Population Health Engaging Consumers, Providers, and Community in Population Health Programs Welcome to Engaging Consumers, Providers, and the Community in Population Health Programs. This is Lecture d. Lecture d This material (Comp 21 Unit 8) was developed by Johns Hopkins University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number 90WT0005. This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/. Health IT Workforce Curriculum Version 4.0

Engaging Consumers, Providers, and Community in Population Health Programs Learning Objectives — Lecture d Recognize and relate health information technologies’ capabilities, users, and purposes. Describe informatics tools broadly and how they measure health program progress. The objectives for this lecture are to: Recognize and relate health information technologies’ capabilities, users, and purposes. Describe informatics tools broadly and how they measure health program progress. Health IT Workforce Curriculum Version 4.0

What Is HIT? HIT consists of an enormously diverse set of technologies for transmitting and managing health information by: Consumers. Providers. Payers. Insurers. All the other groups with an interest in health and health care. To go back to just some of the basics, HIT is a wide swath of both applications and systems. And they're designed to improve function for consumers, providers, payers, insurance, and many other people engaged in health care. Health IT Workforce Curriculum Version 4.0

What Are the Various Components of HIT? — 1 Applications: Patient registries. Accounting/practice management systems (PMS). Computerized physician order entry with clinical decision support (CPOE/CDS). E-prescribing. Electronic medical/health records (EMRs/EHRs). Patient health records (PHRs). What are the various components of health information technology that might be relevant to a population health program? Well, one is patient registries, sometimes called disease registries. So you may want to develop a program related to things like cancer, and there are cancer registries in most communities by law. As a matter of fact, almost in every community. And you'll see these sorts of registries. Vaccination registries are also common. So if you want to implement a program to increase the number of people getting flu vaccines or standard childhood vaccinations, if that's an issue in your community, you may do that. Another vaccine that recently became available is the human papillomavirus vaccine (HPV). Introducing a new vaccine and ensuring that enough people receive it as prescribed can be challenging. CPOE, or computerized order entry and clinical decision support, CDS, those may be for populations in a health system where you want the doctors to make specific recommendations to populations of patients with a common feature. An example of this would be diabetes. We often say that we'd like our diabetic patients to enroll in dietary programs, group support programs, or other sorts of monitoring programs. And the CPOE and clinical decision support together may help target that population more effectively as well as monitor some of the short-term processes and outcome variables and, in an ideal situation, the long-term health benefit. E-prescribing — medication compliance is a major issue for many programs in which they hope to get consumers the right medications at the right place at the right time. Electronic medical records (EMRs), electronic health records (EHRs), and patient health records (PHRs) are becoming more and more frequently used as part of population-based program interventions. So we may start to populate your patient health record — the health record that you as a consumer control — with information that you can use. Or we may ask you to populate it with information like your daily exercise or calorie intake so that we can better care for you. Health IT Workforce Curriculum Version 4.0

What Are the Various Components of HIT? — 2 Applications: Results reporting. Electronic documentation. Appointment scheduling. Patient kiosks. Telemedicine. Interface engines. Some of the other downstream applications are things like result reporting, electronic documentation, and appointment scheduling. Many health systems will design programs around appointment scheduling. A lot of times they're not getting as many patients into the health system as regularly as they should. One other thing they'll install in order to lower the barrier is a patient kiosk, so the patient can interact with a machine instead of a person and, hopefully, get information more quickly. And even telemedicine — there may come a day when you can simply sit at your computer and talk to your primary care physician, a nurse practitioner, or some other allied health professional about your current health status in real time. And that may lower the barrier of having to go to the office. Health IT Workforce Curriculum Version 4.0

What Are the Various Components of HIT? — 3 Process: Health information exchanges (HIEs). Regional health information organizations (RHIOs). Message passing interfaces (MPIs). HIPAA security. There are also features that are more environmental, such as health information exchanges. Health information exchanges allow providers in the exchange to pull up the medical records of consumers who aren’t their regular patients. So if a patient were injured and taken to a nearby hospital, providers would be able to access that patient’s medical records, even if that patient were not a member of the providers’ health system. And so you would go to the health information exchange or the regional health information organization to actually pull that in. There are also things called message passing interfaces, or MPIs. And there are HIPAA security concerns, but we won't go into those here. Health IT Workforce Curriculum Version 4.0

Why Is HIT Useful/Necessary? Health care delivery is inherently fragmented. Multiple providers/services and multiple payers. More than 360,000 care delivery sites in the United States. Inefficient or absent communication. Increased provider specialization. So why is HIT useful or necessary in programs designed to help communities get better health outcomes? Well, lots of times we rely on multiple providers and services. And IT can help to integrate some of those services in a more efficient way. That's the hope. Whether or not that's been realized is debatable. Health IT Workforce Curriculum Version 4.0

What Is the Ultimate Goal of Using HIT? To improve the quality of health services and outcomes for all patients. Not only to collect data. Data used to track, alert, and manage. Individual patient outcomes. Population health outcomes. Improve overall care of all patients. So what is the ultimate goal of population HIT? Well, it's to improve the quality of health outcomes for all patients. You hear about big data so that we can study more patients more quickly. It's not just to collect data, it's to provide tracking and messaging. So if you're missing, for example, refilling your drug prescriptions, you may get an alert that helps you remember to keep taking a prescription that may have great benefit. And that's for individuals. It may also help whole classes of populations by bringing them together in online consulting groups, et cetera. Health IT Workforce Curriculum Version 4.0

Health information technologies’ capabilities, users, and purposes. Engaging Consumers, Providers, and Community in Population Health Programs Summary — Lecture d Health information technologies’ capabilities, users, and purposes. Informatics tools broadly measure health program progress. This concludes Lecture d of Engaging Consumers, Providers, and Community in Population Health Programs. In this lecture, we discussed the various components of health information technology that might be relevant to a population health program, including: Health information technologies’ capabilities, users, and purposes, and How informatics tools broadly measure health program progress. Health IT Workforce Curriculum Version 4.0

Engaging Consumers, Providers, and Community in Population Health Programs Unit Summary Lecture a: population health programs’ key constituents, including a description of constituencies’ needs and goals, and analyzing constituents’ competing objectives. Lecture b: comparison of behavior change models. Lecture c: evaluation of individual, organizational, and community-level behavior change interventions’ designs. Lecture d: components of health information technology, including HIT’s capabilities, users, and purposes, and how informatics tools broadly measure health program progress. This concludes Engaging Consumers, Providers, and the Community in Population Health Programs. This unit includes the following lectures and corresponding topics: Lecture a: population health programs’ key constituents, including a description of constituencies’ needs and goals, and analyzing constituents’ competing objectives. Lecture b: comparison of behavior change models. Lecture c: evaluation of individual, organizational, and community-level behavior change interventions’ designs. Lecture d: components of health information technology, including HIT’s capabilities, users, and purposes, and how informatics tools broadly measure health program progress. Health IT Workforce Curriculum Version 4.0

Engaging Consumers, Providers, and Community in Population Health Programs References — Lecture d Buntin, M. B., Burke, M. F., Hoaglin, M. C., & Blumenthal, D. (2011). The benefits of health information technology: A review of the recent literature shows predominantly positive results. Health Affairs, 30(3), 464–471. Ford, E. W., Boyer, B. T., Menachemi, N., & Huerta, T. R. (2014). Increasing hand washing compliance with a simple visual cue. American Journal of Public Health, 104(10), 1851–1856. Jha, et al. (2008). The use of health information technology in seven nations. International Journal of Medical Informatics, 77(12), 848–854. No audio. Health IT Workforce Curriculum Version 4.0

Population Health Engaging Consumers, Providers, and Community in Population Health Programs Lecture d This material (Comp 21 Unit 8) was developed by Johns Hopkins University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number 90WT0005. No audio. Health IT Workforce Curriculum Version 4.0