The document discusses the need for eHealth equity as the U.S. healthcare system undergoes major technological transformations. It notes that technology is critical but that underserved communities face barriers to access and risk worsening health disparities. Specifically, it finds that minorities and those with language barriers or low incomes have less access to computers, internet and digital health tools. The document calls for national and local efforts to promote adoption of culturally appropriate technologies, educate underserved groups, and ensure no one is left behind in the transition to digital health.
2. Problem Statement
• The nation is in the midst of the most significant TRANSFORMATION of
the health care delivery system since the launch of Medicare.
• Successful transformation is dependent on TECHNOLOGY.
Technology is needed to:
– Improve health care access and outcomes
– Improve care coordination
Technology + MU = Reimbursement
– Monitor quality and outcomes
Technology + ACO = Payment
– Reduce health care costs
• There needs to be a concerted effort to make sure ALL providers
and consumers are READY AND ABLE to adopt changes and use
technology to achieve the national health care goals.
– If not underserved communities will continue to be underserved as a result
of the existing gaps in access to technology and quality care.
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3. eHealth Digital Divide
• BARRIERS to technology access are similar to the barriers to
health care equity:
– Affordability
– Availability
– Appropriateness
– Community Based or Cultural Appropriate
• Hispanics are two times LESS likely than their peers to register
for and use a PHR or patient portal.
– Source: Kaiser Permanente, March 2011,Washington DC Roundtable
on Health Equity
• 72% of the new Medical enrollees will be from communities of
color and 40% of those eligible for health benefit exchange will
not speak English very well.
– Source: CEPHN, March 2012, Health Equity Forum
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4. eHealth Digital Divide
• Low income Californians are less likely (49%) to use the
internet to get health or medical information
• 35% of low income Californians have no computers or
access to internet at home
• The majority of low-income individuals have phones that are
not smartphones (53%)
• Asians have lower access to internet using cell phones
(41%) than blacks (57%) and whites (43%)
• Asians have the second highest rate broadband access at
home (76%)
PPIC 2011 Statewide Survey: Californians & Information Technology
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5. What’s needed at the national level?
• Consumer eHealth policy that
focuses on (1) eliminating health
disparities, (2) promotes eHealth ACCOUNTABLE CARE
among consumers/patients, and (3)
the development and adoption of
MEASURES
universally designed and multilingual
tools
Patient Experience
Care Coordination
Patient Safety
• Coordinated eHealth plan that
Communities
Preventive
addresses the diverse needs of
At Risk
Health
underserved communities, including
providers and patients in or
representing underserved
communities and how they access
technology.
• Advocates for the underserved who
are well-versed in eHealth policy and
grassroots organizing.
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6. What’s needed at the local level?
• Education and awareness of how Consumer eHealth initiatives will
impact underserved communities.
• Strategies and initiatives that ensure no one is left behind during the
transformation from paper to electronic, including providers and
patients.
• Resources aimed at . .
– promoting the adoption of culturally appropriate, consumer friendly, universally
designed tools and
– at educating, convening, and ensuring alignment on key issues impacting the
underserved.
• Highly skilled workforce willing to work in Community or Rural
Hospitals, Health Centers and Clinics, and other places that serve the
underserved.
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7. Opportunities for Achieving eHealth Equity
Assessment Assess the needs of underserved communities that could be addressed through the
advancement of health information technology.
Assess the capacity of existing programs to meet community needs and to address
disparities, health promotion and wellness.
Facilitation Facilitate better coordination and collaboration between entities that seek to improve
care , reduce disparities , and promote prevention using technology.
Facilitate the development and adoption of consumer ehealth strategies by
collaborators and partners that incorporate the needs of the underserved
community.
Consultation Advise technology partners, funders, community organizations, government entities,
and others on implementation of their consumer ehealth strategy.
Advise community health organizations on the latest advancements in HIT, HIE, and
consumer ehealth initiatives in order to help them meet their strategic goals.
Investment Invest in technologies that impact underserved communities (e.g. innovative mobile
applications-devices; care coordination-management tools; transparency-
educational websites; telehealth -medicine projects.
Invest in opportunities that support the HIT workforce in underserved communities
and policy and leadership development among community health workers and
advocates.
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8. ZeroDivide eHealth Equity Objectives
Underserved consumers & their health providers:
Use eHealth tools to reduce health disparities
Use eHealth to increase access & coordination of care
Use eHealth to empower consumers in their health &
wellness
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