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Ihs health literacy tools


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Tools to assist clinicians document health education and health literacy related information into the RPMS Electronic Health Record used at all Federal and most Tribal IHS programs.

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Ihs health literacy tools

  1. 1. Health Literacy ResourcesIn the Indian Health SystemJune 17, 2013CDR Christopher Lamer, PharmD, MHS, BCPS, CDEOffice of Information Technology/Health Education
  2. 2. • Provides a comprehensive health service deliverysystem for approximately 1.9 million AmericanIndians and Alaska Natives.• Serves members of 566 federally recognizedTribes.
  3. 3. Agenda• Health Literacy AssessmentTools• Health Factors• Patient Education• Patient Goals• Handouts
  4. 4. 991Adequate  Health  LiteracyLow  Health  Literacy8812Adequate  Health  LiteracyLow  Health  LiteracyREALMResults(word recognition)Newest Vital SignResults(numeracy/food labels)The patient does not demonstrate the ability to obtain, process, and understand basichealth information.Assessment is made by a low score on a health literacy screening tool or observation.Tools for Assessing Low Health Literacy
  5. 5. Interpreter neededFineMotorSkills DeficitDementiaValues or BeliefsStressorsLow Health LiteracyCognitive ImpairmentNo BarriersVisually ImpairedBlindHard of HearingDeafDoes Not Read EnglishSpeaks English as a second languageHealth Factors: Barriers to Learning
  6. 6. Patient EducationTopic Sub-topic Code+ =Heart FailureHypertensionICD9 (250.03)ExerciseNutritionMedicationsPreventionHome ManagementSelf-ManagementLiterature
  7. 7. SubtopicsActivities of Daily LivingAnatomy & PhysiologyBehavioral and Emotional HealthComplicationsCultural/Spiritual Aspects of HealthDisease ProcessEquipmentExerciseFollow-upHelp LineHome ManagementHealth Promotion Disease PreventionHygieneInfection ControlLiteratureLifestyle AdaptationsMedicationsMedical Nutrition TherapyNutritionPain ManagementPreconception CarePreventionProceduresSafetySecond/Third Hand SmokeSelf Management PlanStress ManagementTestsTobaccoTreatmentWound CareMEDICATIONSSTANDARDS:1. Describe the name, strength, purpose, dosingdirections, and storage of the medication.2. Discuss the benefits and common or important sideeffects of the medication and follow up as appropriate.3. Discuss any significant drug/drug, drug/food, andalcohol interactions, as appropriate.4. Discuss the importance of full participation with themedication plan and that this is the patient’sresponsibility. Discuss any barriers to full participation.5. Discuss the importance of keeping a list of all currentprescriptions and over-the- counter medicines, vitamins,herbs, traditional remedies, and supplements. Encouragethe patient to bring this list and pill bottles toappointments for medication reconciliation.
  8. 8. Patient Education Data Captured• Education Topic• Level of Understanding• Readiness to learn• Free text comment field• Time
  9. 9. Patient Education and Measures• Use of the codes• Use in quality measures• Tobacco cessation• Comprehensive CVD (GPRAMA measure)• Health Education reports• Diabetes measures2010201120120 2000000 4000000 6000000 80000007,541,3246,198,6095,822,93057.8%55.9%
  10. 10. Patient Education PlansExerciseNutritionMedicationsPreventionHome ManagementSelf-ManagementLiterature...Create SNOMED subsetProblemSub-topic OptionalPointer
  11. 11. Proposed Documentation ProcessIntegrated Problem ListDiagnosis (SNOMED) Narrative Status Date added [] Add EducationDiagnosis (SNOMED) Narrative Status Date added [] Add EducationWellness [] Add EducationGeneral Eduction Codes[] Exercise [] Complications[] Nutrition [] Medications[] Lifestyle Adaptation [] Nutrition [] Special InitiativesAssociate with condition: [__________________]Special Initiative Eduction CodesDiabetesBaby FriendlyPrenatalAdministrationAdmission to Hospital[] hypoglycemia[] insulin[] exercise
  12. 12. Patient Goals• Captures patient selected goals• Compatible with personal action plan ormotivational interviewing• Enables followup and captures notes related tothe goal over time
  13. 13. GoalStepFollow Up
  14. 14. Patient Handouts
  15. 15. LogicPatient Wellness Handout (PWH)
  16. 16. 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: 5Directions: INHALE 2 PUFFS BY MOUTH EVERY 4 HOURS IF NEEDED FORBREATHING; **SHAKE WELL BEFORE USING**2. FLUTICASONE PROP 11O MCG (12GM) Rx#: 1234568 Refills left: 11Directions: INHALE 1 PUFF 110MCG/INHL BY MOUTH TWICE A DAY
  17. 17. Controlling your cholesterol can keep your heart and blood vessels healthy.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.Your last diabetes eye exam was done on Aug 10, 2010. You will need tohave another eye exam by Aug 10, 2011.
  18. 18. Clinical Summary and PHRRPMSEHRCaliforniaArea OfficeArea OfficeGPRAONMIHSHealth InformationExchangeCCDExternalHealthcareFacilityHealth InformationExchangeTransitionof CareSummaryClinicalSummaryPersonalHealthRecordPHRServerSecure emailclient on the EHR
  19. 19. Personal Health RecordIndian Health Service Personal Health RecordRegister to use PHRHow to RegisterTo begin using the Personal HealthRecord, click the link below to create anaccount and apply to view your IndianHelath System medical recordUser LoginUsernamePasswordLoginForgot Username or PasswordWhat is the Personal Health Record?You can use the Indian Health Service Personal HealthRecord (PHR) to view your health information. You cantrack medications, lab results, and other helathinfomration from the privacy of your personal computeror mobile device.Who can use the Personal Health Record?Only an Indian Health System patient who registers touse the Personal Health Recordand verifies theiridentity at an Indian Health Service, Tribal, or urbanhealth care facility can view their medical records.About PHR | My Settings | Privacy Policy | Terms and Conditions | Contact Us
  20. 20. Conclusion