Why this is the case is beyond the scope of this article.

With sites that return online Florida auto insurance quotes you won't have to flip through the Yellow Pages or call anyone. You can, with just one request, get assorted rates from up to five insurers on several of these insurance quotes websites. To ensure you get all the help you need, some even provide live chat facilities.

And the process is also very simple: An online form is presented to you in order to capture details that will help them determine your rate. Shortly after you will receive rates from a number of insurance companies that are licensed to provide auto insurance in Florida. When you're done with obtaining as many online Florida auto insurance quotes as you can from several sites, contrast them to pick the best price to value ratio.

It is Comforting to Know That There Are Minds at the Massachusetts Institute of Technology Thinking

It is comforting to know that there are minds at the Massachusetts Institute of Technology thinking up ways to commercialize many new renewable energy technological developments for the solar, hydrogen, and energy storage.

The 2010 MIT Energy Conference was an open house to all of the research projects being conducted by both faculty and students of the institute. The main goal of the research according to MIT Energy Initiative director, Ernest Moniz, is to work with the renewable energy and power industries to commercialize groundbreaking technologies. He noted that their energy technology ideas cannot be commercialized in a garage like you can with Internet Technology (IT).

Exactly 20% of the MIT faculty is involved in some form of energy research. Energy is a big business at MIT. The 2010 MIT Energy Conference was not just some science fair. MIT has been very involved in the energy sector having already formed companies in the industry. The most notable of which is 1366 Technologies.

MIT is also home to one of the 40 nationwide Energy Frontier Research Centers that are solely funded by the U.S. Department of Energy through stimulus funds.

Of their many research projects, developing storage technologies may be one of the most important to the industry. Large scale or utility scale energy storage systems must be commercialized in order to ensure national energy security. Only 2.5% of the American energy grid capacity can be stored compared to 10% in Europe and 15% in Japan. This could be a foreshadowing of further energy troubles for the U.S. if the proper technology is not developed. Energy storage is vital for incorporating solar and wind energy into the grid which are renewable but intermittent energy sources.

The 2010 MIT Energy Conference is a bright spot in the timeline toward our energy independence and security. We can also be sure that there are other academic institutions, companies and organizations that are putting forth the same level of effort in bringing the best possible ideas on energy to fruition.

Status of Science in India

Online Florida auto insurance quotes: That car insurance rates differ from insurer to insurer is no longer news. Don't be surprised if you realize that an insurer somewhere charges a fraction of what you're paying for a comparable plan. If you have an existing plan, you could be the one who pays double the premium others pay for a comparable package. Here's how to ensure you don't pay more than your should.

Getting a good number of online Florida auto insurance quotes will only require a few minutes. This way, you will even lift your savings to a new height as you will be able to contrast rates and packages and be able to make truly informed decisions on what's best for your vehicle insurance. Add the ease of use and you will realize that there's no reason to get your quotes any other way.

Apart from the ease of online Florida auto insurance quotes, you'll also receive lower rates than if you buy elsewhere. Why this is the case is beyond the scope of this article.

With sites that return online Florida auto insurance quotes you won't have to flip through the Yellow Pages or call anyone. You can, with just one request, get assorted rates from up to five insurers on several of these insurance quotes websites. To ensure you get all the help you need, some even provide live chat facilities.

And the process is also very simple: An online form is presented to you in order to capture details that will help them determine your rate. Shortly after you will receive rates from a number of insurance companies that are licensed to provide auto insurance in Florida. When you're done with obtaining as many online Florida auto insurance quotes as you can from several sites, contrast them to pick the best price to value ratio.

Tips for giving assistive technology gifts

Wonderful and informative article about giving assistive technology as gifts.  Although the author is writing about visually impaired gifts, their advice applicable to those with ALS that have communication or physical limitations. 

From: Accessible Insights Blog
http://accessibleinsights.info/blog/2010/12/13/tips-for-giving-assistive-technology-gifts/

For any of my readers who are not visually impaired, you may be wondering if giving a  friend or loved  one who has vision loss a gift of low vision    equipment, (or "assistive technology" as it is called),  is an appropriate gift.  I can understand your concern.  On the one hand, some of the best gifts are those that make someone’s life better or easier, on the other hand, you may be afraid that this type of gift might be received in much the same way as a book  about dieting might be.  In other words, you don’t want to insult someone, especially if  the recipient is really struggling with the emotional aspects of their vision loss.  You might be worried that giving this sort of gift would be acknowledging circumstances that the individual him or herself may not yet be ready or willing to acknowledge. 

While you may be thinking that buying a friend this type of gift is about as exciting as giving a housewife a vacuum cleaner, consider your intention along with the particular needs of the recipient to make it a gift that keeps on giving.  Here are a few tips that may help you to identify the right gift for your special recipient.

Educate yourself.  When it comes to assistive products, there is no one size fits all solution.  You may not realize, for example, that different types of vision loss manifests differently in different people.  Someone who has retinopathy does not literally see the world in exactly the same way as does a person who has macular degeneration.  Therefore, it might be a good idea to take the time to identify the specific needs of your gift recipient.  Learning a bit about how their particular disability affects them in day-to-day, real-world ways can help you to choose the most practical solution that is most effective and beneficial for them, as opposed to the latest whiz-bang gadget or gizmo
          
Examine the packaging.  If you are giving a gift to a senior or a person who has a physical disability which may make it difficult to manage the product packaging, the impact of     your gift may be lost if the recipient can’t get to it.  Look for "frustration free" packaging, or simply prepare the gift in advance if you will be unable to be present at the time it’s opened.  remove plastic ties or shrink wrap, slice open the bubble plastic so that the container is easy to handle  (you can secure it with easier to manage clear tape), and check out the included instructions.  If the gift recipient has low or no vision, and the instructions are printed on paper, your recipient  will not be able to enjoy the gift if they do not possess the technology to scan and read the directions.  Take the time to record the instructions on tape, or provide them in some alternative format so that it is accessible to the recipient.  This extra step is part of the gift, and will be most appreciated.   

Add the value of you.  If your friend or loved one is having a hard time coping with their changing circumstances, make the discovery of assistive technology a shared experience.  Learn alongside your loved one.  This will not only reduce the intimidation factor of what they perceive to be a complicated process, but the shared experience will benefit you both 

Ask someone who would know.  Do you know someone else who has the same disability as your gift recipient?  If so, ask their opinion.  Is this the best version of this particular product?  Is it compatible with their current technology or equipment?  Is the product or gadget as effective as you believe it could be?  Will it do what the manufacturer says it will do?  Is there a more or less feature-rich version of this gift that would be more appropriate?  If you do not know someone who shares your loved one’s disability, go online and seek accessibility consultants or experts who will be glad to help.  there is far more information available than you may realize.  If you’ve come this far, it’s easy to continue to seek help.  Just type "assistive technology gifts" or "low vision aids" into your favorite search engine, and explore the results.  You’ll be amazed at the choices.  You might even discover that instead of buying an expensive gadget, there are innumerable ways to make existing items more accessible for people with disabilities.  Sometimes, keeping things simple can be the best solution of all.

One word of caution.  When it comes to the notion of improving a person’s quality of life, ask yourself if you are really the best judge of what that is.  Sometimes, there can exist a very fine line between the desire to help and the desire to control.  Consider, for example how you might feel if someone concluded that your life was inadequate, and imposed all sorts of solutions that you did not want or need?  What if, say your real estate agent decided that you didn’t need such a big house, it is unnecessary, and therefore you will only be shown one bedroom houses?  Keep in mind that there are still people out there who fail to see the necessity of a computer or a cell phone.  As foreign an idea as that may be to you, they do not feel their life is any worse for the lack.       

On the other hand, a person who has a disability might really appreciate your contribution to what would otherwise be a purchase that is financially prohibitive.  The market for assistive tech gadgets is far smaller than that of the market for say, the latest hand-held device that has an "i" in front of the name.  Consequently, assistive products specifically for people with disabilities can be far more expensive than the mass-market counterparts.  If you are considering a gift certificate, check out the online retailers who specialize in these products.  Most offer gift certificates, and will even accept phone orders, which may be preferable for someone who does not yet have an accessible PC. 

Good communication and a little extra investigation will yield the best gifts that your friend or loved one will use and enjoy, and you may give the best gift of all…the gift of love of learning, new experiences and fresh insights as to the exciting possibilities that await.  
  •  

  • How technology can connect doctors and caregivers

    Caregivers want technology that can help facilitate the care of loved ones. Not only can physicians provide those tools, they also can benefit from them.

    http://www.ama-assn.org/amednews/2011/12/05/bisa1205.htm

    By Pamela Lewis Dolan, amednews staff. Posted Dec. 5, 2011.

    Pulmonologist Scott Manaker, MD, PhD, said that when elderly patients come for their first visits and are accompanied by family members, he begins the conversations with the relatives by determining when and how he can share information about the patients' health.

    With more than 29% of the U.S. population acting as a caregiver to someone else, chances are that physicians eventually will be faced, as Dr. Manaker is, with questions about how they can work with caregivers to ensure the health of the person receiving care.

    The majority of caregivers spend an average of 20 hours per week providing care, in addition to holding down a full-time job. To help make things more efficient, many are turning to technology that not only will supplement the care they are providing in person, but also will help them stay organized and connected with the care recipient's physicians or fellow caregivers.

    The more physicians can help get the needed technology to caregivers, experts say, the easier those caregivers' lives will be. Likewise, the more engaged the caregiver is, the better the outcomes for patients.
    "I find great relief and comfort when the family is involved," said Dr. Manaker, associate professor of medicine at the University of Pennsylvania Medical Center. Having a caregiver working as an ally has made it easier to talk to aging patients facing tough decisions, especially patients who are reluctant to give up their independence, he said.

    Gail Hunt, CEO and president of the National Alliance for Caregiving, said all physicians should be having conversations with caregivers on how they best can support each other. Both physicians and caregivers have valuable information that can help the other one meet their obligations to the patient.

    What caregivers want

    A study published in January by the National Alliance for Caregiving and UnitedHealthcare found that caregivers think technology can help save time (77%), manage the logistics of caregiving more easily (76%), increase feelings of effectiveness as a caregiver (74%), reduce stress (74%) and make a care recipient feel safer (75%).

    "If we have a caregiver who is unable to provide care, or is over-burdened, or overly stressed out with care, there's a much greater likelihood that the patient will need to be placed in some sort of facility, which is much more expensive and costly," said Sarah Czaja, PhD, scientific director at the Center on Aging at the Leonard M. Miller School of Medicine, University of Miami.

    Caregivers spend an average of 20 hours a week providing care.
     
    Czaja, who has been involved with several research projects aimed at providing technology to caregivers, said caregivers often don't know about resources that may help them.

    The help caregivers are looking for can be simple moral support through online support groups, ways to communicate directly with the doctor electronically, or more advanced technology that can be the eyes and ears watching over that patient when they can't.

    Physicians carry the greatest influence in prompting caregivers and patients to try a new technology or tool, according to the National Alliance for Caregiving survey. Among the issues that technology is helping to make easier to manage:

    Coordination of care. Care recipients generally have more than one physician treating them, so caregivers are tasked with making sure not only that the care recipient makes it to all scheduled appointments, but also that those appointments are productive.

    Seventy-seven percent of caregivers want access to the electronic records of the care recipient to obtain information such as health history, medication lists and test results, according to the NAC survey. Many physicians with electronic medical records have online patient portals where patients or their caregivers can download this information. With this access, caregivers can share records from one physician to the next.
    The ability of caregivers to log onto the system and retrieve lab results or care records also means better practice efficiency, Dr. Manaker said. There are fewer phone calls and staff time dedicated to tracking down that data, he said.

    Nearly 30% of the U.S. population acts as a caregiver to someone else.
     
    When Dr. Manaker meets caregivers for the first time, he makes sure patients make all necessary authorizations to have information released to caregivers.

    He has had uncomfortable conversations with well-meaning relatives who want to obtain information to help their loved one, except that certain caregivers were never authorized by the patient to receive the information.
    Whether the caregiver is accessing information over the phone, by email or through a patient portal, physicians must do their part to make sure that exchange complies with the Health Insurance Portability and Accountability Act. Not only does the physician need to obtain permission to share data with caregivers, but the data must be shared securely. Though emailing may be convenient, if it's done on an unencrypted or open network and identifiable information is being sent about the patient, the physician is at risk of a HIPAA violation.

    Medication compliance. Studies have found that chronically ill patients are noncompliant with their medication about half the time. Some can't afford to fill their prescriptions, but others don't remember to take their medication. For physicians, caregivers can be the best resource they have in ensuring that the medications they prescribe are actually taken by the patient.

    With a more accurate assessment of medication compliance, doctors will find it easier to determine the effectiveness of a prescribed treatment in case changes are needed. Medication tracking can be easy for caregivers living under the same roof as the care recipient, but for the more than 50% who live elsewhere, medication compliance is trickier. There are several tools on the market that physicians can suggest.
    Seventy percent of caregivers not living with a care recipient say a system that would remind the patient when to take medications and dispense pills at the right time would be beneficial, according to the National Alliance for Caregiving survey. There are tools on the market that send audio reminders to the patient to take medications. An alert is sent to the caregiver if a pill hasn't been taken. There also are smart-pill technologies in development that would send alerts to caregivers or physicians when a pill is swallowed.
    Chronically ill patients are noncompliant with their medication about half the time.
     
    Tools that require action on the care recipient's part must be affordable and easy to use, Hunt said. Physicians can play a great role in finding the right tools for these patients and their caregivers.
    Remote monitoring. The longer patients can stay at home and out of long-term-care facilities, the better. Often the key to keeping patients at home is the ability to monitor their conditions between physician visits.
    Seventy percent of caregivers said remote monitoring devices that collect data such as vital signs, blood pressure and blood sugar levels, and send that information to physicians or care managers for analysis, would be helpful, according to the National Alliance for Caregiving survey.

    Adam Darkins, MD, chief consultant for the Dept. of Veterans Affairs Office of Telehealth Services, said chronic patients generally are not seen more than once every few months in a doctor's office. "It often happens that in the clinic, all is well, but then they deteriorate two weeks before, or six weeks after [the visit]. And when that happens, they get their right to an urgent appointment by being an [extreme case]," Dr. Darkins said. The VA decided: Instead of putting all the resources into a clinic visit, why not put them into monitoring people?

    "A key piece to doing this right from the start was making sure the caregiver was involved," Dr. Darkins said.
    The Veterans Health Administration is often viewed as the gold standard when it comes to telemedicine and home monitoring, Hunt said. Through remote monitoring, the VA has reduced the days in the hospital by up to 30%, according to Dr. Darkins, and has increased patient satisfaction by up to 70%.

    With the right technology, caregivers can feel empowered to take on the task of monitoring a patient, but there must be an assessment of the caregiver's ability to care for the patient. That role of assessing the caregiver and making sure they understand their role is often one that falls on the physician.
    Finances are often barriers with this type of technology, both for caregivers and physicians. If physicians were to offer it, they would need staff to manage it. At the VA, the system has a dashboard-type display with a red flag system. A care coordinator within the physician clinic monitors those flags for needed interventions. Another option for physicians is educating caregivers on how to recognize red flags on their own if the monitoring is being done manually and how to know when to call the physician's office for advice.

    Explaining technology

    Although cost is often cited as a barrier to physician technology adoption, the same is true for caregivers. But despite their concern about costs, nearly half of caregivers surveyed by the National Alliance for Caregiving thought technology could help save money.

    Hunt said physicians should educate caregivers on technology and its benefits and help them understand that many technologies are affordable.

    Of those surveyed, 88% said that if a health professional involved with the care of the patient explained that the technology would help, caregivers would be more likely to try it. And 80% said they would be more likely to try a technology they were shown how to install and use.

    "Technology has a lot of potential ways to aid both the caregiver and the physician in terms of management of care," Czaja said. "They must work together to identify the options that work best for everyone."



     ADDITIONAL INFORMATION: 

    ACOs could change caregiver role

    For many caregivers, one primary responsibility is coordinating the care of their loved ones. They schedule appointments with each specialist and manage the patient's medical records so each doctors knows what the other one has done.

    But that role could change if the care recipient becomes a patient of an accountable care organization.
    Under the ideal ACO model of shared responsibility for the patient, care coordination would fall on the organization acting as the head of the ACO, or the patient's medical home, which would be responsible for the care plan of each patient. But more work is needed to ensure that patients remain at the center of those plans.

    James Lee, MD, medical director for hospital efficiency at the Everett (Wash.) Clinic who headed that organization's ACO demonstration project, said that in an ideal system, a precise care plan for each patient would be crafted by team members at the patient's medical home. That plan would be transmitted to every member of the patient's care team, including the caregiver.

    Instead of a caregiver taking on the responsibility of reconciling the medical records of each physician the patient sees, all the records would be in a shared electronic medical records system and viewable by the caregiver. The National Quality Forum, Dr. Lee said, "recognizes IT as the glue that ties caregivers and patients and physicians together." The challenge is to "improve the IT piece so that it is transparent and bi-directional."

    Dr. Lee said that even though ACOs have the technology in place that would allow the care plan to be visible to all parties within an EMR, "today, we don't have a consensus on what patient-centered care plans should look like."

    "We have made some progress, but a clear care plan will be necessary to give caregivers more information," he said.

    On Oct. 20, the Centers for Medicare & Medicaid Services released the final rule describing the Medicare Shared Savings Plan program being launched by CMS in 2012. As many as 270 ACO networks are expected to participate in the program that will allow them to share bonus money for achieving certain cost-saving goals.

    Caregiver access needs to follow HIPAA

    Caregivers need access to information to make informed decisions. But regulations in the Health Insurance Portability and Accountability Act don't make exceptions for caregivers, even if their intentions are good, if they have no authority to view a patient's medical chart. Therefore, physicians must be careful when working with people seeking information.

    The best step physicians can take in ensuring patient privacy is to receive express consent from patients on who they want to grant access to, and exactly what that person is authorized to see.

    Betsy Hodge, an attorney in the health care practice at Florida law firm Akerman Senterfitt, said doctors should make clear to patients exactly what someone would have access to if the patient shared login and password information on a physician portal. Even better, she said, is if a caregiver had his or her own login information and access to only the information the care recipient feels comfortable sharing.

    Attorney Rene Louapre, who works at the New Orleans offices of McGlinchey Stafford, said physicians should have a paper trail of patients grant-ing caregivers authorization to access records.

    Hodge agrees, saying that physicians should try to be as specific as possible on whatever form the patient may sign. It should detail exactly what will be disclosed, and the patient should write down names of everyone with whom he or she is grant-ing access. Those forms should be reviewed with the patient often, as caregivers often change.

    Each state also has privacy laws.