Information technologies that facilitate care coordination: provider and patient perspectives

Health information technology is a core infrastructure for the chronic care model, integrated care, and other organized care delivery models. From the provider perspective, health information exchange (HIE) helps aggregate and share information about a patient or population from several sources. HIE technologies include direct messages, transfer of care, and event notification services. From the patient perspective, personal health records, secure messaging, text messages, and other mHealth applications may coordinate patients and providers. Patient-reported outcomes and social media technologies enable patients to share health information with many stakeholders, including providers, caregivers, and other patients. An information architecture that integrates personal health record and mHealth applications, with HIEs that combine the electronic health records of multiple healthcare systems will create a rich, dynamic ecosystem for patient collaboration

Public Health and Epidemiology Informatics: Recent Research and Trends in the United States

Objectives To survey advances in public health and epidemiology informatics over the past three years. Methods We conducted a review of English-language research works conducted in the domain of public health informatics (PHI), and published in MEDLINE between January 2012 and December 2014, where information and communication technology (ICT) was a primary subject, or a main component of the study methodology. Selected articles were synthesized using a thematic analysis using the Essential Services of Public Health as a typology. Results Based on themes that emerged, we organized the advances into a model where applications that support the Essential Services are, in turn, supported by a socio-technical infrastructure that relies on government policies and ethical principles. That infrastructure, in turn, depends upon education and training of the public health workforce, development that creates novel or adapts existing infrastructure, and research that evaluates the success of the infrastructure. Finally, the persistence and growth of infrastructure depends on financial sustainability. Conclusions Public health informatics is a field that is growing in breadth, depth, and complexity. Several Essential Services have benefited from informatics, notably, “Monitor Health,” “Diagnose & Investigate,” and “Evaluate.” Yet many Essential Services still have not yet benefited from advances such as maturing electronic health record systems, interoperability amongst health information systems, analytics for population health management, use of social media among consumers, and educational certification in clinical informatics. There is much work to be done to further advance the science of PHI as well as its impact on public health practice

Expanding Use of Sodium-Glucose Cotransporter-2 Inhibitor (SGLT2i) In Managing Patients with Diabetes and Chronic Kidney Disease in Primary Care

Practice Problem: In 2022, the addendum of standards of medical care in diabetes management was annotated to recommend the broader use of sodium-glucose cotransporter 2 inhibitors (SGLT2i) to treat patients with Type 2 diabetes mellitus (DM) and diabetic nephropathy. Despite the Department of Veterans Affairs’ (VA) efforts to include SLGT2i as a formulary, non-restrictive prescription in the primary care ordering menu, the overall utilization rates of SGLT2i remained relatively low in primary care. PICOT: The PICOT question that guided this project was: In patients with DM and chronic kidney disease (CKD) (P), how does an evidence-based guideline algorithm bundle (I) compared to standard care (C) affect providers’ adherence and prescribing practices of including SGLT2 inhibitors (O) within 10 weeks (T)? Evidence: An extensive evidence literature review supported that the algorithm approach with current guidelines has allowed clinicians to identify patients eligible for SGLT2i was based on comprehensive risk assessment with various comorbidities and risk factors. The guideline-based algorithm was a quick reference guide to provide clarity and indication for patients with the most significant potential benefits from SGLT2i therapy. Intervention: The algorithm bundle, designed to reflect the current guidelines, was intended to enhance primary care clinicians\u27 prescribing confidence in SGLT2i and guide better decision-making. The algorithm bundle comprised the physical laminated algorithm card, embedded reminder in the e-prescribing menu, and a focused education session for the primary care providers. Outcome: The project outcomes reflected that the algorithm bundle has clinical significance in improving prescribers’ knowledge of SGLT2i agents and practice compliance, as evidenced by a rise in SGLT2i prescriptions. Conclusion: The algorithm bundle intervention in this project resonates with the American Diabetic Association’s (2022) latest recommendation to widen indications for using SGLT2 to optimize the management of DM and CKD patients. The evidence supports using a guideline-based algorithm to guide clinicians with a comprehensive assessment of high-risk patients and a better decision-making tool. Continued efforts to educate and audit primary care providers are essential to identify potential knowledge gaps and to sustain practice compliance of using SGLT2i as part of the standard of care

The Promise of Health Information Technology: Ensuring that Florida's Children Benefit

Substantial policy interest in supporting the adoption of Health Information Technology (HIT) by the public and private sectors over the last 5 -- 7 years, was spurred in particular by the release of multiple Institute of Medicine reports documenting the widespread occurrence of medical errors and poor quality of care (Institute of Medicine, 1999 & 2001). However, efforts to focus on issues unique to children's health have been left out of many of initiatives. The purpose of this report is to identify strategies that can be taken by public and private entities to promote the use of HIT among providers who serve children in Florida

Identifying Gaps and Setting Priorities for Employment and Training Research

The report summarizes recent workforce and employment related research, to identify current gaps in employment and training research and makes recommendations for future research processes and priorities that could better inform policy makers, practitioners, job seekers and employers. The report reviews workforce and related research funded by several federal agencies, including the US Departments of Labor, Education, Agriculture, Health and Human Services, and Housing and Urban Development, the National Science Foundation and other federal entities, as well as research undertaken by regional, state and local workforce agencies and philanthrophic organizations

Addressing the Health Needs of an Aging America: New Opportunities for Evidence-Based Policy Solutions

This report systematically maps research findings to policy proposals intended to improve the health of the elderly. The study identified promising evidence-based policies, like those supporting prevention and care coordination, as well as areas where the research evidence is strong but policy activity is low, such as patient self-management and palliative care. Future work of the Stern Center will focus on these topics as well as long-term care financing, the health care workforce, and the role of family caregivers

Investing in People

Foundations have long created programs to provide grants to individuals—most often in the form of fellowships, scholarships, and prizes. Several of these programs have become so prominent that they are now institutions in and of themselves. Consider just a few examples: the Pulitzer Prize, Fulbright Program, and MacArthur "genius" awards. Governments, as well as foundations large and small, fund individual support programs.The Robert Wood Johnson Foundation has generously allowed the authors of this report to examine its portfolio of individual support programs to explore what the authors believe are some of the strategic fundamentals underlying this type of programming that could be applied to future individual support grantmaking. The purpose of this study is to inform those interested in individual support programs about not only some of the strategy considerations underlying this type of grantmaking but what these programs can be expected to achieve—and under what circumstances.

Listening to patients: How understanding health information use can contribute to health literacy constructs

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/83167/1/14504701159_ftp.pd

Reconnecting the Patient: Why Telehealth Policy Solutions Must Consider the Deepening Digital Divide

This Article attempts to untangle the complicated web of providing telehealth to those populations it is potentially capable of further alienating from access to healthcare including: 1) race/minority populations, 2) aging adults, 3) individuals with disabilities, 4) non-English speakers, 5) individuals living in rural areas, 6) socioeconomic class, and 7) children, in order to advance the argument that telehealth can be successful in providing healthcare access to these populations. Rather than suggesting that telehealth simply “cannot work” for these populations, instead this Article considers how telehealth can and must meet the needs of these individuals through technology, access, and policy developments. First, this Article explains how telehealth is defined and how the definition has and can continue to influence policy development. Next, this Article explores the issues surrounding the “digital divide” and how this relates to telehealth use. Then this Article discusses how access to technology impacts particular populations. This Article then considers legislation and policy developments both at the federal and state level that have emerged thus far that could help overcome challenges of accessibility, affordability, and usability. Finally, this Article offers policy recommendations for ensuring that the delivery of telehealth can be accessible to those populations with potentially less access to technology to ensure telehealth’s successful availability and use for these populations can continue beyond Covid-19

Telehealth Utilization among Low Income Population during COVID-19: An Analysis of COVID-19 Research Database

The COVID-19 Research Database is a public data platform. This platform is a result of private and public partnerships across industries to facilitate data sharing and promote public health research. We analyzed its linked database and examined claims of 2,850,831 unique persons to investigate demographic, socio-economic, and behavioral causes for telehealth utilization in the low-income population. Our results suggest that patients who had higher education, income, and full-time employment were more likely to use telehealth. Patients who had unhealthy behaviors such as smoking were less likely to use telehealth. Our findings suggest that interventions to bolster education, employment, and healthy behaviors should be considered to promote the use of telehealth services