1. Needs, Barriers, and Opportunities Associated with Using Health IT: a personal Perspective Accessibility and Usability in Health Information Technology (HIT): A Research and Action Conference to Empower People with Disabilities, Older Adults, and Caregivers September 17, 2015 Jeromie Ballreich

2. About me… Suffered a spinal cord injury (C4/C5) and near drowning March 13, 2005. Diagnosed quadriplegia Quadriplegia makes me an user of health information technology

3. About me… now PhD student at Johns Hopkins University Lives with my girlfriend and cat Require care from multiple providers on outpatient basis Require home caregiver Economist perspective: $2 million in healthcare expenditure since my accident

4. What is Health IT to me? My health record Health history Hospitalizations in Miami, Philadelphia, Hershey, Central PA, and Baltimore Surgical history Past medications Past conditions Current medications Current conditions Transfers responsibility of remembering and knowing from me and providers to the EHR Ideally, my EHR can better inform providers

5. How I currently use Health IT? Student at Johns Hopkins University, Baltimore, but is Pennsylvania resident Johns Hopkins Health System for most health needs, but not ALL PCP (Geisinger Health System) in Pennsylvania for certain health needs Both Hopkins and Geisinger use EPIC, but not integrated Not integrated within Hopkins Some specialists/affiliates operate independently Student health services separate

6. How I interact with Health IT? I can access via online portal, but infrequently… Review my scripts Message provider Schedule/review appointments See lab results Static to dynamic Regular PCP check-up ICD-9 diagnosis (quadriplegia) triggered a bone density scan Mychart.hopkinsmedicine Preventive medicine alert!

7. My Needs… Document information from multiple providers EHR better reflect my true health record Reduce my time filling out health status forms Focus on the “chronic” part of my condition Provide me a platform to LEARN about my health COMMUNICATE with providers VIEW my health

8. My Barriers… Not interoperable Too many systems (health systems, pharmacies, providers) Too many EHRs for me Not fully embraced by all providers Rarely receive communication from some providers Rarely discussed or mentioned in visits Not integrated with other services Think outside of traditional healthcare

9. My Opportunities… Integrate day-to-day medical care Continue to make Health IT a multi-way street Integrate across other devices

10. Opportunity: Day-to-day Medical Care (1/2) Quadriplegia is not my main health concern, but all the “side effects” are. “Side effects” requires day-to-day medical care Poor circulation, paralysis, and lack of feeling means I am susceptible to pressure ulcers Day-to-day medical care starts with me and my caregiver Recent heel pressure ulcer May 7, 2015

11. Opportunity: Day-to-day Medical Care (2/2) Day-to-day medical care is the responsibility of my caregiver and I, but we are often not medical professionals Use Health IT to extend traditional healthcare to the home Augment day-to-day care with a trusted source of information Integrate with insurers and providers Take the “prescription platform” and extend to all medical equipment, supplies, and care

12. Opportunity: Multi-way Street Information should go both ways for ALL participants Example Imagine uploading a picture of my ankle pressure ulcer Get timely advice by a provider without going to them physically Document the “little” issues Secure and safe

13. Opportunity: Other devices Phones, tablets, computers are all platforms to access Health IT Devices offer more than just access to a Health IT system Document biometrics (watches, other wearables) Apps can improve creativity and accessibility My concern is safety and privacy

14. THANK YOU!