On October 23rd, 2014, we updated our
By continuing to use LinkedIn’s SlideShare service, you agree to the revised terms, so please take a few minutes to review them.
Decreasing Health DisparitiesPresentation Transcript
The Role of Informatics in
Decreasing Healthcare Disparities
Janet Newton, Valerie Schmidt,
Blesson Vargheese, and
Health Information Technology
Adoption barriers among minorities
Janet Newton, RN
Health Information Technology (HIT)
• HIT refers to a number of technologies
– Electronic Health Record (EHR)
– Personal Health Record (PHR)
– Technology used in the management of chronic
conditions (email, text messaging, or remote
– Population health tools (registries and
– Consumer Health Informatics (CHI) online health
tools used for general health information
Health Information Technology (HIT)
• There has been a push in recent years to
implement HIT, especially a Personal Health
– A PHR is a tool used to document one’s health history
– It can be instrumental in increasing one’s awareness
about and involvement in their healthcare.
• It is believed that through the implementation of HIT
we, as a country can positively impact the quality of
care and safety for all Americans.
Health Information Technology (HIT)
• It has been shown that simply having knowledge
about a health issue can enhance one’s health
• The internet can be a great source of information
about a diagnosis or health promotion.
• The United States is a country built on the
philosophy that “All men are created equal”.
However, often there is great disparity in the
healthcare opportunities afforded to different groups
Healthcare disparities can be divided along different
Adoption Barriers among Minorities
• A perceived lack of benefit to the consumer
• Lack of trust in the technology or privacy concerns
• Limited computer access
• Poor computer knowledge, literacy and skills
• Limited internet availability either because of financial or
Minority consumers are
sometimes reluctant to
use online Personal
The Affordable Care Act of 2010
Impact on Decreasing Healthcare Disparities
Shelby Watson, RN
Affordable Healthcare Act
• Signed into law in 2010
• Mandates that all Americans
have access to healthcare
• Incorporation of new
standards and infrastructure
• Reimbursement for physicians
based on the quality of care
provided to patients instead of
reimbursement of services
Affordable Care Act and Data Collection
• Section 10334 – Designates a new National Institute on
Minority Health and Health Disparities.
• Section 4302 – requires population surveys that will address
federally funded health care programs and will provide
feedback on data including race, ethnicity, sex, primary
language, disability status, and information on individuals who
live in rural and frontier areas. ("Health Disparities and ACA,"
2012, p. 1)
• Quality Improvement and Research
Affordable Care Act Coverage
• Expands Medicaid coverage for
minorities, which will cover almost
40% of African American and
• Insurance companies can no longer
deny coverage to those with pre-
existing conditions, or charge
• New exchanges afford the
opportunity to choose a plan and
premium package that provides
benefits and alleviates the disparity
for those who may not qualify for
Affordable Care Act in the Community
• Community Health Centers (CHCs) expected to
play a key role in the future of providing primary
and preventative care services to minority groups
and underserved populations.
• Earmarked $11 billion to facilitate serving an
estimated 40 million patients by 2019, which
represents double the amount currently being
• Data collected on these CHCs will be utilized to
provide targeted care in the future
Affordable Care Act and Preventative Care
• Focus on preventative care measures and goals for
the future of expanding wellness care management.
• Section 4102 of the law already includes an oral
health campaign and aims to promote oral health
for minority groups
• Provisions and funding provided for maternal and
child health to include $1.5 billion dedicated to
services such as home visiting programs and
educational support for individuals to improve
Affordable Care Act and the Future
• New requirements to electronically report data will provide insight for
needs assessments and healthcare spending of the future
• ACA is the first major step since the implementation of Medicaid
which aims to relieve the disparity among minority populations
regarding health care coverage and preventative care awareness.
• Estimated 46 million people currently uninsured
• 47% of those individuals live in households with income at or below
133 percent of federal poverty guidelines. ("Health Disparities and ACA," 2012, para.
• Expected 32 million additional Americans will have health coverage
by 2019 (Saenz, 2010, para. 2)
Affordable Care Act and the Future
• Expected 32 million additional Americans will have
health coverage by 2019 (Saenz, 2010, para. 2)
• Aim is to alleviate current dilemma and positively
influence the market by driving down the cost of
Opportunities for HIT to help
address healthcare disparities
Valerie Schmidt , RN
Access to Technology
• Mobile phone access to underserved populations has decreased
• According to the Institutes for Alternative Futures
existing gaps in access to internet have narrowed
• Many of the underserved communities in the US were
the largest users of cell phone voice minutes per person
Access to technology
• Existing gaps in access to internet have narrowed
• Percentage of adults with broadband internet access at
home is consistent among White/non-Hispanic and
Hispanic/English speaking population according to PEW
Internet and American Life Project
Access to Technology
• National efforts are encouraging the use of HIT in
• Health Information Technology Act
• Office of the National Coordinator (ONC)
• Regional Extension Center Program (REC)
• Health information technology tools assist providers
• Improve decision making processes
• Improved Coordination of Care
• Facilitate quality improvement reporting
• More cost effective
• Consumer Health Technology potential to help patients
• Cost effective
• Personal Health Records
• Increase access to broader range of quality services
• Remote monitoring
Patient Opportunities Cont.
• Patient Education
• Provide interpretive programs in various languages
• Health Kiosks
• Opportunistic kiosks
• Integrated kiosks
PATIENT SELF MANAGEMENT AND
Blesson Vargheese , RN
• Research shows that there is a critical health disparities
among societal members of various racial and ethnic and
• Geographical inaccessibility, poverty, unavailability of qualified
healthcare personnel and lack of consumer awareness
critically contributes to this health disparity.
• Telemedicine and self management among these vulnerable
individuals serve as critical medical mitigation tools that aim at
alleviating this predicament.
• Telehealthcare and telemedicine systems works as a
significant linkage between the healthcare provider and the
• Telemedicine assists in offering medical as well as
• Telemedicine refers to the application of ICT in the provision of
healthcare to individuals that have inaccessibility, owing their remote
• Telemedicine can be perceived as exchange of information between
two physicians and also between a healthcare provider and a patient,
in an endeavor to promote self management.
• Conversely, telehealth encompasses the definition of telemedicine
and also incorporates employment of telecommunication in the
delivery of non-clinical services.
• Such services within telehealth may also encompass research, and
promotion of health education.
• ICTs have the prospective to develop information management,
access to health services, healthcare improvement, progress of high-
quality healthcare, reducing unwarranted costs.
• A telehealth is a critical system that enables patients to
manage their various ailments better, thereby assisting in
improving their wellbeing.
• Self management is critical in controlling chronic diseases
such as diabetes and aids patients to lead quality lives.
• Various telehealthcare systems are available, and among
them include the Bosch system.
• The Bosch system has been a significant too for self
management, owing to its wide acceptability and use across
the US and Europe.
• Careful adherence and compliance to various systems of self
management and telemedicine and self management has had
patients experience positive effects on their health, particularly
patients with long-term diseases.
• Various researches indicates that though numerous flaws may
be experienced within the systems, the overall outcomes of
the telemedicine systems serves critically to improve the
• This was evident in patients who may seem to be racially
• An example is the African Americans who only constitute 17%
of the US population but have a 49% HIV prevalence.
• Owing to the employment of the telemedicine systems, the
control of this scourge has been significant, thereby improving
• Telehealth and telemedicine among individuals that are
racially and geographically marginalized significantly employs
technology in the mitigation measures.
• As such, it is critical to promote the use of various technology
modes such as video conferencing and the internet.
• Access to the internet also poses another key predicament to
these systems, owing to its inaccessibility and illiteracy among
various members of these marginalized groups.
• It is critical to empower these marginalized members through
various campaigns for embracing of technology and education
promotion among these groups.
• Intervention of the government may critically serve in
mitigating over this predicament, through the provision of
funding for the process.
• Patients and healthcare providers ought to apply ICT in their
endeavor to alleviate various ailments.
• This will significantly help in reducing costs and improving
healthcare to societal members considered to be remote.
• Inaccessibility of ICT among remote healthcare providers and
patients continue to pose a major challenge to telehealth and
• The government ought to intervene in this predicament
through the provision of funds and installation of ICT systems
within these remote environments.
• Healthcare providers also ought to campaign for telemedicine
in the remote areas in order to bridge the healthcare disparity
and improve healthcare delivery.
Chicago, N. a. (2010). Understanding the Impact of Health IT in Underserved . Bethesda: NORC at the University of Chicago.
Davis, O. I., Bean, K., & McBride, D. (2013). Decreasing Health Disparities through Technology: Building a Community Health Website | Davis | The
Journal of Community Informatics. Retrieved from http://ci-journal.net/index.php/ciej/article/view/704/1005
Fong, B., Fong, A., & Li, C. (2011). Telemedicine technologies information technologies in medicine and telehealth. Chichester, West Sussex, U.K.
Futures, I. f. (2006). The DRA Project Accellerating Disparity Reducing Advances. Alexandria: Institute for Alternative Futures.
Garvin, J., Odom-Wesley, B., Rudman, W., & Stewart, R. (2009, June). Healthcare Disparities and the Role of Personal Health Records.
Retrieved April 8, 2014, from http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_043826.hcsp?dDocName=bok1_043826
Gibbons, M. C. (2011). Use of Health Information Technology among Racial and Ethnic Underserved Communities. Retrieved from
Health Reform. (2012). Retrieved from http://www.ehidc.org/resource-center/white-papers-and-briefs/doc_download/204-white-paper-point-of-care-
Jacelon, R. (2012). Impact of telehealth on patient self- management of heart failure: a review of literature. PubMed, 27(1), 33-43.
Kühne, K. (2010). Patient self-management by telehealth using the Bosch model of care. Pubmed. , 16(4), 33-43.
Leadership, education & training program in maternal & child nutrition. (2013, April). Retrieved April 8, 2014, from
Lopez, L., Green, A. R., Tan-McGrory, A., King, R., & Betancourt, J. (2011). 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, 37(10), 437-445.
Saenz, M. (2010). Health Disparities and the Affordable Care Act. Retrieved from http://www.ncsl.org/research/health/health-disparities-and-the-
Swain, M. (2013, May 10). Can Health IT Reduce Health Disparities? New ONC Report Explores Opportunities. Retrieved from Health IT BUZZ
Latest on Health information technology from ONC: http://www.healthit.gov/buzz-blog/from-the-onc-desk/health-reduce-health-disparities-