A collaborative effort of students from Jacksonville Universties RN-BSN program

1. Informatics Role
in Decreasing
Healthcare
Disparities
Georgienne Gordon
Barbara Harris
Elke Houser
Melissa Hurt

2. Healthcare Disparities
Contributing Factors
 Medically underserved communities
 Economic Challenges
 Individuals with Disabilities
 Personal Behaviours
 Culture
 Education
 Language
Healthcare disparities are the differences in treatment of
a disease process, quality, access, outcome of
healthcare within a specific race, ethnicity or
socioeconomic group.

3. Information Technology and
Healthcare
 The mission of merging
Information Technology and
healthcare was designed to
promote patient safety,
improve the quality,
accessibility and continuity of
patient care by the
collection, integration and
analysis of data

4. Health Information Technology
for Providers
Electronic Health Record (EHR)
The electronic health record is the collection of health information
pertaining to an individual. The record contains medical history,
medications and allergies, laboratory and diagnostic studies,
immunizations and billing information. The importance of this record is
the capability of being shared different facilities for continuity of care
and in emergencies.
Computerized Provider Order Entry (CPOE)
The order entry system allows orders to be entered directly by the
healthcare providers. The goal is to promote and improve quality of
care and patient safety by eliminating illegible handwriting and
transcription errors. The system checks for order accuracy, speeds the
implementation of ordered diagnostic test and treatment modalities.

5. Health Information Technology
for Providers (continued)
Telemedicine
Telemedicine is the use of technology to consult, provide and
expedite health care services to distant facilities. Diagnostic
studies, x-rays, and EKG can be transmitted to remote testing
facility for interpretation. Having the capability of telemedicine
improves patient’s outcome by early detection, treatment and
consult if warranted
E-prescribing
Allows the provider to enter a prescription electronically to the
patient’s pharmacy. It ensures that the medication has been
ordered for the patient. The pharmacist and provider have the
ability to communicate regarding patients medication and
allergies.
Electronic Radiology Systems
A provider can schedule diagnostic tests, generate client
instructions and preparation procedures. The systems can
included order entry, scheduling, transcription of results, and
file room management.

6. EHR adoption rate for Medical
Offices
0%
10%
20%
30%
40%
Medical Offices
2009
2011
2012

7. Health Information Technology
for Consumers
 Personal Health Record (PHR)
The patient-oriented focus within the healthcare arena has
been on the role of the personal health record. PHR’s are
internet-based tools which enables the patient to
access, input, change or coordinate and control their health
information.

8. Health Information Technology
for Consumers (continued)
 Consumer Health Informatics (CHI)
Consumer health informatics is the use of internet-based and
electronic resources to educate and improve medical
outcomes and healthcare decision making for
patients, caregivers and consumers. The consumer has the
capability to retrieve information and recommendations
regarding diseases, medications and treatments.

9. Health Information Technology
for Consumers (continued)
 Social Media
The Social media is an emerging potent resource
among healthcare consumers. Advanced technology
allows people to interact socially online. 2004 was the
introduction of Web 2.0, this upgrade to the internet
increased the level or intensity of user interaction with
the technology.

10. Health Information Technology
Barriers
 Technology Gaps
 Lack of Insurance
 Data Collection

11. Technology gaps
 Exist among communities of
color, immigrants, those who do not
speak English well
 According to APIAHF, CPEHN, Consumers
Union & NCLR (2013) 55% of Latino and
58% of African American households have
home internet connection as compared
to 75% of White households.

12. Technology Gaps
 If they don’t have internet access at
home, they may consider using a public
computer such as at the public library but
my worry about the security of their
information on a public computer.
 If they do use a public computer to
access information, the websites being
used my not be user friendly for those
populations.

13. Lack of Insurance
 This is a barrier for the poor, immigrants, communities
of color and those who do not speak English well.
 These populations often do not seek medical
attention as often because they do not have
insurance.
 When they do they end up going from doctor to
doctor with medical records getting left at each
place and not having a complete record anywhere.
 They may seek medical attention at the emergency
room when the public health office where they
normally are seen is closed. This produces two sets of
records because the medical record does not follow
them from place to place.

14. Data Collection
 Physician’s offices and medical centers
are just beginning to collect information
on race, ethnicity, language and other
demographic information (APIAHF et
al, 2013) and store it in the patient’s chart.
 This information is important because
knowing this information will help the
medical staff provide more effective care
for the patient.

15. Health Information Technology
and Quality Improvement
 American Recovery and Reinvestment
Act of 2009
 Patient Protection and Affordable Care
Act of 2010
 Underlying causes of disparities

16. Recommendations for
Organizations
 Automate and Standardize collection of
race and ethnicity data
 Prioritization for identifying
 Focused HIT efforts to address
fragmentation of care
 Development of focused clinical decision
support systems
 Input from minorities and limited English to
develop HIT tool

17. Electronics and HIT
 Wireless Technology
 Text messaging
 Email
 Automated reminders via above

18. Clinical Decision Support
Systems
 Preventive Care
 Guideline adherence
 Electronic alerts, reminders or prompts for
facilitation of provider decision making

19. First steps
 Infrastructure
 Quality and cost of care
 Design to address and eliminate from
ground up

20. Improving Health Outcomes
 The Provider
The goal of informatics technology in the healthcare
field is to promote and improve patient safety. And that
means patient safety for all. Health care providers now
have the capability to retrieve and input data literally at
the touch of a button with the use of PDA's and other
mobile devices. The provider is able to provide safe and
timely care through EHR, mhealth, telemedicine and e-
medicine even while being away from the office. The
application allows the provider to communicate
through interpretation, written or verbal, for persons with
language barriers. Applications are also available for
consulting a physician for the patient who requires
additional care. Any changes to care is transferred to
the patient's EHR for updating.

21. Improving Health Outcomes
 The Consumer
With the use of PDA's, computers and other mobile
devices the consumer is able to receive
information, education and recommendations
regarding their disease process, medications and
treatments. Through the translation application
information can be readily transferred to the desired
language. Like the provider this information can be
available to the consumer with the touch of the
finger. Any changes to care is transferred to the
patient's EHR for updating.

22. References
Asian & Pacific Islander American Health Forum, California Pan-Ethnic Health Network, Consumers
Union, National Council of La Raza. (February 24, 2013). Equity in the digital age: How health information
technologies can reduce disparities. Retrieved from http://www.cpehn.org.
Gibbons, M. (2011) Use of health information technology among racial and ethnic underserved
communities, Perspectives in Health Information Management, Winter 2011. Retrieved from Pubmed
Central, website: http://www.ncbi.nm.nih.gov.ju.idm.oclc.org/pmc/artices/pmc30358301
Hebda, T. And Czar , P. (2013). Handbook of Informatics for Nurses and Healthcare Professionals (5th
edition). Upper Saddle River, NJ. Pearson.
Hsiao, C., Jha, A., King, J., Patel, V., Furakawa, m. and Mostashari, F. (2013), Office based physicians are
responding to incentives and assistance by adopting and using electronic health records, Health
Affairs, August 2013 32: 1470-1477 , doi:10.1377/hlthaff.2013.0323
Lopez, M.D., M.P.H., L., Green, M.D., M.P.H., A. R., Tan-McGrory, M.S.P.H., M.B.A., A., King, M.D., M.P.H., R., &
Betancourt, M.D., M.P.H., J. R. (2011, October). Bridging the digital divide in health care: The role of health
information technology in addressing racial and ethnic disparities. The Joint Commission Journal on Quality
and Patient Safety, 10, 437-445.
What is Telemedicine?(2013)
http://www.news-medical.net/health/What -is-Telemedicine.aspx