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Informatics Role in Decreasing Healthcare DisparitiesGeorgienne GordonBarbara HarrisElke HouserMelissa Hurt
Healthcare DisparitiesContributing FactorsMedically underserved communities Economic ChallengesIndividuals with DisabilitiesPersonal BehavioursCultureEducationLanguageHealthcare disparities are the differences in treatment of a disease process, quality, access, outcome of healthcare within a specific race, ethnicity or socioeconomic group.
Information Technology and HealthcareThe mission of merging Information Technology and healthcare was designed to promote patient safety, improve the quality, accessibility and continuity of patient care by the collection, integration and analysis of data
Health Information Technology for ProvidersElectronic Health Record (EHR)The electronic health record is the collection of health information pertaining to an individual. The record contains medical history, medications and allergies, laboratory and diagnostic studies, immunizations and billing information. The importance of this record is the capability of being shared different facilities for continuity of care and in emergencies.Computerized Provider Order Entry (CPOE)The order entry system allows orders to be entered directly by the healthcare providers. The goal is to promote and improve quality of care and patient safety by eliminating illegible handwriting and transcription errors. The system checks for order accuracy, speeds the implementation of ordered diagnostic test and treatment modalities.
Health Information Technology for Providers (continued) TelemedicineTelemedicine is the use of technology to consult, provide and expedite health care services to distant facilities. Diagnostic studies, x-rays, and EKG can be transmitted to remote testing facility for interpretation. Having the capability of telemedicine improves patient’s outcome by early detection, treatment and consult if warrantedE-prescribingAllows the provider to enter a prescription electronically to the patient’s pharmacy. It ensures that the medication has been ordered for the patient. The pharmacist and provider have the ability to communicate regarding patients medication and allergies. Electronic Radiology SystemsA provider can schedule diagnostic tests, generate client instructions and preparation procedures. The systems can included order entry, scheduling, transcription of results, and file room management.
EHR adoption rate for Medical Offices
Health Information Technology for ConsumersPersonal Health Record (PHR)The patient-oriented focus within the healthcare arena has been on the role of the personal health record. PHR’s are internet-based tools which enables the patient to access, input, change or coordinate and control their health information.
Health Information Technology for Consumers (continued)Consumer Health Informatics (CHI)Consumer health informatics is the use of internet-based and electronic resources to educate and improve medical outcomes and healthcare decision making for patients, caregivers and consumers. The consumer has the capability to retrieve information and recommendations regarding diseases, medications and treatments.
Health Information Technology for Consumers (continued)Social MediaThe Social media is an emerging potent resource among healthcare consumers. Advanced technology allows people to interact socially online. 2004 was the introduction of Web 2.0, this upgrade to the internet increased the level or intensity of user interaction with the technology.
Health Information Technology BarriersTechnology GapsLack of InsuranceData Collection
Technology gapsExist among communities of color, immigrants, those who do not speak English wellAccording to APIAHF, CPEHN, Consumers Union & NCLR (2013) 55% of Latino and 58% of African American households have home internet connection as compared to 75% of White households.
Technology GapsIf they don’t have internet access at home, they may consider using a public computer such as at the public library but my worry about the security of their information on a public computer.If they do use a public computer to access information, the websites being used my not be user friendly for those populations.
Lack of InsuranceThis is a barrier for the poor, immigrants, communities of color and those who do not speak English well.These populations often do not seek medical attention as often because they do not have insurance.When they do they end up going from doctor to doctor with medical records getting left at each place and not having a complete record anywhere.They may seek medical attention at the emergency room when the public health office where they normally are seen is closed. This produces two sets of records because the medical record does not follow them from place to place.
Data CollectionPhysician’s offices and medical centers are just beginning to collect information on race, ethnicity, language and other demographic information (APIAHF et al, 2013) and store it in the patient’s chart.This information is important because knowing this information will help the medical staff provide more effective care for the patient.
Health Information Technology and Quality ImprovementAmerican Recovery and Reinvestment Act of 2009Patient Protection and Affordable Care Act of 2010Underlying causes of disparities
Recommendations for Organizations Automate and Standardize collection of race and ethnicity dataPrioritization for identifyingFocused HIT efforts to address fragmentation of careDevelopment of focused clinical decision support systems Input from minorities and limited English to develop HIT tool
Electronics and HITWireless TechnologyText messaging EmailAutomated reminders via above
Clinical Decision Support SystemsPreventive CareGuideline adherenceElectronic alerts, reminders or prompts for facilitation of provider decision making
First steps InfrastructureQuality and cost of careDesign to address and eliminate from ground up
Improving Health OutcomesThe ProviderThe goal of informatics technology in the healthcare field is to promote and improve patient safety. And that means patient safety for all. Health care providers now have the capability to retrieve and input data literally at the touch of a button with the use of PDA's and other mobile devices. The provider is able to provide safe and timely care through EHR, mhealth, telemedicine and e-medicine even while being away from the office. The application allows the provider to communicate through interpretation, written or verbal, for persons with language barriers. Applications are also available for consulting a physician for the patient who requires additional care. Any changes to care is transferred to the patient's EHR for updating.
Improving Health OutcomesThe Consumer With the use of PDA's, computers and other mobile devices the consumer is able to receive information, education and recommendations regarding their disease process, medications and treatments. Through the translation application information can be readily transferred to the desired language. Like the provider this information can be available to the consumer with the touch of the finger. Any changes to care is transferred to the patient's EHR for updating.
ReferencesAsian & Pacific Islander American Health Forum, California Pan-Ethnic Health Network, Consumers Union, National Council of La Raza. (February 24, 2013). Equity in the digital age: How health information technologies can reduce disparities. Retrieved from http://www.cpehn.org.Gibbons, M. (2011) Use of health information technology among racial and ethnic underserved communities, Perspectives in Health Information Management, Winter 2011. Retrieved from Pubmed Central, website: http://www.ncbi.nm.nih.gov.ju.idm.oclc.org/pmc/artices/pmc30358301Hebda, T. And Czar , P. (2013). Handbook of Informatics for Nurses and Healthcare Professionals (5th edition). Upper Saddle River, NJ. Pearson.Hsiao, C., Jha, A., King, J., Patel, V., Furakawa, m. and Mostashari, F. (2013), Office based physicians are responding to incentives and assistance by adopting and using electronic health records, Health Affairs, August 2013 32: 1470-1477 , doi:10.1377/hlthaff.2013.0323Lopez, M.D., M.P.H., L., Green, M.D., M.P.H., A. R., Tan-McGrory, M.S.P.H., M.B.A., A., King, M.D., M.P.H., R., & Betancourt, M.D., M.P.H., J. R. (2011, October). Bridging the digital divide in health care: The role of health information technology in addressing racial and ethnic disparities. The Joint Commission Journal on Quality and Patient Safety, 10, 437-445.What is Telemedicine?(2013)http://www.news-medical.net/health/What -is-Telemedicine.aspx