This summary presentation covered several topics: - The presenter's background in healthcare finance and strategy consulting. - How regional extension centers can help with electronic health record implementation and clinic workflow changes. - Examples of improving diabetes management at a community health center through targeted quality improvement efforts. - Using an electronic health record and algorithms to identify and follow up with patients who are out of range on key health metrics. - Presenting health information and educating participants through effective online portals and avatars. - Mapping multi-morbidity and emergency department utilization patterns in Medicaid to identify priority areas. - Challenges and opportunities for mobile health initiatives in developing countries where non-communicable diseases are rising issues.

1. Summary Presentation
Duke/UNC Health Informatics Seminar Series
Eddie Alcorn
April 26, 2013

2. My background
Applications in my field
Recommendations
Agenda

3. Background
Former high school
teacher
Graduating MSPH/MBA
candidate
Finance director for
student-run free clinic
Future strategy
consultant at UNC Health
Care
SHAC Health Fair, April 14, 2012

4. Regional extension centers help with the implementation
of the EHR and the clinic process flow
Focus on project implementation
These changes result in a “data coma” period where
minimal improvement is made towards objectives.
Learning curve
Improvement in diabetes management at Roanoke
Chowan CHC through concerted efforts
Target efforts on patients who are out of range
EHRs and Quality Improvement -
Dr. Sam Cykert

5. 1. Measurement
1. chart reviews (subsample)
2. certified EHR and “meaningful use” (automate)
2. Algorithms for medication intensification (who
executes?)
3. Electronic templates with point of care reminders
4. Drill down lists (can’t do with paper charts) and plan for
out-of-range patients
5. Self management training / Motivational Interviewing
Improvement in Diabetes
Management at Roanoke Chowan

6. Daily Disease Reporting: School-based health clinic
information transmitted to pediatric provider data systems
Interoperability issues
WIC Program Education: Use of an avatar greatly increases
participant engagement
Effective presentation of information
Health Information Portal: Mapping geographic variation
of multi-morbidity and ED utilization in Medicaid patients in
NC
Focus on the areas with matching intensity
NC Community Health Information
Portal – Dr. John Graham

7. Multi-Morbidity vs. ED Utiltization
Multiple Morbidities in
Medicaid Recipients
ED Utiltization per Medicaid
Recipient

8. Obesity prevalence correlated with
preponderance of fast food restaurants

9. Non-communicable diseases are quickly replacing
infectious diseases and malnutrition as the leading
cause of death in developing countries
Health priorities are not always immediately apparent
High cell phone usage by providers and patients
offers opportunities to skip steps in development
Spread innovation throughout health care system
Planning for mHealth in a Low Income
Country – Challenges in Guatemala
Dr. Patricia Abbott

10. Questions?