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Health literacy ihs copy


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A brief overview of what the IHS is doing to promote health literacy and health communications in 2011

Published in: Health & Medicine, Education
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Health literacy ihs copy

  1. 1. Indian Health SystemHealth Communication ToolsImproving Health Literacy
  2. 2. Health Communications• Effective use of communication and technology by health care and public health professionals can bring about an age of patient- and public-centered health information and services. By strategically combining health IT tools and effective health communication processes, there is the potential to: • Improve health care quality and safety. • Increase the efficiency of health care and public health service delivery. • Improve the public health information infrastructure. • Support care in the community and at home. • Facilitate clinical and consumer decision-making. • Build health skills and knowledge.
  3. 3. Health Literacy• Health Literacy is an objective of Health Communications.• Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.
  4. 4. Overview• Tools for Assessment• Patient Education• Patient Goals• Patient Engagement
  5. 5. Tools for Assessment
  6. 6. Tools for Assessment• Health Factors • • Barriers to Learning • Learning Preferences • Confidence
  7. 7. Barriers to Learning• No Barriers • Interpreter needed• Visually Impaired • FineMotorSkills Deficit• Blind • Dementia• Hard of Hearing • Values or Beliefs• Deaf • Stressors• Does Not Read English • Low Health Literacy• Speaks English as a • Cognitive Impairment second language
  8. 8. Learning Preferences• Do or Practice• Read• Small Group• Talk• Media
  9. 9. Patient Confidence• Confidence is used to assess the likeliness that the patient will take an active role in managing their health and well being. • Ask the patient, “How sure are you that you can manage and control most of your health problems.”
  10. 10. Patient ConfidenceHealth Factor DefinitionVery Sure The patient is confident that they can take an active role and manage most of their health problems. The patient is very likely to achieve their health goals.Somewhat Sure The patient is at least 70% confident that they can take an active role and manage most of their health problems. The patient is likely to achieve their health goals.Not Very Sure The patient is less than 70% confident that they can take an active role and manage most of their health problems. Support and education should be provided to assist them in increasing their confidence and ability to participate in self care activities.I do not have any The patient does not acknowledge health problems. It is unlikelyhealth problems that the patient will be willing to set and achieve health goals at this time. Emphasis should be placed on providing the patient with support and education to understand their health problems, improve their confidence and ability to participate in self care activities.
  11. 11. Patient Education
  12. 12. Teach back• What did your doctor tell you the medication is for?• How did your doctor tell you to take the medication?• What did your doctor tell you to expect?
  13. 13. Ask Me 3••
  14. 14. Patient Education• Document Patient Education Codes •
  15. 15. Documenting Patient Education • GPRA and UDS measures • Meaningful Use Performance Measures • Meaningful Use Clinical Quality Measures
  16. 16. Documenting Patient Education Level of Readiness to Topic Sub-Topic Time Understanding Learn Education Code
  17. 17. Documenting Patient Education
  18. 18. Documenting Patient Education
  19. 19. Patient Handouts• module=search&option=crit&newquery=1
  20. 20. Handouts and the EHR
  21. 21. Handouts and the EHR
  22. 22. Handouts and the EHR
  23. 23. Goal Setting
  24. 24. Patient Goals Component
  25. 25. Patient Engagement
  26. 26. Patient Wellness Handout
  27. 27. My Wellness Handout Report Date: Aug 13, 2010------------------------------------------------------------------------------********** CONFIDENTIAL PATIENT INFORMATION [CCL] Aug 13, 2010 **********DOE,JANIE HRN: 3 CHEROKEE INDIAN HOSPITAL1 MAIN STREET CHEROKEE, NC 28734CHEROKEE, NORTH CAROLINA 28719 SMITH, DOCTOR555-555-5555 828-497-9163Thank you for choosing CHEROKEE INDIAN HOSPITAL.This handout is a new way for you and your doctor to look at your health.______________________________________________________________________HEIGHT/WEIGHT/BMI - Weight and Body Mass Index are good measures of yourhealth. Determining a healthy weight and Body Mass Index also depends onhow tall you are.You are 5 feet and 10 inches tall.Your last weight was 220 pounds on Aug 03, 2010.You should have your weight rechecked at your next visit.______________________________________________________________________MEDICATIONS - This is a list of medications and other items you aretaking including non-prescription medications, herbal, dietary, andtraditional supplements. Please let us know if this list is notcomplete. If you have other medications at home or are not sure ifyou should be taking them, call your health care provider to be safe.1. ALBUTEROL MDI (HFA) 6.7GM Rx#: 1234567 Refills left: 5 Directions: INHALE 2 PUFFS BY MOUTH EVERY 4 HOURS IF NEEDED FOR BREATHING; **SHAKE WELL BEFORE USING**2. FLUTICASONE PROP 11O MCG (12GM) Rx#: 1234568 Refills left: 11 Directions: INHALE 1 PUFF 110MCG/INHL BY MOUTH TWICE A DAY
  28. 28. Directions: TAKE ONE (1) TABLET BY MOUTH DAILY FOR KIDNEY PROTECTION! AND BLOOD PRESSURE4. GLIPIZIDE 10MG TAB Rx#: 1234570 Refills left: 8 Directions: TAKE ONE (1) TABLET BY MOUTH TWICE A DAY5. METFORMIN= 500MG *PLAIN* TABS Rx#: 1234571 Refills left: 10 Directions: TAKE THREE TABLETS BY MOUTH EVERY MORNING AND TAKE! TWO TABLETS EVERY EVENING TAKE WITH FOOD FOR DIABETES TREATMENT______________________________________________________________________BLOOD PRESSURE - Blood Pressure is a good measure of health.Your blood pressure was 110/65 on Aug 10, 2010.Your blood pressure is good! It is very important to have your bloodpressure checked often.______________________________________________________________________SCREEN FOR HUMAN IMMUNODEFICIENCY VIRUS (HIV)HIV is a virus that causes a serious infection. HIV infectioncan cause sickness and death. A person can have HIV for many yearsand not know it. Everyone should be tested for HIV when they arebetween 13 and 64 years old. According to our records, you have nothad an HIV test. Talk to your provider about how you can get anHIV test.______________________________________________________________________ALLERGIES - It is important to know what allergies and side effects youhave to medicines or foods. Below is a list of allergies that we know of.Please tell us if there are any that we missed.
  29. 29. ______________________________________________________________________ALLERGIES - It is important to know what allergies and side effects youhave to medicines or foods. Below is a list of allergies that we know of.Please tell us if there are any that we missed. NUTS PENICILLIN - SEVERE EDEMA______________________________________________________________________IMMUNIZATION (shot) RECORD - It is important to keep track of yourimmunizations.You received the following immunization(s): DTaP on 01-Oct-1960 DTP on 11-Feb-2005 Td-ADULT on 06-Jul-2004 Td-ADULT on 07-Jun-2005 IPV on 15-Jun-2005 HEP B PED on 08-Apr-2009 FLU,NOS on 26-Aug-2004 FLU-TIV on 19-Apr-2005 PNEUMO-PS on 01-Nov-2004 PNEUMO-PS on 07-Jun-2005______________________________________________________________________1 Immunization Due HEP B ADLT______________________________________________________________________
  30. 30. Your total cholesterol result was 150 mg/dL on Aug 10, 2010.Your last LDL (bad cholesterol) result was 70 on Aug 10, 2010.Your last HDL (good cholesterol) result was 40 on Aug 10, 2010.Your last triglyceride result was 120 on Aug 10, 2010.LDL (bad cholesterol) should be under 100 mg/dL. Your LDL cholesterolis good! You should have your cholesterol checked every year.______________________________________________________________________DIABETES CAREHEMOGLOBIN A1cHemoglobin A1c is a test that measures your blood sugar control over a3-month period. You should have this test done every 3-6 months.Your last A1c test on file was 8.0 done on Aug 10, 2010.Ask your health care provider how you can keep lowering your A1c.DIABETES KIDNEY ASSESSMENTDiabetes can cause kidney damage. There are tests that can see how well yourkidneys are working. Getting these tests at least once a year can help yourhealth care provider protect your kidneys and lower your risk of gettingkidney damage and dialysis.Your kidneys were tested on Aug 10, 2010. You will need to have yourkidneys tested again on Aug 10, 2011.DIABETES EYE EXAMDiabetes can affect your eyes and vision. Early detection of eye problemscan help you to get the treatment you need to lower your chances of havingproblems such as blurred vision or blindness.
  31. 31. Your last mammogram was on Nov 07, 2005. It is recommended that youreceive a mammogram every year. Ask your health care provider to order amammogram for you.COLON HEALTH SCREENINGYou are up to date for colon health screening. Your next colon healthscreening will be due on Apr 05, 2019.______________________________________________________________________My Healthcare GoalsASHTMA - Lifestyle Adaptation Goal: will avoid too much time outdoors when the pollen is high______________________________________________________________________ASK ME 3 - Every time you talk with a doctor, nurse, pharmacist, or otherhealth care worker, use the Ask Me 3 questions to better understand yourhealth. Make sure you know the answers to these three questions:1. What is my main problem?2. What do I need to do?3. Why is it important for me to do this?
  32. 32. Patient Feedback• “My son was sick and he had to see so many doctors and this could have helped, it’s easier to carry a record, instead of trying to remember all the information.”• “Medication listed would have been helpful because it was hard to remember the names of them - I can’t even pronounce the names.”• “(When you can’t) establish a (primary) doctor, you can carry a record to share with doctors at different clinics to make it easier.”• “This paper would save people a lot of time, especially with waiting. When I had problems with my chest my family wanted to take me to (my IHS clinic), I said no, no. Take me to (the big city hospital). When I got there, they had to call (the IHS clinic) and it took them forever to get my information. It would be quicker if I had this.’
  33. 33. Provider Feedback• “"I have been telling patients that they are overweight for years, now they get the handout and are asking me what weight they should be at”• "Patients are asking for their immunizations and want to know what their blood pressure should be”• “Patients will look at their medications on the list and tell me that they are no longer taking some of them”
  34. 34. PWH at Registration• Patients go to registration to update information.• If a PWH hasn’t been printed in 6 months, registration prints one out for patients to review prior to their clinic appointment.• Patients review the document before their visit and have time to prepare questions.• New intake form questions.
  35. 35. PWH in the Clinic• The PWH is generated when the patient is taken into the clinic room or when they are checked in.• The nurse or provider review relevant information on the PWH such as immunizations or other preventative maintenance due.• Use to reconcile medications.
  36. 36. PWH in the Pharmacy • The pharmacy prints the PWH prior to counseling. • Use the allergy and medication listing to update the medication profile in RPMS and to address the requirements of medication reconciliation • Can serve as a Personal Medication Record as required for providing Medication Therapy Management services. • Provides the patient with an up-to-date medication profile to take home.
  37. 37. PWH and Meaningful Use• Patient Reminders • DENOMINATOR: Number of unique patients 65 years old or older or 5 years older or younger. • NUMERATOR: Number of patients in the denominator who were sent the appropriate reminder.• Clinical Summary • DENOMINATOR: Number of office visits by the EP during the EHR reporting period. • NUMERATOR: Number of office visits in the denominator for which the patient is provided a clinical summary within three business days.• Medication Reconciliation • DENOMINATOR: Number of transitions of care during the EHR reporting period for which the EP was the receiving party of the transition. • NUMERATOR: Number of transitions of care in the denominator where medication reconciliation was performed.
  38. 38. Personal Health Record• A personal health record, or PHR, is an electronic application through which patients can maintain and manage their health information (and that of others for whom they are authorized) in a private, secure, and confidential environment.• A patient portal is an internet application that allows patients to access their electronic health records and permits two-way communication between patients and their healthcare providers.
  39. 39. IHS PHR• Integrated with Master Patient Index• Real time access to health information
  40. 40. Medication Display
  41. 41. Blue Button
  42. 42. Coming Soon: ToolkitTools to promote Health LiteracyTool 1. Health literacy white paper (website)Tool 2. Health communication and health literacy tools overview presentationTools to promote key change 1. Improve Supportive SystemsTool 3. SignageTool 4. Improving Patient Care (IPC) program (website)Tool 5. Community ResourcesTools to promote key change 2. Improve Spoken and Written CommunicationTool 6. Cultural considerationsTool 7. Ask Me 3Tool 8. Teachback MethodTool 9. Pharmacist consultationTool 10. Brown bag medication reviewTool 11. Medication reconciliation (website)Tool 12. Plain writing handout (website)Tool 13. Assessing Reading Level Readability FormulasTool 14. Documenting patient education / Patient Education Codes Manual (website)Tool 15. Patient education handoutsTool 16. Assessing patient education needsTool 17. Personal Health RecordTool 18. Patient Wellness Handout (PWH)Tools to promote key change 3. Improve Self-Management and EmpowermentTool 19. Patient goals / Action PlansTool 20. Assessing patient confidenceTool 21. Obtain patient feedback
  43. 43. Conclusion