The Role of Informatics in Decreasing Healthcare Disparities

1. Jacksonville University School of Nursing
Information Management in Healthcare
Group 02 Project
June 9, 2013

2. I. Ability to Pay for Scarce Resources/Jennifer Dumakor Slides 6- 9 & 19
II. Geographical location with limited access to
Clinical Specialists (remote and rural locations,
war zones, etc.)/Mary Louise Dietrich Slides 11, 20-23
III. Patient knowledge and education related to
health and wellness (Medications, education,
monitoring, etc.)/Sandra Anketell Slides 13, 24-25
IV. Race/Ethnicity, Age, Religion, Sexual Orientation,
and Gender/Shelia Varner Slides 15, 26
V. Joint Participation All Remaining
Slides

3. Healthcare Disparities are defined as “differences in
health outcomes and their determinants between segments of
the population, as defined by
social, demographic, environmental, and geographical
attributes (
Truman, Smith, Roy, Chen, Moonesinghe, Zhu, Crawford, and
Zaza, 2011, p. 3). As we now enter the world of Informatics, it
is imperative for all of us to recognize the benefits afforded to
us, related to reducing or eliminating such disparities.
Informatics can provide a number of resources, services, and
options for our patients impacted by
social, demographic, economic, environmental and
geographical conditions. Informatics is the “equalizer” in the
fight for healthcare equality.

4. How will Informatics impact Healthcare disparities related
to:
 Ability to pay for scarce resources
 Geographical location with limited access to Clinical
Specialists (remote and rural locations, war zones, etc.)
 Patient knowledge and education related to health and
wellness (Medications, education, monitoring, etc.).
 Race/Ethnicity, Age, Religion, Sexual Orientation, and Gender

7. • The elderly
• The disabled
• Low income persons and/or those below the
poverty level
• Those persons with limited
education, skills, and/or knowledge
• The disadvantaged

8. • Lack of ability to pay for healthcare
insurance and/or services
• Discrimination related to socio-economic
status and health status
• Provider bias and ignorance related to
inability to pay for services and/or perceived
lack of self-motivation, related to health and
wellness
• Inability to pay for transportation, to access
larger institutions that have scarce resources.

12. • Resources are not available in rural or
remote locations, such as: Specialists and
clinicians, medical technology, medical
equipment, supplies, and telemedicine, etc.
• Physical access may be limited, and
potentially dangerous, in areas that are
impacted by war, conflict, or physical and
environmental disasters
• Technological and physical access may be
limited due to physical or political
constraints.
• Lack of affordable transportation to
clinics, physicians, and other healthcare
providers and resources

14. • Level of education attained by the patient
• Availability of “special needs” educational
resources
• Availability of medical and clinical resources
such as on-line, telephonic, printed, and on-
site educational offerings and screenings
• Lack of technology to support health and
wellness education and training
• Lack of clinical personnel to
educate, reinforce, and provide education
and workshops specific to health and
wellness, as well as, related to specific
disease states inherent in the community or
population

15. “More than one-third of U.S. adults have trouble reading
and understanding basic medical information” with 36% of
patients, understanding at the basic to below basic levels.
[Source: “The Health Literacy of America’s Adults: Results
From the 2003 National Assessment of Adult Literacy,” U.S.
Dept. of Education, National Center for Education
Statistics, September 2006 ]
According to the Pew Internet and American Life Project, of
3,014 adults interviewed on the phone, 59% have “gone online
for health information,” with 16% seeking support from
“peers” (Fox, 2012).

17. • Lack of trust and understanding related to
cultural, social, and religious practices
• Lack of understanding related to new
technology
• Physical and mental limitations, such as:
Mobility, vision, hand dexterity, and memory
• Lack of resources related to translated
materials

18. • Overall poor health and lack of wellbeing
• Evidence of chronic diseases such as:
Diabetes, hypertension, obesity, arthritis, and
other preventable health issues
• A high level of stress that threatens the body’s
ability to ward off future disease and reduces the
effectiveness of the immune system
• An increase in the cost of healthcare to deal with
conditions that have progressed, due to an
inability to treat such conditions in the early
stages, or to prevent such conditions in the first
place

19. • A diminished workforce
• Depression
• Poverty and increased reliance on governmental
assistance
• A decreased life expectancy rate
• A high mortality rate

21. • Health Reform Activities-The Affordable Care Act , the
American Recovery And Reinvestment Act (2009), and
Meaningful Use, focus on reducing healthcare disparities
and setting national standards for performance
improvement and positive patient outcomes.
• Meaningful Use has set priorities as related to “patient
engagement, reducing racial disparities, improved
efficiencies, increased safety, coordination of care, and
measures to improve population health (Hebda &
Czar, 2013, p. 280-281). These initiatives will electronically
monitor, track, and trend patients, to determine necessary
resources and services for all patients, including the
elderly, disabled and poor.

22. • The Health Resources and Services Administration defines
telehealth as, “the use of technology to deliver
healthcare, health information, or health education at a
distance (NCSL, n.d.). This technology, and its application
to remote and rural locations, delivers
information, services, and education to those that would
otherwise not have such resources.
• Telenursing can use technology to “deliver nursing care and
conduct nursing practice,” for those with limited access to
clinical services and advice (Schlachta-Fairfield, Elfrink, &
Deickman, 2008, p. 558).
• Other “tele” services are also available such as:
Teleradiology , telemedicine, and telepharmacy (Schlachta-
Fairfield, Elfrink, & Deickman, 2008, p. 558).

23. • The Health Resources and Services Administration defines
telehealth as, “the use of technology to deliver healthcare,
health information, or health education at a distance (NCSL,
n.d.). This technology, and its application to remote and
rural locations, delivers information, services, and
education to those that would otherwise not have such
resources.
• Telenursing can use technology to “deliver nursing care and
conduct nursing practice,” for those with limited access to
clinical services and advice (Schlachta-Fairfield, Elfrink, &
Deickman, 2008, p. 558).
• Other “tele” services are also available such as:
Teleradiology , telemedicine, and telepharmacy (Schlachta-
Fairfield, Elfrink, & Deickman, 2008, p. 558).

24. • Telerobotic surgery or Mobile Robotic Telesurgery
(MRT), as it has been named, can provide a “surgical robot
system in mobile settings and/or extreme environments
such as the battlefield or natural disaster areas with
surgeons operating wirelessly”
(Lum, Rosen, King, Friedman, Donlin, Sankaranarayanan,
Harnett, Huffman, Doarn, Broderick, & Hannaford, 2007, p.
1).

26. • Healthcare Informatics can replace the traditional
informational packets, group workshops and face-to-face
encounters, with a virtual classroom and/or remote
interactions, for our patients.
• Telehealth initiatives can provide “in-home care
management” via remote monitoring and data collection
(Care Innovations, 2011-2013).
• Smart phone applications can monitor a patient’s heart
rhythm over the telephone (AliveCor, 2011-2013).
• Systems are available to monitor medication occurrences
and events (AARDEX Group, n.d.)

27. • The Internet: The Internet is a great resource of
information. It is very accessible, even if you do not
have a computer of your own. Libraries and the
workplace may offer free use for Internet access.
Sites may be geared to the specific needs of the
client, as related to: Culture, ethnicity, educational
level, language, religion, just to name a few.
• The Internet provides a forum with which to
“network” with others that may have the same
disease or illness.
• The Internet also provided information related to
specific diseases and illnesses, as well as, links to
specialists and clinical support.

28. • With advanced technology, a person with a physical
disability, such as blindness, is able to utilize the technology
through voice activation on computers.
• In regards to lack of trust, Health Information Management
(HIM) professionals can communicate safeguards to protect
privacy for various Personal Health Record (PHR) formats.
HIM professionals are experts on privacy regulations and
procedures. HIM professionals can be active supporters in
designing PHR tools that are sensitive to low income
populations.
Information technology can enable increased monitoring of
important clinical parameters among racial and ethnic
minority patients. Patient sensor ("smart") technology can
enable remote monitoring and direct delivery of patient data
(Gibbons, 2011).

29. As healthcare professionals, it is up to us to help bridge
the gap related to healthcare disparities. There will be a
number of ways in which to narrow the gap: Healthcare
reform legislation, technology, incentives, and education, to
name just a few.
Informatics provides us with a vehicle to transport
information, services, education, remote technology, and
training to those who have been without for so long. As we
learn the advantages of informatics, we will be able to
discover new ways to address the disparities.
As the focus becomes one of quality care, best
practices, and positive patient outcomes, we must find ways
to provide equal and efficient care for all of our patients.
Affordable healthcare is one avenue on this journey.
Informatics is the vehicle to help us reach our destination.