1. Health Care RoI from Digital Inclusion Partnerships
May 17, 2017
Amy Sheon

2. Overview
Why digital inclusion in health care?
What can be done?

3. Disparities Why is it important? By demographic group By geography
Other
Digital inclusion is about HEALTH before care;
Prevent widening of disparities from digital inequalities

4. Disparities in Health Outcomes & Behavior
Diabetes
Obesity No Phys Activity
High Blood pressure

5. Socioeconomic Disparities in Cleveland
% with 10 MBPS Internet
% <125% poverty
%Black %Unemployed

6. What the Health does Internet have to do with it?
Appointment Scheduling
Track/monitor
Renew Prescriptions
Health
ed/info
View lab results
Message provider
Reminders
Telehealth
Sign up for /update insurance
Social support network
Comparison shop for meds
Connect with community services
INTERNET, TRAINING
Other gov’t benefits
Request transportation
Learn about research studies
Find healthy food, cooking tips, nutrition info
Provide data
Find recreation
Portal
Skills
Equipment
Content
Access

7. What the Health does Internet have to do with it?
Appointment Scheduling
Track/monitor
Renew Prescriptions
Health
ed/info
View lab results
Message provider
Reminders
Telehealth
Sign up for /update insurance
Social support network
Comparison shop for meds
Connect with community services
INTERNET, TRAINING
Other gov’t benefits
Request transportation
Learn about research studies
Find healthy food, cooking tips, nutrition info
Provide data
Find recreation
Portal
Skills
Equipment
Content
Access

8. MetroHealth System
Via David Kaelber/Better Health Partnership

9. Patient Portal Participate in research; update health status
Caregiver proxy access

10. Estimated Savings by Function
Saving per year
Author’s calculations from Kaelber 2015 and personal communications; Perzynski 2017

11. Low Levels of MyChart Use at MetroHealth

12. MyChart Disparities by Ethnicity and Age
Perzynski, et al 2017

13. MyChart Use by Broadband Access
Perzynski, et al 2017

14. Cleveland/MetroHealth Approach
Identify functions of value
Assess patient skill level and connectivity
Refer for comprehensive skill training & connectivity
Dig inclusion experts train CHWs to provide basic portal training

15. Assumption: Population by Skill Level
29%
19%
31% 8%
29%

16. Assumption: Acceptance of Training

17. Projected Training Costs
@$24/hr
@$14/hr

18. Potential Impact of Digital Skill Training on Disparities in Portal Adoption

19. Taking the model to scale
Testing universal screening for digital skills and connectivity
At MetroHealth
At United Way
Test using Community Health Workers to screen and refer
If successful: city agencies assess digital skills & connectivity?

20. References
Horrigan, John B “Lifelong Learning and Technology.” Pew Research Center.
Kaelber, David “MetroHealth Core Case Study for Davies Award: Return on Investment Financial Value: Historical Ambulatory EHR ROI.” Application for Davies Award. Cleveland, OH: MetroHealth System. df.
Perzynski, Adam T., Mary Joan Roach, Sarah Shick, Bill Callahan, Douglas Gunzler, Randall Cebul, David C. Kaelber, Anne Huml, John Daryl Thornton, and Douglas Einstadter “Patient Portals and Broadband Internet Inequality.” Journal of the American Medical Informatics Association. Accessed April 14. doi: /jamia/ocx020.
Wassef, Michael A, Bret Wagner, Joshua Russow, and David C Kaelber “Personal Health Record Self-Scheduling by Patients Decreases No-Show Rates and Operational Efficiency in Primary Care and Specialty Follow-Up Visits.” presented at the American Medical Informatics Association, Chicago, November

21. Thank You! With thanks to:
Amy R. Sheon, Ph.D., M.P.H.
Executive Director, Urban Health Initiative
Case Western Reserve University School of Medicine case.edu
Healthdatamatters.org
HDM.livestories.com
With thanks to:
Adam Perzynski & David Kaelber (MetroHealth)
Bill Callahan (Connect Your Community)
Wanda Davis (Ashbury Senior Computer Community Center