Equity in the Digital Age: How Health Information Technology Can Reduce Disparities

While enormous medical and technological advancements have been made over the last century, it is only very recently that there have been similar rates of development in the field of health information technology (HIT).This report examines some of the advancements in HIT and its potential to shape the future health care experiences of consumers. Combined with better data collection, HIT offers signi?cant opportunities to improve access to care, enhance health care quality, and create targeted strategies that help promote health equity. We must also keep in mind that technology gaps exist, particularly among communities of color, immigrants, and people who do not speak English well. HIT implementation must be done in a manner that responds to the needs of all populations to make sure that it enhances access, facilitates enrollment, and improves quality in a way that does not exacerbate existing health disparities for the most marginalized and underserved

Missing links: challenges in engaging the underserved with health information and communication technology

We sought to understand underserved patients' preferences for health information technology (HIT) and examine the current use of personal health records (PHRs) in Community Health Centers (CHCs) serving low-income, uninsured, and underinsured patients. Forty-three patients and 49 clinic staff, administrators, and providers from these CHC systems were interviewed using open-ended questions assessing patient experience, perceptions of the CHC, access barriers, strategies used to overcome access barriers, technology access and use, and clinic operations and workflow. All seven CHC systems were at some stage of implementing PHRs, with two clinics having already completed implementation. Indiana CHCs have experienced barriers to implementing and using PHRs in a way that provides value for patients or providers/staff There was a general lack of awareness among patients regarding the existence of PHRs, their benefits and a lack of effective promotion to patients. Most patients have access to the internet, primarily through mobile phones, and desire greater functionality in order to communicate with CHCs and manage their health conditions. Despite decades of research, there remain barriers to the adoption and use of PHRs. Novel approaches must be developed to achieve the desired impact of PHRs on patient engagement, communication and satisfaction. Our findings provide a roadmap to greater engagement of patients via PHRs by expanding functionality, training both patients and clinic providers/staff, and incorporating adult learning strategies

J Public Health Manag Pract

ContextThe Patient Protection and Affordable Care Act\ue2\u20ac\u2122s (PPACA) emphasis on community-based initiatives affords a unique opportunity to disseminate and scale up evidence-based community health worker (CHW) models that integrate CHWs within health care delivery teams and programs. Community health workers have unique access and local knowledge that can inform program development and evaluation, improve service delivery and care coordination, and expand health care access. As a member of the PPACA-defined health care workforce, CHWs have the potential to positively impact numerous programs and reduce costs.ObjectiveThis article discusses different strategies for integrating CHW models within PPACA implementation through facilitated enrollment strategies, patient-centered medical homes, coordination and expansion of health information technology (HIT) efforts, and also discusses payment options for such integration.ResultsTitle V of the PPACA outlines a plan to improve access to and delivery of health care services for all individuals, particularly low-income, underserved, uninsured, minority, health disparity, and rural populations. Community health workers\ue2\u20ac\u2122 role as trusted community leaders can facilitate accurate data collection, program enrollment, and provision of culturally and linguistically appropriate, patient- and family-centered care. Because CHWs already support disease management and care coordination services, they will be critical to delivering and expanding patient-centered medical homes and Health Home services, especially for communities that suffer disproportionately from multiple chronic diseases. Community health workers\ue2\u20ac\u2122 unique expertise in conducting outreach make them well positioned to help enroll people in Medicaid or insurance offered by Health Benefit Exchanges. New payment models provide opportunities to fund and sustain CHWs.ConclusionCommunity health workers can support the effective implementation of PPACA if the capacity and potential of CHWs to serve as cultural brokers and bridges among medically underserved communities and health care delivery systems is fully tapped. Patient Protection and Affordable Care Act and current payment structures provide an unprecedented and important vehicle for integrating and sustaining CHWs as part of these new delivery and enrollment models.1U48DP001904-01/DP/NCCDPHP CDC HHS/United States1U48DP006008-01/DP/NCCDPHP CDC HHS/United States2P60MD000538-10/MD/NIMHD NIH HHS/United StatesP60 MD000538/MD/NIMHD NIH HHS/United StatesR01 AG046149/AG/NIA NIH HHS/United StatesR01 CA175329/CA/NCI NIH HHS/United StatesR01 HL085567/HL/NHLBI NIH HHS/United StatesR01 MD007716/MD/NIMHD NIH HHS/United StatesR25 HL105444/HL/NHLBI NIH HHS/United StatesU01 CA086322/CA/NCI NIH HHS/United StatesU48 DP001904/DP/NCCDPHP CDC HHS/United StatesU48 DP005008/DP/NCCDPHP CDC HHS/United StatesU58 DP001022/DP/NCCDPHP CDC HHS/United StatesU58 DP004685/DP/NCCDPHP CDC HHS/United StatesU58 DP005621/DP/NCCDPHP CDC HHS/United StatesU58DP001022/DP/NCCDPHP CDC HHS/United StatesUL1 TR000038/TR/NCATS NIH HHS/United StatesUL1TR000038/TR/NCATS NIH HHS/United States2015-07-01T00:00:00Z25414955PMC441664

Exploring the workforce shortage of dermatologists through telehealth as an innovative supply chain and logistics management technological solution.

As COVID-19 continues to evolve in the United States (U.S.), now more than ever, medical care is leveraging technology and innovation in its delivery of treatment to patients in need of healthcare. The average wait time nationally for a new patient dermatology is 33 days, but the average wait time is 96 days in rural areas. As a result, many healthcare researchers are not evaluating workforce shortages of specialists like dermatologists as a supply chain and logistics management issue. The paper uses a content analysis of the literature to explore the ability of telemedicine as a logistics management tool that uses technology to meet the patient demand for dermatologists

The Affordable Care Act and Beyond: Opportunities for Advancing Health Equity and Social Justice

In 2010, the most monumental health care legislation in forty-five years was enacted. The Patient Protection and Affordable Care Act ( ACA ) makes changes great and small in virtually every important component of the American health care system. The new law\u27s implications will not be known fully for many years because state governments and federal agencies are in the process of interpreting key provisions, drafting rules and devising general implementation strategies. And, uncertainty exists about the scope of the ACA because of the recent Supreme Court ruling in National Federal of Independent Business v. Sebelius. The court upheld nearly all of the provisions in the ACA, but it ruled that the federal government cannot withhold Medicaid funds from states that refuse to expand their Medicaid programs to cover individuals with incomes of as much as 133 percent of the federal poverty level. This article seeks to analyze the most significant changes that affect communities of color and to examine the resulting health equity and social justice implications. Part I explains the moral and economic case for eliminating racial and ethnic health care disparities. Part II analyzes provisions in the new law designed to expand access to health insurance. Part III focuses on the special access challenges communities of color face and how the ACA provisions attempt to address these. Part IV examines key ACA provisions that are explicitly intended to reduce health disparities and improve the health of racially and ethnically diverse populations. Part V argues that achieving health equity for racial and ethnic minority groups will require policy strategies focused outside of the health care arena. This article concludes with recommendations on how to leverage federal spending to advance racial and ethnic equality

Health Information Technologies in Diabetes Management

About 1 in 11 adults worldwide now have diabetes mellitus, 90% of whom have type 2 diabetes (T2D). Successful glycemic control helps to prevent and reduce complications of T2D, including cardiovascular disease, kidney disease, blindness, neuropathy, and limb amputation, and reduce death related to the disease. However, maintaining optimal glycemic control requires ongoing monitoring and treatment, which can be costly and challenging. To improve diabetes management, the development of innovative self-care strategies is warranted. Advances in health information technologies (HITs) have introduced approaches that support effective and affordable health-care delivery and patient education. Technologies in mobile, computer, e-mail, and Internet approaches have shown evidence in enhancing chronic disease management, suggesting great potential for diabetes management technologies. In this chapter, we provided an overview of the HITs in use for T2D management. We synthesized the latest findings on HITs’ effect in reducing HbA1c and managing complications, cardiovascular conditions, in particular. Further, we discussed limitations in the current research in this area and implications for future research. Last, we presented challenges of applying HITs in T2D management in the real-world context and suggested steps to move forward

The Texas Community-Engagement Research Alliance Against COVID-19 in Disproportionately Affected Communities (TX CEAL) Consortium

The coronavirus disease 2019 (COVID-19) pandemic requires urgent implementation of effective community-engaged strategies to enhance education, awareness, and inclusion of underserved communities in prevention, mitigation, and treatment efforts. The Texas Community-Engagement Alliance Consortium was established with support from the United States’ National Institutes of Health (NIH) to conduct community-engaged projects in selected geographic locations with a high proportion of medically underserved minority groups with a disproportionate burden of COVID-19 disease and hospitalizations. The purpose of this paper is to describe the development of the Consortium. The Consortium organized seven projects with focused activities to address COVID-19 clinical and vaccine trials in highly affected counties, as well as critical statewide efforts. Five Texas counties (Bexar, Dallas, Harris, Hidalgo, and Tarrant) were chosen by NIH because of high concentrations of underserved minority communities, existing community infrastructure, ongoing efforts against COVID-19, and disproportionate burden of COVID-19. Policies and practices can contribute to disparities in COVID-19 risk, morbidity, and mortality. Community engagement is an essential element for effective public health strategies in medically underserved minority areas. Working with partners, the Consortium will use community engagement strategies to address COVID-19 disparities

Patient-Centered Care for Underserved Populations: Definition and Best Practices

Defines key components of patient-centered care for diverse, vulnerable populations, and describes how patient-centered philosophies can be incorporated into effective delivery models targeting the underserved. Provides recommendations for policymakers