Encourage mixed-methods and participatory approaches to evaluating which health information is most relevant to clinicians and patients to improve health care decision-making. Personalised Health and Care 2020 is a strategy published by the National Information Board, outlining how the health and care system will use data and technology, to transform outcomes for patients and citizens in the coming years.. NHS Digital has an important part to play in this work. Kruse CS, Kothman K, Anerobi K, et al. In 2017, 17% of American adults used smartwatches or wrist-worn fitness bands38 that can sense heart rate, physical activity, and even atrial fibrillation (https://support.apple.com/en-us/HT208955). Washington, DC: The National Academies Press; 2014. To reduce health disparities, health IT must address SDHâthe conditions in which people are born, grow, live, work, and age.6 These include, but are not limited to, factors such as socioeconomic status, education, the built environment, employment, social support networks, and access to health care. 2016 Nov-Dec;82(6):972-980. doi: 10.1016/j.aogh.2016.11.006. However, adoption rates of such IT are lower in lower-income, rural, elderly, and populations with disabilities.39â42 Moreover, current mHealth technologies are available almost exclusively in English, and require high levels of consumer technical literacy to use and maintain. Community engagement, trust building, and partnership are the foundations of successful health IT interventions to reduce disparities. Health information technology (HIT) can support care delivery by providing various degrees of coordination. Pew Research Center. This website uses cookies. Partnering health disparities research with quality improvement science in pediatrics. Uniting the Vision for Health Equity through Partnerships: The 2nd Annual Dr. Elijah Saunders & Dr. Levi Watkins Memorial Lecture. 800-638-3030 (within USA), 301-223-2300 (international). The workshop examined patient, clinician, and system perspectives on the potential role of health IT in addressing health disparities. Health information technology, or HIT, refers to a system designed to store, share, and analyze the data collected in any healthcare facility. Improving communication with non-English speakers is another way that IT may be used to address health disparities.11 Computerized translation products might increase health literacy, safety, and patient engagement among non-English speakers. The role and function of the Municipal Health Services . From the beginning of the 1990s, the Information and Communication Technologies (ICTs)—driven by the rise and the success of the Internet—played a major role in improving the access, the efficiency, the quality, and therefore the effectiveness of any process related to healthcare. Using zip code-level mortality data as a local health status indicator in Mobile, Alabama. Proc SIGCHI Conf Hum Factor Comput Syst. Patients also increasingly use IT to track and manage their own health, and to participate in shared decision-making, although a substantial digital divide continues to characterize health IT use.1 Given the persistence of health disparities, it is critical to ensure that the benefits of advances in health IT serve to reduce, rather than inadvertently exacerbate, such disparities.2. 30. Lower-income Americans still lag in tech adoption. Big data science: opportunities and challenges to address minority health and health disparities in the 21st century. Health IT researchers and health care systems should build on lessons learned. The inclusion of community voices in the development of new technologies is vital to ensure adoption. Registered users can save articles, searches, and manage email alerts. Too little is known about the interplay between community characteristics and patient-reported social needs. Standardize data collection in EHRs and develop innovative technologies to capture new data on health disparities populations. The workshop examined patient, clinician, and system perspectives on the potential role of health IT in addressing health disparities. | Communicating with diverse patients: How patient and clinician factors affect disparities. Social determinants such as food insecurity, social isolation, and financial stress significantly impact health. Today, we have at our fingertips access to a variety of information and services to help us manage our relationships with the organizations that are part of our lives: banks, utilities, government offices — … Data on income, education level, country of origin, and SDH may then be linked to predict health care needs and outcomes. Health technology in Australia. Explore public-private and other partnerships to incentivize the creation and adoption of health IT to reduce health disparities. Too often, underserved communities are seen as consumers of health care rather than as potential producers of tools to improve health. The Electronic Medical Records and Genomics (eMERGE) Network: past, present, and future. 26. 2005;97:951â956. The leadership of health care organizations plays an essential role in managing the change that invariably accompanies the implementation of an IT application. 2010;12:3â16. Australia has a secure online health record system called My Health Record. Schinasi LH, Auchincloss AH, Forrest CB, et al. 36. Available at: 39. World Rev Nutr Diet. Available at: 40. 2020 Aug 20;4(8):e20679. Ann Epidemiol. This site needs JavaScript to work properly. 2015;5:4. Mobile health (mHealth) technologies could reduce disparities by providing relatively inexpensive, large-scale digital interventions to underserved populations. 8. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Ha JF, Longnecker N. Doctor-patient communication: a review. Demographics of internet and home broadband usage in the United States. Muller MJ, Kuhn S. Aspects of participatory designâresponse. For example, clinical decision support (CDS) systems can join information about evidence-based practices with digitized data on the patientâs history, values, and preferences to guide and support personalized patient care.17 EHR-integrated CDS can reduce errors due to bias, as well as reduce misuse and overuse of medical services. Researchers should identify and address deficiencies in health IT data exchange systems that may contribute to disparities, especially deficiencies related to privacy and security. Finally, given the vast ecosystem of (often incompatible) health IT systems supported by different commercial vendors, further research is needed to improve interoperability, data integration, and health information exchange, particularly in underresourced health care settings, such as community health centers, rural health centers, and small private practices. Linking with nonhealth social determinants will require strong interoperability across systems, including health care, mental health/substance use, foster care, housing, nutrition, etc. Attendees were asked to identify and discuss various health IT challenges that confront underserved communities and propose innovative strategies to address them, and to involve these communities in this process. 5. Clipboard, Search History, and several other advanced features are temporarily unavailable. Finally, to advance health IT and promote health equity, it will be necessary to record and capture health disparity data using standardized terminology, and to continuously identify system-level deficiencies and biases. A Digital Health Intervention for Weight Management for Latino Families Living in Rural Communities: Perspectives and Lessons Learned During Development. An integrative model of patient-centerednessâa systematic review and concept analysis. Scholl I, Zill JM, Härter M, et al. Improve coordination between IT users and IT developers; increase health IT training in primary care settings. This goal should guide what, how, and by whom standardized data are collected and what interventions are adopted. Registered users can save articles, searches, and manage email alerts. James A, Berkowitz SA, Ashburner JM, et al. Health systems should guard against exacerbating disparities by ensuring that the mHealth innovations they offer are cross-platform (Apple users average higher socioeconomic status than Android users43), come with sufficient user support, and are multilingual. Technology must play a central role for proposed health care reform to contain costs, improve access, and save lives. Ethn Dis. Kujala S. User involvement: a review of the benefits and challenges. Innovative technologies that capture new data streams will be most effective if data collection methods are standardized.2 The literature recommends which SDH data should be collected, but says little about the form such data should take, or on the data capture technologies and/or data protection methods needed to obtain such data in a way that can be used to address health disparities. Get new journal Tables of Contents sent right to your email inbox, June 2019 - Volume 57 - Issue - p S115-S120, https://www.hindawi.com/journals/jdr/2017/1348242/, https://jnd.org/community-based-human-centered-design/, www.statista.com/statistics/739398/us-wearable-penetration-by-age/, www.pewresearch.org/fact-tank/2017/03/22/digital-divide-persists-even-as-lower-income-americans-make-gains-in-tech-adoption/, www.pewresearch.org/fact-tank/2018/09/10/about-a-quarter-of-rural-americans-say-access-to-high-speed-internet-is-a-major-problem/, www.pewinternet.org/fact-sheet/internet-broadband/, www.pewresearch.org/fact-tank/2017/04/07/disabled-americans-are-less-likely-to-use-technology/, www.comscore.com/Insights/Infographics/iPhone-Users-Earn-Higher-Income-Engage-More-on-Apps-than-Android-Users, MLR_2019_02_02_ZHANG_MDC-D-19-00079_SDC2.docx; [Word] (29 KB), Role of Health Information Technology in Addressing Health Disparities: Patient, Clinician, and System Perspectives, Articles in PubMed by Xinzhi Zhang, MD, PhD, Articles in Google Scholar by Xinzhi Zhang, MD, PhD, Other articles in this journal by Xinzhi Zhang, MD, PhD, Equity in the Age of Health Care Information Technology and Innovation: Addressing the Digital Divide, Leveraging Advances in Technology to Promote Health Equity, Implementing an EHR-based Screening and Referral System to Address Social Determinants of Health in Primary Care, Measuring Exposure to Incarceration Using the Electronic Health Record. eCollection 2020. Venkatapuram S, Bell R, Marmot M. The right to sutures: social epidemiology, human rights, and social justice. may email you for journal alerts and information, but is committed Easy accessibility of service : Internet based companies find that internet makes offer of … Embracing digital … 2018;39:19. No conflict of interests from authors are reported. 2019 Feb 21;29(Suppl 1):193-200. doi: 10.18865/ed.29.S1.193. ADVERTISEMENTS: Role of Information Technology in Environment and Human Health! Clinicians with experience in informatics can help build trust with skeptical users, leading to more participant engagement, which might then translate into more successful IT projects.22 More research is needed to determine whether and how such approaches work in diverse clinical settings.23. Outreach to diverse populations to collect novel dataâsuch as on sleep, stress, and physical activityâusing mHealth technologies should adhere to emerging data standards (eg, Open mHealth) that are compatible with EHR data standards. 2015;3:85â95. Data should be collected in a way that is not disruptive, and researchers should provide results and feedback that are useful to patients. 3. 2016;23:407â412. Patients in contextâEHR capture of social and behavioral determinants of health. Participants noted the need for more research on how health IT can be used to evaluate and address the social determinants of health. Salihu HM, Wilson RE, King LM, et al. The workshop was a collaboration between the National Science Foundation and the National Health IT Collaborative for the Underserved. J Gen Intern Med. More research is needed to better understand the utilization of qualitative methods versus quantitative methods. All registration fields are required. Effective interventions must also be designed to be scalable and sustainable in health disparities populations. 2008;335:271â274. Disabled Americans less likely to use technology. 2014. Researchers may achieve more useful results employing mixed-methods that develop both qualitative and quantitative data.19,20 Qualitative methods can provide an in-depth exploration of the underlying causes of inequities in IT adoption and impact. Int J Med Inform. 2020 Oct 16;20(1):958. doi: 10.1186/s12913-020-05808-z. Community-level data might provide insights into these determinants. Novel, rapid-cycle, continuous evaluation research is needed to explore optimal approaches to collecting, integrating, and using social determinants data to effectively guide clinical care. EHRs in primary care practices: benefits, challenges, and successful strategies. Conclusions From the Workshop âAddressing Health Disparities Through the Utilization of. Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2. 2013;15:761â771. 2003;22:1â16. Funding of Hispanic/Latino Health-Related Research by the National Institutes of Health: An Analysis of the Portfolio of Research Program Grants on Six Health Topic Areas. Norman D, Spencer E. Community-based, human-centered design. However, differences in EHR encoding systems and data fragmentation across practices and institutions constitute barriers to analyzing these data. Mendelson, a vice-president with The Lewin Group, is an expert on state health policy with a strong background in strategic and regulatory issues surrounding health information technology. Genet Med. 25. Public health seeks to ensure that the benefits of medical advances are available to all, regardless of race/ethnicity or socioeconomic status. Health surveillance of premises. Castaneda C, Nalley K, Mannion C, et al. 10. It is also important to examine existing diverse data types, including EHR and nontraditional data sources, to see whether the data produced are biased in a way that may affect or limit our understanding of, or ability to intervene in, disparities reduction. 2017. Annu Rev Publ Health. The extent to which technology can be integrated into the workflow efficiently, effectively, and satisfactorily by clinical users is an area of concern for diverse practices24 and health care systems.25 The design of IT interventions must also account for clinician-patient communication.26 For example, the employment of medical scribes to enter data into the EHR, has had a positive impact on physician and patient satisfaction, as well as on provider productivity.27, The design and implementation of procedures, programs, and practices, including mobile health and telemedicine, that ameliorate health disparities can impact patient care, patient-physician interactions, and training.28 For example, chronic disease management and outcome may require specific strategies aimed at narrowing inequality as part of their fundamental design.29 Community involvement in design, implementation, and evaluation of such IT is recommended.30. Health Serv Res. Meeting people where they live will optimize health ITâs benefits and ensure that disadvantaged patients benefit from these advances. [Equity, intercultural approaches and access to information on traditional, complementary and integrative medicines in the AmericasEquidade, abordagens interculturais e acesso a informações sobre medicinas tradicionais, complementares e integrativas nas Américas]. 19. Some error has occurred while processing your request. Am J Med Sci. Screening for social determinants of health in clinical care: moving from the margins to the mainstream. This workshop highlights the promises of leveraging health IT to improve health outcomes in underserved populations and reduce health disparities. Using electronic health records for population health research: a review of methods and applications. Highlight selected keywords in the article text. The evidence is needed to determine how public-private partnerships could facilitate developing and using IT to enhance provider-patient interactions, and allow patients to self-report health data and participate in health care decisions.9 Research suggests that for such partnerships to succeed, authentic discussions of the objectives, roles, and expectations of all parties, along with potential conflicts of interest, are critical.10 All parties must be involved in a process of continuous learning and be willing to partner with others to meet the communityâs needs. The role of technology and physical aids in service delivery system are summarized below: 1. Harris DA, Pensa MA, Redlich CA, Pisani MA, Rosenthal MS. Ann Am Thorac Soc. Miller WL, Crabtree BF, Harrison MI, et al. For 24% of rural Americans, high-speed internet is a major problem. 34. Expanding public-private partnerships was emphasized, as was the importance of clinicians and IT developers partnering and using novel methods to learn how to improve health care decision-making. Furthermore, very little is known about which patient-level or community-level social determinants are associated with specific health outcomes in specific patient populations. For more information, please refer to our Privacy Policy. N Engl J Med. Open and continuous communication and shared decision-making between clinicians and patients through a health IT system is desirable. BMC Health Serv Res. Depending on their position, health IT professionals might build, implement, or support electronic health records (EHRs) and other systems that store patient-related data. Health IT success and failure: recommendations from literature and an AMIA workshop. doi: 10.26633/RPSP.2020.143. For example, the certification process provided by the Office of the National Coordinator (ONC) for health IT (http://www.healthit.gov/) increased IT adoption and meaningful use among rural providers. These summarized findings are based on scientific talks and discussions presented at the NIMHD-funded workshop âAddressing Health Disparities through the Utilization of Health Information Technology,â in Gaithersburg, Maryland. It also collects, organizes, and … Arrieta M, White HL, Crook ED. 2016;115:233â238. Efforts to address disparities should reflect the experiences of the affected populations, and the methods for doing so should themselves be respectful of the needs and customs of those populations. The potential uses of EHR data will only be realized with the accrual of data from diverse populations using standardized categories. Int J MCH AIDS. Having a My Health Record means your important health information including allergies, … J Diabetes Res. 2018;378:1291â1301. 2017;27:95â106. Pediatrics. Health IT innovations can give care providers more detailed information about their patients, enabling more precise, targeted treatment regimens. 2019 Jun;57 Suppl 6 Suppl 2(Suppl 6 2):S115-S120. N Engl J Med. Hosp Top. Behav Inform Technol. Encouraging the participation of affected communities by inviting community membersâ ideas and solutions is highly recommended. 2018. 2009;16:291â299. Participatory approaches to system development that engage physicians in designing new clinical IT tools21 have proven effective. These processes make up the ways and the context in which professionals and the public search for, understand, and use health information, significantly impacting their health decisions and actions. Ethn Dis. Please enable scripts and reload this page. Epub 2015 Jan 5. NIH 1993;36:18â1. Reprints: Xinzhi Zhang, MD, PhD, Division of Clinical Innovation, National Center for Advancing Translational Sciences, 6701 Democracy Boulevard, Room 915, Bethesda, MD 20892-4874. Hernandez-Aguado I, Zaragoza GA. Support of public-private partnerships in health promotion and conflicts of interest. PD-atricians: leveraging physicians and participatory design to develop novel clinical information tools. The authors are grateful to all the speakers, discussants, and attendees of the workshop. Five constants of information technology adoption in healthcare. A cluster-randomized trial of blood-pressure reduction in black barbershops. 2018;33:463â470. Historically, however, vulnerable communities have been slow to benefit from technological advances in health care.1 The needs and interests of health disparities populations point to the types of data that are most important to collect, and the types of study designs and IT interventions most suitable to these populations.3 Therefore, it is critical that researchers engage with community members early in research processes, and study designs should reflect community concerns. Integrating mixed methods in health services and delivery system research. Community engagement, cultural competency, and patient-centered care were highlighted as key to improving health equity, as well as to promoting scalable, sustainable, and effective health IT interventions. Ochsner J. eCollection 2020. Over the last decade, health information technology (IT) has dramatically transformed medical practice in the United States. Recent advances in health information technology (IT) hold great promise for improving health outcomes. A smart, ubiquitous electronic … 2016;4:e19. The next frontier in communication and the ECLIPPSE study: bridging the linguistic divide in secure messaging. Researching reducing health disparities: mixed-methods approaches. 2017. Kaplan B, Harris-Salamone KD. Lippincott Journals Subscribers, use your username or email along with your password to log in. 2020 Nov 11;44:e143. Andermann A. Commun ACM. Health information technology (HIT) is the application of information processing involving both computer hardware and software that deals with the storage, retrieval, sharing, and use of health care information, data, and knowledge for communication and decision making. Participants noted the need for more research on how health IT can be used to evaluate and address the social determinants of health. Brandon DT, Isaac LA, LaVeist TA. Stud Health Technol Inform. While the EHR is potentially a major source of actionable data, many practical concerns need to be addressed to ensure its use in this way, such as aligning the needs of health care providers and IT engineers; promoting trust in the EHR as a reliable source of data; and making EHRs more user-friendly to clinicians, patients, and researchers. Avilés-Santa ML, Hsu L, Lam TK, Arteaga SS, Artiles L, Coady S, Cooper LS, Curry J, Desvigne-Nickens P, Nicastro HL, Rosario A. The positive impact of technology in healthcare is clear. 2014;9:e107828. Over the last decade, health information technology (IT) has dramatically transformed medical practice in the United States. The authors declare no conflict of interest. Mudrick NR, Breslin ML, Nielsen KA, Swager LC. J Natl Med Assoc. 2016;37:61â81. NLM A qualitative study. Information Technology (IT) has the potential to improve the quality, safety, and efficiency of healthcare. Widespread use of health IT within the health care industry will improve the quality of health care, prevent medical errors, reduce health care costs, increase administrative efficiencies, decrease paperwork, and expand access to affordable health care. The findings and conclusions in this paper are those of the authors and do not necessarily represent the official position of the National Institutes of Health. Z99 TR999999/ImNIH/Intramural NIH HHS/United States. 15. Wolters Kluwer Health Author information: (1)Ashish Joshi, MD, PhD, MPH, is an assistant professor in the College of Public Health at the University of Nebraska Medical Center in Omaha, NE. Stakeholder-Centered approaches to system development that engage physicians in designing new clinical IT have. Community-Level social determinants of health IT Collaborative for the underserved the technical aspects of managing patient health information (! 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Rev Panam Salud Publica and health care needs and outcomes Author Institution... Manage email alerts Sarkar, MD, MPH for their critical comments for. As public clinics, hospitals, and manage email alerts must overcome from., Aldana-Martínez NS, Ghelman R. Rev Panam Salud Publica Vision for equity! Key recommendations are summarized in this paper focuses on the partnerships needed to ensure health... For Weight management for Latino Families Living in rural role of information technology in health services: perspectives and lessons learned development...
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