Ankota: Ushering in the Next Generation of Homecare Blog

We would love to believe that everyone came to PDHCA in Phoenix to learn about the great Non-Medical Home Care Software Solution that Ankota provides, but of course they came (and so did we) to learn so much more.  This post offers a few takeaways from an awesome keynote address by Dr. Verna Carson Benner from her training on "Becoming an Alzheimer's Whisperer." 

In her training, Dr. Carson Benner describes a concept that they call the "Theory of Retrogenesis" which draws parallels between the way a child develops function and the way an Alzheimer's patient loses function.  This concept, depicted in the slide below (slide courtesy of C&V Senior Care Specialists who reserve all rights), helps you to draw parallels between the first stage of Alzheimers and the behavior of a 5 year old child, then between phase-2 and a toddler, and between phase-3 and an infant.

Five Tricks for Providing Better Alzheimer's Care

1. Don't Quiz, Argue or Reason
2. If at first you don't succeed, wait five minutes*
3. To combat repetition, find a "job" for the person you're caring for (such as folding towels or building with Legos(r))
4. If a loved one complains "My mom didn't have breakfast", or "Nobody has been in to see my dad today", calmly explain that that "Your mom/dad can't remember, and fill them in"*
5. Old photo albums and songs from the past are likely to connect with the patient because long-term memory lasts the longest.

*Note: Alzheimer's patients generally have less than 5 minutes of short-term memory, so if for example you propose a shower and get a negative response, rather than forcing the issue, you might instead wait 5 minutes and try an approach like "let's go for a nice walk but get cleaned up first"

This post merely scratches the surface of what you can learn from Verna and her team.  For more information, click on the banner below.

See related news release ANKOTA ANNOUNCES LAUNCH OF ANKOTA HDM FOR PRIVATE DUTY HOME CARE (January 18, 2010).

http://www.ankota.com/releases/bid/33990/ANKOTA-ANNOUNCES-LAUNCH-OF-ANKOTA-HDM-FOR-PRIVATE-DUTY-HOME-CARE

Q: Why is Ankota entering the Private Duty market?

A: (Will) Private Duty has always been part of our plan. Our vision is to change the way that healthcare is planned, coordinated, and delivered outside of the hospital setting, and Private Duty is an important piece of that equation.

It's also a big market, and growing rapidly. The Bureau of Labor Statistics reports that 1.2 million people work in private duty care and more than 400,000 jobs are expected to be added by 2020, making it the fastest growing segment in home care. We see a huge opportunity to help Private Duty companies better plan and schedule their services and operate more profitably, especially in an era that demands greater accountability.

Q: Why is Private Duty growing so quickly?

A: (Will) There are several trends driving this, but one of the primary reasons is that Private Duty companies are uniquely positioned to provide what are called "non-medical" services to the elderly. The "Silver Tsunami" is coming, and the population that is aged 65+ is expected to triple over the next 20 years. People prefer to live at home as long as possible and avoid nursing facilities as long as they can. The demand for home health and support services will continue to increase, and Private Duty will play a major role.

Q: Why does Private Duty need another software company?

A: (Will) They DON'T need another software company! They need to be more productive with the resources they have and they need to grow their businesses profitably. Technology can enable a lot of that, but most software companies miss this opportunity. We're stepping in to solve it with technology that organizes health care into a "delivery model," to make it more efficient and reliable. We call it "Healthcare Delivery Management," or HDM for short.

Ankota had the pleasure of joining close to 400 practicioners and supporters of the Private Duty Home Care Industry in Phoenix from January 24th - 26th, 2010 at the NAHC 5th Annual Private Duty Home Care Leadership Summit & Exposition.  Care givers are the best people you'll ever meet and this meeting was no exception!  We appreciate everyone who came to learn more about Ankota and our new comprehensive software offering for Private Duty Care.

As a thanks to all the participants and those who were unable to attend the summit, we compiled a video summary with highlights of the event.

Thanks to all of the speakers featured in the video, each of whom granted Ankota permission to use their materials on our blog.  We intend to post more of the best practices in upcoming articles here on our blog.

For those of you who'd like to learn more about Ankota and our software for Private Duty Care as well as our Advanced Care Management solutions for Nursing, DME Delivery, Infusion Therapy and Respiratory Therapy, please visit the rest of our site here or contact us.

Today's post comes courtesy of guest-blogger Casey Accardi, the daughter of Ankota CTO and co-founder Ken Accardi.   We're proud of Ken's educational and career bio and how it makes him so well suited to help us advance the causes of health care delivery and home care technology, but Casey's post uncovers a part of the story we haven't told before and  where Ken gets his passion for healthcare.

Tracing his Steps

by Casey Accardi

When I decided to write a memoir for this project, my first impulse was to call my father's mother, Grandma Joan. To say that Joan loves genealogy would be an understatement. She's traced our family tree back to 1640, and would gladly look into yours too if you asked. In fact, she'd probably look into yours even if you didn't ask... she has a tendency to go on "genealogy-sprees" where she finds out everything she can about whichever family strikes her interest at the time, just for fun. I'm not kidding - Joan really loves genealogy. Naturally, I figured she would be my go-to-gal for a project of this nature. However, after a delightfully long half hour on the phone with her where I tried my very best to take notes and stay on task, I realized that Joan wasn't as good of a go-to-gal as I'd expected. While she does seem to know of every last person I'm related to that's lived in the past 400 years, she doesn't really have much to offer in terms of actual stories about these people. Nothing of real substance, nothing I can genuinely relate to. So I could spend the next few pages telling you about every single Accardi who has ever lived in Sicily (let me tell you, there have been quite a few) but I figure if it doesn't resonate with me, it won't resonate with you.

Instead, I'd like to talk about my dad. I guess you could say that my dad is a success story of sorts. But, being the modest, affable, team-player kind of guy that he is, he would never be the one to tell you that. Back in my athletic days (which are long gone), my Dad and I would often spend Sunday afternoons kicking the soccer ball around the back yard; he would encourage me as I struggled with foot-eye coordination. He always wore a small brace around his knee, which I never really thought to question. My understanding at the time was that as a kid, he had a problem with his knee, and the doctors fixed it but it was still safest for him to wear a brace sometimes. I was easily satisfied; my elementary-school-self didn't seek more of an explanation.

On a rainy Saturday afternoon in March of my 7^th grade year, my dad told me he was going shoe shopping and asked if I wanted to come. I may not be the girliest girl in the bunch, but I wasn't about to turn down a shopping offer. So off we headed to Nordstrom; Dad settled in the men's department while I checked out every pair of shiny flats on the ladies side. After making my selections, I joined my dad in his department. As I approached I heard him say to the quintessentially gracious sales associate, "Could you please bring out this pair in an eight and a ten?" She promptly returned with the two pairs of shoes... my dad tried the eight on his left foot and the ten on his right foot. After gaining my approval on his new pair of surprisingly fashionable loafers, we proceeded to the counter where my dad purchased one size eight shoe and one size ten shoe (for the price of one pair of shoes - thanks Nordstrom!) and then headed for the car.

I've never really been the type of person to initiate conversation about potentially awkward topics, but my dad's shoe size selection at Nordstrom left me too curious to resist. How had I never noticed that he wears two different shoe sizes? After contemplating the best way to bring it up, I just went with, "So Dad, why exactly do you wear two different sized shoes?" My dad has always been great at explaining - both my parents are engineers and when I was in kindergarten and all curious, I would occupy my time on long car rides by asking them how things work. He could always manage to explain the science behind complicated things (space ships, submarines, the solar system) in a way that even itty-bitty could understand. This time was no different. With his usual warm yet matter-of-fact tone, my dad explained that when he was born, the bones in his lower left leg weren't solid -- they were about as strong as cartilage and never hardened. Starting at 18 months, he had over a dozen operations trying to correct this, all of which failed. He had to wear a heavy-duty brace and even with it on, couldn't walk very well. Shortly after his 12^th birthday, my dad's doctor ran out of ideas and said the only option was amputation (this is where Grandma Joan reenters the plot!). Joan wouldn't take no for an answer; she kept searching and found a world renowned orthopedic surgeon at Columbia Presbyterian Hospital who was willing to take my dad's case. This doctor agreed to try an experimental procedure that involved replacing dad's faulty bones with bones from a cow. The operation proved successful - after nearly 13 years dad could finally play sports and walk around the neighborhood like all the other kids.

All of this information was a lot for me to digest at once. It was hard to understand that when he was the very same age I was at the time, he would most often be found confined to a hospital bed. While I whined about wanting new clothes or not getting the solo I'd wanted, he had probably whined about being in severe pain. All of a sudden, my selfish concerns seemed like nothing compared to his childhood. It made me realize that when my dad tries to encourage me to get out there and try new things, he's not doing it to annoy me -- he's trying to give me the opportunities he never had. It dawned on me how much I admire my dad.  In his first 13 years of life, he endured more than most people endure in a lifetime, and still managed to have lots of friends in high school, become an excellent trumpet player and jazz musician, graduate with honors from college, and start his own business.

I also realized how appreciative I should be of my Grandma Joan. Yes, she has a tendency to ramble and can be pretty darn wacky, but without her persistence in advocating for my dad I don't know if I'd be here today. Maybe it has to do with the fact that he is her only son - I'm sure she'd hate for there to be no Accardis of the future to trace their genealogy back to her.

Casey Accardi is a junior in Wellesley High School.  She is an avid singer and co-president of the Boston Children's Chorus and writes their blog at http://www.bostonchildrenschorus.blogspot.com/.  She also writes for http://www.teenlifeboston.com/.  Casey will be featured with Opera Boston in their world premier of the opera Madame White Snake opening February 26th at the Cutler Majestic Theater in Boston.  More information is available at www.operaboston.org/operas_mws.php

Today's entry comes from guest blogger Heather Rooney from H2 Marketing.  At the bottom is a link where you can learn more about Heather and her team.

The Agency of the Future: Empathy. Innovation. Execution.

January 8, 2010 by Heather Rooney

Home care is in the midst of a strategic inflection point - a moment when multiple factors are coming together simultaneously, each with the independent ability to fundamentally change the way that businesses operate. In the midst of this defining moment, healthcare is center stage and home care is playing a particularly significant role. 

While our industry has undergone dramatic evolution in the past, this time it is different.  Healthcare has risen to the top of our national consciousness, with substantial attention focused on care for the chronically ill.  One only has to look at the statistics to understand why - Over 75% of healthcare dollars are spent on patients with one or more chronic condition, and over 133 million Americans have at least one chronic disease.  According to the 2009 Obama Healthcare Plan, chronic conditions cost $1.7 trillion every year.  Moreover, these statistics are only expected to rise as baby boomers continue to age.

On the one hand, the market is ripe for "disruption" (Clayton Christensen, The Innovator's Solution), a time when new market entrants deliver solutions to problems that the established players have chosen to ignore.  Most of the profitable growth trajectories in history have been initiated by disruptive innovations.  In contemporary society, just look to Amazon.com and Netflix for quick examples of disruption.  In healthcare, we can already observe early signs of potential disruption. With favorable demographics and a growing national awareness about the challenges associated with a chronically ill patient population, vendors and providers are actively developing novel approaches including pioneering technologies and new models of care.  From giants of industry like GE and Intel to small start-up companies, organizations of all sizes are looking to carve their place the home care market.

While the disruptive potential is significant, home care possesses an extraordinary opportunity in the midst of this strategic inflection point.  Experts at working with the chronically ill patient population, home care providers are uniquely capable of delivering solutions to our present day problems.  The ideal scenario is to have an established company initiate disruptive innovation - this is a nearly unstoppable force! The key is being willing to cast aside conventional ideas about "the way things have always been," and be willing to bravely try something new. Just like the book Who Moved My Cheese, winning providers will understand that the "cheese" is changing and the time has come to step out into the maze in search of the next "blue ocean" (Blue Ocean Strategy).

The "Who Moved My Cheese" Moment

The book Who Moved My Cheese provides an exceptional illustration of the challenges and opportunities that we are experiencing in today's healthcare environment. The book refers to two sets of mice in a maze - both recognize that their block of cheese is dwindling.  The difference lies in how they choose to address the problem. The first two mice make the decision to stay with their current cheese as long as possible. The second set of mice realize that the current block of cheese cannot sustain them forever, and they make the courageous decision to venture out into the maze in the hopes of finding a new block of cheese.   In the end, the first set of mice is too weak to search for new cheese after holding on to their current cheese for too long. The second set of mice successfully locates a new block of cheese, and they continue to thrive with sufficient nourishment having been brave enough to face the unknown. 

This parable is appropriate for our current home care environment, as the "cheese" has been changing for some time and signs point to continued "cheese movement." In recent months, we have observed efforts to reduce hospital readmissions through potentially bundling of payments and monitoring of the transition process from acute to sub-acute settings (CARE Transitions). Recent programs have provided for increased care coordination through the Medical Home Demonstration Project and the Chronic Care Improvement Project. The new Independence At Home Initiative aims to facilitate more comprehensive in-home service delivery for the chronically ill home bound population. And, all of these programs have occurred in the context of ongoing cuts in reimbursement and movement toward pay for performance across the continuum.

As we consider our recent past and look to the future of home care, we must acknowledge that our current system is evolving.  From cuts in Medicare reimbursement to new models of care, our nation is focused on identifying methods of caring for the aging population with optimal quality and maximum efficiency.  Ultimately, the "cheese" is moving, and it is up to us to make conscious decisions about how we choose to proceed.  It is important to note that this concept does not just apply to Medicare-certified home health agencies; rather, it will affect everyone that touches the aging population - home health, hospice, private duty, HME/DME, infusion, adult day care centers, and many more. 

Challenge = Opportunity

Change is upon us, and the only certainty is uncertainty - at this exact moment (January 1, 2010), we do not know what the final version of healthcare reform will entail and how it will specifically affect home care providers. Moreover, the landscape for aging-in-place and home centered care will continue to be defined over the next several years as we attempt to identify the ideal method of caring for this unique population.

As we sit in the midst of this uncertainty, it is up to us to proactively position our industry for a future full of opportunity. It begins with the recognition that our current challenges present a substantial opportunity for growth, development and change.  With this shift in mindset - from fear to adaptation - we open our collective consciousness to the ample supply of opportunities that lie ahead.  Furthermore, we begin to release our grip on the dwindling cheese so that we are free to consider the abundant supplies of cheese that are right in front of us. 

In essence we can start the process of transforming into the "agency of the future" today - and it begins with a critical shift in mindset.  The agency of the future will look into the maze with enthusiasm and excitement tempered by humility and caution. This agency will recognize that the road ahead requires creativity, as there are no templates to follow. The agency of the future will carefully traverse the "road less traveled" looking for new opportunities, overcoming obstacles, and persisting even when the path seems difficult.

Two roads diverged in a wood, and I,

I took the one less traveled by,

And that has made all the difference.

-Robert Frost

Although seemingly simple and obvious, the road less traveled can be challenging to navigate as it requires a special blend of organizational attributes designed to turn challenges into opportunities: empathy, innovation and execution. 

Want to read more? The above article is an excerpt from the latest H2 Marketing whitepaper entitled The Agency of the Future - Empathy. Innovation. Execution. This whitepaper is the first in a series of whitepapers focused on the defining characteristics of the agency of the future. To download the complete copy of this new whitepaper, click on the following link: http://www.h2-marketing.com/pdfs/The_Agency_of_the_Future.pdf

Today I'm joining with several hundred other home care executive leaders at the Northeast Home Health Leadership Summit ,entitled "On the Road to Reform."  We're in the same neighborhood of Boston where the Massachusetts state senatorial race changed the course of health care reform less than 24 hours ago.  Isn't it Ironic!

But before getting too worried about anything, let's put some things into perspective:

• Health care is a source of job growth
• Home care will win for many reasons including the aging population, the improved patient satisfaction that comes with aging in place, and the cost reduction that occurs when patients stay out of hospitals
• The best pieces of health care reform will survive and thrive

The bottom line is that the future of home health care is bright!   

Winston Churchill said, "Success is moving from failure to failure without loss of enthusiasm" - not a bad thought.

But if you're still feeling a little stressed perhaps listening to Alanis Morissette sing her hit "Ironic" will help give you some relief.  Enjoy!

p.s. - there will be lot's to blog about as a result of this home health leadership summit - Stay Tuned!

As a home care professional or someone evaluating home care software, you might occaisionally see phrases like HL7 compliant or HL7 integration and wonder what the heck does that mean...

This is an even geekier topic than I usually address, but I came across a super health care software geek at a company called Interfaceware who explained it in this short and entertaining video.

How does HL7 work? from iNTERFACEWARE.COM on Vimeo.

Bottom line is this...  Computers speak to each other in a variety of ways like sendingmessage or files of information to one another.  The contents of the message or file can be pretty much anything so long as the sender and the receiver agree.  Most modern communication between computers today is done by sending a message in a language called XML over the http protocol (http is what you use to go to a website, such as typing http://www.ankota.com which is a message requesting the display of our website).  The XML "language" is really just a description of a format where there is a "tag" and a "Value" in a certain structure, like <DOB>08/24/1963</DOB> is a way of sharing a date of birth of August 24th 1963.   But instead of everyone making up their own tags and figuring out their own interfaces, you can think of HL7 as a dialect that many computer companies can follow to communicate.  The most common use of HL7 is for various devices and pieces of software in hospitals to send things to your bill...  

Today, NAHC shared the following information about National Influenza Vaccination Week that is going on now and we're publishing it here to help spread the word to the home care, private duty and DME companies who follow our blog.

National Influenza Vaccination Week (NIVW) is a national observance that was established to highlight the importance of continuing influenza vaccination, as well as foster greater use of flu vaccine after the holiday season into January and beyond. This year's NIVW (originally scheduled for December 6-10, 2009) will be held January 10-16, 2010. Visit www.Flu.gov/getvaccinated for more information.

Since the spread of 2009 H1N1 influenza is likely to continue into the new year, NIVW will be an important opportunity to promote uptake of 2009 H1N1 flu vaccination at a time when demand for vaccine usually drops significantly. While influenza is unpredictable, and while we do not know the likelihood of a future wave of H1N1 influenza, we do know that if more people are vaccinated, the disease is less likely to spread in the coming months.

One of the many goals for NIVW is to engage at-risk audiences who are not yet vaccinated, hesitant about vaccination, or unsure about where to get vaccinated. Every year, certain days during NIVW are designated to highlight the importance for certain groups, like health care workers and children, to get vaccinated. This year's national schedule is as follows:

Day Focus

• Sunday, January 10 Kickoff
• Monday, January 11 General audience and health care workers
• Tuesday, January 12 People with chronic health conditions that put them at high risk of serious influenza-related complications
• Wednesday, January 13 Children, pregnant women, and caregivers of infants less than 6 months old
• Thursday, January 14 Young adults (19 to 24 years old)
• Friday, January 15 Seniors
• Saturday, January 16 Wrap-up

Below is a link to our popular post that explains how to tell the difference between the H1N1 virus and a cold.  To learn more about software for home care efficiency, software for private duty care telephony and software to help improve DME delivery operational excellence, please contact us.

At the start of a decade and in the midst of a down economy most noted by job loss, there is lots of speculation about where the new jobs will be, and home care is at the top of the list.

I've reviewed several stories on this topic, including two in particular from NPR and from the Huffington post.  The Huffington post story predicts the creation of 441,000 home care services jobs in the decade, raising the total jobs to approximately 1.4 million.  The images below will link you to those stories.

One of the big questions raised in the NPR offering is whether these will just be jobs or whether they have a chance to grow into careers?   The possibility definitely exists...  Here's a potential recipe for success:

• Jobs are created (this is inevitable because of the demographics)
• Home Health Aides in quality agencies learn to take on more advanced skills under the instuction and supervision of nurses.  Things such as changing wound dressings and tracking patients taking meds as built into a calendar by the nurse
• These and other skills are institutionalized into a higher level of aide with more training and a higher level of certification that results in better pay and higher demand.
• Work that today requires a trip to a doctor's office or hospital is continuously evaluated to see what can be done in the home
• Overall a more structured deliniation evels of aide skills and nursing skills is created, resulting in a solid career path

We're excited to be part of a growing industry and also dedicated to helping facilitate change and improvement in the services offered and the careers that result.  For more information about home care software and private duty care software from Ankota, please contact us.

Yesterday I had the priviledge of meeting with Hazel Kuchinsky who is the owner and CEO of IvoryHouse Health Services.  Hazel, whose company is headquartered just moments away from Ankota, agreed to share some of her wisdom with our leadership team about private duty care, aging in place, and care management.  I want to thank Hazel for the insights that she shared - we will use them to make our products better!

What I didn't expect was that Hazel, who is first and foremost a nurse and company CEO but has the picture perfect look of a loving grandma, would point me to her blog and let me know that she's about to make her launch on Twitter.  Good for you Hazel!  Hazel also talked about a recent piece that she published on Brain Aerobics - activities that help prevent memory loss and decrease thinking problems.  With her permission I bring that to you here.

Brain Aerobics: The Light at the End of the Tunnel

by Hazel Kuchinsky

One piece of excellent news in the past year was that brain health seems to be improving among older Americans. A large national survey from the University of Michigan found that over a 10-year-period ending in 2002, memory loss and thinking problems were down significantly among senior aged 70 and up, from 12.2 percent to 8.7 percent.  That's a change that translates into hundreds of thousands of men and women, though Alzheimer's is still a top concern for millions worldwide.

Researchers aren't sure why the decrease in cognitive impairment is occurring, but they suspect that a better educated and more affluent older generation that is less likely to smoke and more likely to eat better and get regular exercise may be helping to keep the brain young.

Here is a list of wellness approaches and prevention facts that may help set the tone for a brain healthy year.

1. Keep socially engaged. Make sure you are going out regularly and keeping up with your family either through e-mail, letters, phone calls and planned reunions. Your friends also need the same attention. Giving attention certainly helps you receive in kind.
2. Eat healthy food, fruits, vegetables, proteins. Practice good nutrition. Understand what is best for your brain. Eat plenty of fish, vegetables and avoid fatty and friend foods. Clogging those veins prevents adequate blood supply to your brain.
3. Keep your immune system healthy. Treat yourself well, get at least 8 hours of sleep daily, and recognize any depression and deal with it with your physician, eat healthy.
4. Lower your blood pressure. Work on taking your BP medicine daily, eat less salt, lose weight if necessary, and exercise regularly.
5. Do brain health and memory activities. Find word puzzles and do them frequently. Play word games such as Scrabble, puzzles, play memory word games, and matching pictures.
6. Physical activity-at least 30 minutes each day. This can be walking, cleaning house, sweeping the carpet, walking the steps, and chair exercises. These 30 minutes can be divided into 10 minute increments.
7. Treat Depression. Prolonged depression and untreated depression places a burden on your brain. It causes memory impairment.
8. Treat pain and chronic pain. Remember medications can cause forgetfulness and problems with ambulation.
9. Play card games. Fish, bridge, matching colors, solitaire and hearts. Play trivia, and how something is the same and different.
10. Establish good relationships that consist of a give and take. Allow yourself time with your friends.
11. Practice being happy and laugh frequently. Read the comics, get books that you enjoy and bring laughter into your life.
12. Stay mentally challenged. Attend adult education classes. Renew your interest in old hobbies. Learn how to do new things. All of these activities demonstrate help you prevent memory loss. Formal lowers the risk of Alzheimer's.
13. Practice good weight management. Having a thicker middle increases the risk of developing Alzheimer's' disease. Belly fat in particular may be bad for the brain.
14. Work at a job which keeps your mind sharp into old age. The more complex the job, the better the memory and thinking skills held up after retirement. Retirement may not be for everyone.
15. Avoid a routine that keeps everything the same. For instance, Drive different ways to the market, friend's houses' and the malls.
16. Keep your Cholesterol in check. Keeps TRACK of the numbers. High numbers can create and does increase clogging of veins in the brain.
17. Pass the fish. If you like fish such as tuna, salmon and other types of oily fish may help to lower the risk of memory decline and stroke. Avoid fried fish.
18. Learn the computer. Surf the web for new information and ways of doing new games etc.This helps your brain to be involved in decision -making and complex reasoning.
19. Ask you primary physician to check vitamin levels-Vitamin D and B12, Check your Thyroid functioning.
20. Keep important phone numbers in your memory and on occasion test yourself. Change your pass codes monthly and memorize them and do always keep a cheat sheet.
21. Avoid falls and hitting your head as you age. Make sure your balance is okay and your house is safe. This includes throw rugs being picked up, having grab bars in the bathroom, good lighting and using it. Watch the steps-Highlight with red and yellow tape at the start and finish of the steps. Do not carry too much at one time.
22. Remember memory impairment is not part of normal aging. See your physician and tell him what is going on.
23. Keeping your heart healthy will keep your brain healthy. What is good for the heart is good for the brain.
24. Managing risk factors may delay or prevent cognitive problems later in life.
25. Keep your wellness program going with your physician. Make sure he checks your Vitamin D, B12, Folic Acid, and Thyroid functioning. Dysfunction in any of these areas can cause memory problems.

Thanks again Hazel! 

At Ankota, we pride ourselves on listening to the industry and rapidly incorporating your wisdom into our products.  If you'd like to learn more, please contact Ankota. 

Computers have gotten less expensive year after year. The reason for the cost reductions has varied over time.  Sometimes it has been a breakthrough in component costs (especially as related to miniaturization).  Other times it has been because of outsourcing the assembly.  A big breakthrough in 2009 was the Netbook PC.  Having said that, be careful because Netbooks are not as capable as PCs and depending on what you need to do with a computer, a netbook might not be sufficient.

Netbooks are those small cute-looking laptop-like devices that you've seen popping up.  The generally sell for under $300.  They have a smaller size but come with built in wireless cards so they can connect to the Internet.  Here's a size comparison between a netbook and a laptop PC...

Not to get too technical, but one of the breakthroughs that have made Netbooks possible is the use of solid state memory instead of hard disk drives (hard disks spin and thus use more electricity).  So often netbooks have much less storage than a laptop (e.g., laptops have 120GB hard drives whereas many Netbooks only have 8GB of solid state memory).  So, they're not designed to store a great deal on information.  Among the other tradeoffs are that they generally don't have a CD/DVD drive, and the battery life is often only two hours.  Here's a table, courtesy of GadgetMix.com comparing netbooks to laptops.

Even though the netbooks don't have a lot of capability, I've found them to be effective for field use.  As a dedicated machine for nursing or other health activity reporting, they're well suited.  In fact, the lack of storage is an advantage for HIPAA compliance (supporting a design where the Netbook only stores the information until it can be uploaded).  Ankota is keeping a close eye on how netbooks will play in the future of telephony and mobile applications for home care and private duty.

For those true Geeks among you, keep your eyes open for the next breakthrough, which will be the "Smartbook".  Smartbooks will be netbooks that connect through phone company networks and thus are available anywhere that cell phone coverage is available.