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M. Chris Gibbons - Health IT and Healthcare Disparities


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"Health IT and Healthcare Disparities" was presented at the Center for Health Literacy Conference 2011: Plain Talk in Complex Times by M. Chris Gibbons, MD, MPH, Associate Director, Johns Hopkins Urban Health Institute.

Description: This presenter will discuss the use of technology and consumer health information to improve healthcare disparities.

Published in: Education, Health & Medicine
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M. Chris Gibbons - Health IT and Healthcare Disparities

  1. 1. Health IT and Healthcare Disparities M Chris Gibbons, MD, MPH Associate Director, Johns Hopkins Urban Health Institute Assistant Professor, Medicine, Public Health and Health Informatics Johns Hopkins University
  2. 2. Technology and Disease Pathogenesis <ul><li>Information Technology based approaches </li></ul><ul><li>offer significant promise in helping to gain a more robust and comprehensive characterization of disease and disparities pathogenesis at the individual and population levels. </li></ul>
  3. 3. Tip of the Iceberg <ul><li>EMR’s </li></ul><ul><li>CPOE </li></ul><ul><li>e-consultation </li></ul><ul><li>Telemedicine </li></ul><ul><li>Remote monitoring </li></ul><ul><li>Intelligent Devices </li></ul><ul><li>Sensor Technology </li></ul><ul><li>Programmed Evidence-Based Processes (PEP’s) </li></ul>
  4. 4. Reality <ul><li>HC System </li></ul><ul><li>Vs </li></ul><ul><li>Patients and Caregivers </li></ul>
  5. 5. Consumer Health Informatics <ul><li>Consumer health informatics (CHI) is the branch of medical informatics that “analyzes consumers’ needs for information, studies and implements methods of making information accessible to consumers, and models and integrates consumers’ preferences into medical information systems.” </li></ul><ul><li>Eysenbach G. BMJ 2000; 320(7251):1713-6 </li></ul>
  6. 6. Early Examples of CHI <ul><li>Web sites providing self-care information </li></ul><ul><li>Internet-based disease management tools </li></ul><ul><li>personal health records (PHRs) </li></ul><ul><li>online support groups </li></ul>
  7. 7. Emerging Examples of CHI <ul><li>Online Health Risk Calculators </li></ul><ul><li>Personal Health Records </li></ul><ul><li>Calendaring, ODL’s </li></ul><ul><li>On Demand </li></ul><ul><li>Health Gaming </li></ul><ul><li>RFID </li></ul>
  8. 8. Challenges <ul><li>Digital Divide </li></ul><ul><li>Usability </li></ul><ul><li>Health Literacy </li></ul><ul><li>UCD, CID, </li></ul>
  9. 9. Users <ul><li>Patients </li></ul><ul><li>Caregivers </li></ul><ul><ul><li>Formal </li></ul></ul><ul><ul><li>Informal </li></ul></ul><ul><ul><ul><li>Family </li></ul></ul></ul><ul><ul><ul><li>Patient Navigators, CHW’s </li></ul></ul></ul>
  10. 10. IT Enabled Opportunities <ul><li>Caregivers </li></ul><ul><ul><li>Documentation </li></ul></ul><ul><ul><li>Reporting </li></ul></ul><ul><ul><li>Decision Support </li></ul></ul><ul><ul><li>Training Certification </li></ul></ul><ul><ul><li>Patient/Caregiver Education </li></ul></ul><ul><ul><li>Social Support </li></ul></ul><ul><ul><li>Quality Assurance </li></ul></ul><ul><ul><li>Patient satisfaction </li></ul></ul><ul><ul><li>Trust </li></ul></ul>
  11. 11. IT enabled Opportunities <ul><li>Across the Health and Care Continuum </li></ul><ul><li>Harm Reduction </li></ul><ul><li>Prevention/Wellness </li></ul><ul><li>Screening </li></ul><ul><li>Diagnosis </li></ul><ul><li>Medical Treatment </li></ul><ul><li>Self care/ Self Management </li></ul><ul><li>Survivorship </li></ul>
  12. 12. Do CHI Tools work? <ul><li>Early evidence suggests these tools may significantly improve health outcomes. </li></ul>
  13. 13. Can Social Media help address Healthcare Disparities? <ul><li>Are there determinants of disparities that can be impacted by Social Media? </li></ul><ul><li>Is using social media for healthcare marketing, data dissemination, decision support, selfcare management or data dissemination useful among disparities populations? </li></ul>
  14. 14. The Future of Health IT <ul><li>Social Media </li></ul><ul><li>Interaction, sharing information and collaboration is key </li></ul><ul><li>Growth in the utilization of social media and web 2.0 applications is 3x faster than overall growth in internet utilization </li></ul>
  15. 15. Social Media “Disparities” 2009 Quirk’s Marketing Research Review
  16. 16. Social Media “Disparities” 2009 Quirk’s Marketing Research Review
  17. 17. Why improving access and quality is not enough <ul><li>Minority patients stress the value of being able to ‘‘tell their story and be heard’’. </li></ul><ul><li>They also emphasize the importance of information sharing rather than decision-making sharing. </li></ul><ul><li>They often believe there is an acceptable role for non-adherence as a mechanism to express control and act on treatment preferences when inequitable experiences exist. </li></ul><ul><li>Peek M. et al Patient Education and Counseling 72 (2008) 450–458 </li></ul><ul><li>Rose L, et al J Adv Nurs. 2000 Sep;32(3):587-94 </li></ul><ul><li>Capitman J et al CPTD for R/E minorities; Evidence report and evidence-based recommendations. 1500-00-0031, DHHS 2003 </li></ul>
  18. 18. Social Media opportunities to impact Healthcare Disparities <ul><li>Patient related opportunities </li></ul><ul><ul><li>improve shared decision making </li></ul></ul><ul><ul><li>enhance patient engagement </li></ul></ul><ul><ul><li>Reduce the prevalence of “acceptable” noncompliance </li></ul></ul><ul><ul><li>Promote adherence </li></ul></ul><ul><ul><ul><li>Nike+iPod – Physical activity & Fitness </li></ul></ul></ul><ul><ul><ul><li>Qwitter, Quitnet, Habitchanger – Smoking cessation </li></ul></ul></ul><ul><ul><ul><li>Whrrl, Yelp – Healthy diet and nutrition </li></ul></ul></ul><ul><ul><ul><li>Foursquare, GyPsii, Plazes – other health or healthcare oriented activities </li></ul></ul></ul>
  19. 19. HIT & Healthcare Disparities <ul><li>Provider related opportunities </li></ul><ul><ul><li>Improve information sharing and patient centered collaborative care </li></ul></ul><ul><ul><li>Obtain important nonclinical information - ODL’s </li></ul></ul><ul><ul><li>Enhance access to health care services </li></ul></ul><ul><ul><ul><li>Patients like me </li></ul></ul></ul><ul><ul><ul><li>Second Life </li></ul></ul></ul><ul><ul><li>Future </li></ul></ul><ul><ul><ul><li>“ Doctors like me”, “Patients like mine” </li></ul></ul></ul><ul><ul><ul><li>“ Doc”sourcing </li></ul></ul></ul>
  20. 20. HIT & Healthcare Disparities <ul><li>Research related opportunities </li></ul><ul><ul><li>Clinical trial recruitment and retention – (CER) </li></ul></ul><ul><ul><li>Observational trials and hypothesis generation </li></ul></ul><ul><ul><li>Community Based Participatory Research </li></ul></ul><ul><ul><li>Social media information exchange – consumer databases </li></ul></ul><ul><ul><ul><li>Patients like me </li></ul></ul></ul><ul><ul><ul><li>Crowd Sourcing </li></ul></ul></ul><ul><ul><ul><li>NexGen PHR’s </li></ul></ul></ul><ul><ul><ul><li>Consumer Health Informatics tools </li></ul></ul></ul>
  21. 21. The Future is NOW <ul><li>Cure Together </li></ul><ul><li>Patients Like Me </li></ul><ul><li>Sermo </li></ul><ul><li>Others </li></ul>
  22. 22. HIT & Healthcare Disparities <ul><li>By embracing emerging electronic tool it provides opportunities to </li></ul><ul><li>a) better design text based interventions </li></ul><ul><li>b) tailor text based tools to the individual needs of users </li></ul><ul><li>c) overcome health literacy based limitations through non text based interventions and tools </li></ul>
  23. 23. HIT & Healthcare Disparities <ul><li>RESULT </li></ul><ul><li>Enhance Understanding of Health, Disease & Disparities pathogenesis </li></ul><ul><li>Improve HC system and clinical effectiveness, patient centeredness & outcomes </li></ul><ul><li>Eliminate Healthcare disparities </li></ul>