VII. Access to Healthcare

trains often require time that can disrupt the planned schedule for the bus or train. In addition, charging stations for powered wheelchairs or scooters that are integrated into transit vehicles would greatly expand the distance that could be traveled or the time that can be spent away from a home base.  Implement architectural design standards that meaningfully consider how persons using assistive mobility devices navigate through public transportation stations.  Enhance wayfinding and navigation apps to access real-time updates on public transportation infrastructure, including the status of elevators or vehicle lifts/ramps. Planning for these variations in routes is important to all travelers, including those with disabilities, and for all surface transportation needs. Real-time updates on public transit infrastructure are important to all travelers on all types of trips to all destinations.  Develop remote or robotic assistance strategies to reduce wait timesand maximize the efficiency of staff, such as distance-based control of gates, elevators on request, and moveable robotic ramps/lifts for train access at stations.  Develop shared neighborhood automated vehicle networks that can provide access to personalized transportation for all individuals, at all times, andto all destinations. Smaller vehicles may also prove to be a key strategy in addressing first-last mile challenges. Such vehicles would need to be usable without a driver’s license and accessible by individuals with wheelchairs or scooters in order to be usable by the broad community as a connection to public transportation.

Novel vehicle designs and technology developments are necessary to meet the expanded needs of the aging population.  Develop technology and policies, including pertaining to privacy issues, to support machinereadable personal profiles for travel support and human services in transportation, as well as to identify the appropriate services that meet the user’s needs. For example, providing data to transit companies regarding the ability and needs ofan individual (e.g., type of personal mobility system, ability to transfer, and description of assistance needed) would allow appropriate assistive technologies or staff support to be available at the appointed time. Such personalization will reduce wasted time, improve the efficiency of scheduling, and positively impact quality of life.

VII. Access to Healthcare

Access to effective healthcare plays a critical role in helping older adults stay active and independent as they age. Currently many older adults, the majority of whom have multiple chronic conditions, receive suboptimal, fragmented, uncoordinated and, at times, contradictory or harmful care from multiple providers in multiple care settings. Many different individuals have important roles to play with respect tothe application of activities and strategies that support the maintenance of function and independence with age. Participants in this care system include: patients/clients; their families, caregivers, and communities; clinicians; social services and support systems; and community services. Alignment and coordination among these participants through technology can increase the effectiveness and efficiency of these services. In a digital healthcare system, telehealth and electronic care (eCare) planning—the focus areas discussed below—can enable older adults to maintain their independence by increasing access to effective care, coordinating this care, providing support for prevention and chronic disease management, and helping to reduce the stress on older adults, their caregivers, and clinicians.