HIT for Consumers in Communities of Color:

1. HIT for Consumers in Communities of Color: Strategies to "Leapfrog" Disparities in Access, Adoption and Use Presented by: Panelists: Ruth T. Perot, Managing Director, NHIT Danielle Brooks, Policy/Research Consultant, NHIT Cynthia Solomon, President, Follow Me, Inc. Thomas Maguire, Director, Public Policy, Verizon Communications Ho Tran, MD, President/CEO, National Council of Asian Pacific Islander Physicians; Member, NHIT National Advisory Council November 15th, 2013

2. Webinar Overview • This webinar is the third in a 2013 series that highlights the impact of HIT on • the underserved and health disparities. The National Health IT Collaborative for • the Underserved (NHIT) works in partnership with organizations and individuals • to assure that providers and consumers, with a focus on communities of color, • benefit from HIT advances and resources.

3. Webinar Objectives • Understand current patterns/trends for HIT access, adoption and use in COCs • Identify barriers to engagement among people of color • Discuss strategies/options to overcome these barriers • Learn about promising/best practices to engage consumers of color in HIT • Present and discuss recommendations to build on current trends and successes

4. Webinar Support • Webinar Co-Sponsors • National Council of Asian Pacific Islander Physicians • National Medical Association • Today’s Presenters • Webinar Participants • NHIT National Advisory Council • NHIT thanks the Office of Minority Health, U.S. Department of Health and Human Services, that provided support for the research conducted for this webinar.

5. Promoting Consumer Engagement and Empowerment through the Adoption and Use of Health Information Technology Tools in Communities of Color: An Overview Danielle Brooks, J.D. Policy/Research Consultant, NHITIndependent Consultant, Amplify Public Affairs, LLC. Contact:djeanbrooks@gmail.com

6. Adoption and Use of Health Information Technology Tools in Communities of Color: Background • Literature review and environmental scan of the adoption rate, use and outreach of HIT tools in communities of color (COC). • Specifically, the document reviewed the use of personal health records (PHRs), patient portals, and mobile healthcare applications (MHCA) that consumers in COC use to engage in their personal health care management. • Research was conducted over the course of a five week period. • Online databases were assessed through publically available sites and select publications provided by organizations in the field. • Overall, research on adoption rate, use and outreach of HIT tools in COC is scant.

7. Statistics • By 2045 over half of the United States population will be a person of color. Latinos are the fastest growing minority population. • Despite population growth, members of these communities continue to experience worse health care outcomes. • PHRs, patient portals and MHCA have been proven to increase consumer engagement resulting in better healthcare outcomes for adopters. • Despite these realities, consumers in COC adopt PHRs and patient portals at a lower adoption rate than the general patient population. • However, members of the African American and Latino patient community are more likely to use MHCA than any other patient group

8. Barriers to the Adoption of PHRs and Patient Portals • Health literacy • Perceived use and effectiveness of the tool • Lack of provider adoption and use • Language barriers and immigration status • Trust • Technical infrastructure

9. Growing with Innovation: Leveraging the MHCA • MHCA have the potential to close the gaps in health care outcomes. • African Americans and Latinos are statistically more likely to use their phone for the sole method of gaining online information. • Of the MHCA used, African Americans (59%) were more likely than Latinos (51%) to track basic health indicators like diet, weight, and exercise. Latinos , however, were more likely than any other patient group to research health information on their mobile phone (25% for Latinos , 19% for African Americans and 15% for whites). • Further studies suggest MHCA have the potential to improve both the cost and efficiencies of healthcare in certain COC.

10. Recommendations • MHCA must be accessible to those with low literacy rates and available in multiple languages. Designing tools that use voice recognition and touch screen technologies will be crucial to the success and adoption of these tools. • Tools must be transparent and open about information use; why it is collected, who has access to it, and how it is used. • Tools must be accompanied by the appropriate training and outreach by providers in order to increase adoption and perception of the effectiveness of the tool. • Tools should be able to be tailored to individual preferences. Applications must be presented in a manner in which the consumer will both understand and engage.

11. Recommendations (Cont’d) • Trusted organizations with proven outreach capacity should be resourced to inform and educate COCs about the benefits of HIT for health improvement and consumer empowerment. • Pilot projects implemented by vendors in partnership with COC agencies to create and test MHCAs aimed at reducing/eliminating disparities in such areas as diabetes, hypertension and asthma. • Tools must be supported, endorsed, and paired with provider technology in order to provide coordinated care.

12. Cynthia Solomon President, Follow Me, Inc.

13. Meaningful Use MandateFacilitating Patients’ Active Management of Care • Meaningful Use Requirements Include Consumers • Reporting on Clinical Quality Measures • Patient and Family Engagement • Patient Safety • Care Coordination • Population and Public Health • Efficient use of Healthcare Resources • Clinical Processes/Effectiveness

14. MiVIAPatient Safety for Migrant Workers in Sonoma Valley • Focus on uninsured and transient populations lacking a medical home • Eliminates geographic barriers in primary, specialty and tertiary care • Patient education and advocacy tools • Members create their own personal HIE, sharing information between providers and family members

15. HealthShack™Patient & Family Engagement at WIND Youth Services in Sacramento WIND Youth Services Home HealthShack.info • Administrators • Outreach Workers • Youth Ambassadors Link via WIND Website Database Server HealthShack Website Web/App Server UC Davis Medical & Health Youth Members File Server • Content & Tools: • Resume Builder • Emergency ID Card • Trusted Resources • Website/Blog • Social Network Links • Video & Audio • Permissions& Consent HealthShack Website Doctors, Nurses, Therapists, Specialists • Member Data & Documents Input: • Health • Education • Employment • Housing Community Providers Link Via Provider Website (read-only access) Adult Advocates & Allies Funders: Sierra Health Foundation, UnitedHealth Group

16. Key Challenges for PHR Adoption • Technology • Overload in approach to 2014 • Interoperability • EMR Pushback • Literacy • Lack of awareness of PHRs • Consumer literacy lags ACA implementation • Sustainability • Funding to support community-level involvement • Monetizing product while maintaining trusted environment

17. Thank You! Putting a Face on Consumer Engagement CONTACT US www.altruit.com/healthshack

18. Technology: Transforming Health Care National Health IT Collaborative for the Underserved (NHIT) Webinar November 15, 2013 Tom Maguire, Verizon

19. Chronic disease is the most common, costly and preventable health problem in America. $3T 2013 $4.5T 2019

20. Health Care Access Challenges Access to Primary Health Care Will Further Constrict

21. Mobile Health Solutions Converged Health Management Virtual Visits Designed to provide clinicians with real time biometric data from patients’ connected devices so they can intervene and manage patient care with the goal of managing healthcare and decreasing costs Built to help reduce inappropriate ER use and extend clinical reach by providing a new point of service for members to connect with a clinician

22. Managing Chronic Care with Remote Monitoring : Converged Health Management

23. Virtual Visits 3 Virtual Visits 2 1 Verizon’s Virtual Visits is a mobile health solution that connects patients and providers for remote doctors visits when they need it. Using an application on a Smartphone/tablet, patients with simple ailments can be assessed remotely via interactive questionnaires and video conference. Customer advertises VV to theirmembers/employees Virtual healthcare consultations, leveraging multiple modes of communication – computer, tablet, phones Capture patient information,symptoms,and co-pay 4 5 Documentation of clinicalnotes and plan, includinge-prescribing of medications Visit Summary and receipt of payment April 3, 2011 Product Benefits: • Balance supply and demand of healthcare clinicians • Increases access to care • Controls healthcare costs • Enhance patient engagement Verizon’s Virtual Visits will provide an end-to-end solution to facilitate convenient, lower cost virtual consultation by a clinician, with electronic prescribing of medications

24. Policy Challenge: State Medical Licensure Remove State Licensing Barriers to Practice “Anytime, Anywhere” Telemedicine

25. Policy Challenge: Reimbursement The physician can only bereimbursed for services if: • His or her contact with the patient is a virtual face-to-face consultation • The patient is in an identified “Health ProfessionalShortage Area” • The patient is in a“medical facility”  Reform Outdated Reimbursement Rules to Advance Telemedicine

26. Q&A

27. Next Steps • Sponsor future webinars to share current information and successes from the field and foster exchange of views • Report forthcoming on “Promoting Consumer Engagement and Empowerment through the Adoption and Use of Health Information Technology Tools in Communities of Color” • Visit www.nhitunderserved. org

28. Ruth T. Perot Managing Director, NHIT rperot@shireinc.org Thank You! Contact Us: Luis Belen Senor Consultant, NHIT lbelen@MedicSuccess.com