needs, barriers, and opportunities associated with using health it: a personal perspective...
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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
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
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
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
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
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!
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
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
My Opportunities…
• Integrate day-to-day medical care• Continue to make Health IT a multi-way street• Integrate across other devices
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
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
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
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
THANK YOU!
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