Starting in 2000, the Assessing Care of Vulnerable Elders (ACOVE) project endeavored to develop a comprehensive set of quality-indicators to improve the care of "vulnerable elders," community-living persons 65 years of age and older who are at high risk for death or functional decline. This group uses a disproportionate share of health care resources and is most susceptible to the effects of poor quality care. Until ACOVE, objective measures to evaluate their care were lacking. The ACOVE project developed quality-of-care process indicators to evaluate the care provided to vulnerable elders.

ACOVE-3, the third phase of this project completed in 2007, includes 392 quality indicators covering 26 different conditions in all four domains of care: screening and prevention, diagnosis, treatment, and follow-up and continuity. Three of these conditions involve the most basic functions of the human body - cognition, ambulation/mobility, and elimination - which are hugely important to consider when assessing the decline of a patient's health due to aging. Educating the physicians of tomorrow on cognitive impairment, falls and mobility disorders, and urinary incontinence should feature prominently in the education of physicians.

To help ease this process, Dr. David Reuben, in collaboration with AGS, RAND Health, and Pfizer, have developed ACOVE - an interactive video-lecture CD containing three distinct modules which efficiently and entertainingly delineates the unique challenges presenting to those entrusted with the care of the vulnerable elderly with these conditions. An interesting and attractively designed program, ACOVE guides the physician through crucial facets of these three conditions, while simultaneously integrating relevant patient interaction. ACOVE's primary target audience include residents as well as practicing physicians, but the patient is not left out of the equation. A variety of handouts are available for download that are designed for patients (as well as a multitude of handouts specific to physicians). The bulk of the content is organized into three modules, one for cognitive impairment, one for falls and mobility disorders, and the last for urinary incontinence. Dr. Reuben's lectures are accompanied by a virtual image of him, often juxtaposed to helpful text, images, graphs, or other video relevant to the topics that are being presented. ACOVE was developed with the intention of educating physicians on how to assess and care for older patients with these conditions by appealing to both visual and auditory learners. The CD is interactive, as the user can select not only modules, but also individual topics within each module. Learners can navigate through the module content with ease using easy-to-use navigation buttons on the screen. Additionally, Dr. Reuben gives frequent tips and words of advice to accompany the topic content.

However, while ACOVE is interactive, and was quite advanced at the publish date (February 2006), users technically savvy with current e-learning products may find the program's platform a bit dated. The overall user experience may benefit from enhancements such as an interface that allows interaction within the content of the modules, the ability to see your progress through the modules, and self-assessment opportunities. While the technology used in the production of the video and the platform to host the content may not be the latest and the content is largely summarative, the information is presented in a clear, concise, and effective manner. The marked expertise of Dr. Reuben permeates throughout the programs' presentations, and ACOVE performs well in educating physicians on the unique needs of their vulnerable older patients. With three separate modules and a total running time of just eighty minutes, ACOVE succeeds in its effort of helping to improve the quality of care for vulnerable older adults. This CD's production has already been discontinued; however, ACOVE is readily available for download - right now and for free - only at POGOe.org!