HealthShack.infoThe door is always open…

HealthShack.infoPRESENTERS:

• Aaron Amos, Kevin Johnson - Youth Health Ambassadors

• JD Rudometkin - HealthShack Project Manager

• Catrina Virata, MPH - UC Davis HealthShack Data Evaluation Team

• Tirza Cannon - HealthShack Resource Liaison

HealthShack.infoCOMMUNITY PARTNERS:

• WIND Youth Services• Follow Me Inc.• Linkage to Education• Sierra Health Foundation• CSU Sacramento - Division of Nursing • Youth & Young Adult Clinic at UC Davis Children's Hospital

•Web-based

•Secure & HIPAA compliant

•Youth-friendly tools & resources

•Social networking

What is HealthShack.info?HealthShack.info is a youth-controlled,interactive, online

Personal Health Information System (PHIS). Designed forand by marginalized and homeless youth.

Personal Health Information System (PHIS)

• Stores health information• Provides health information and resources• Youth client portal for updates and personal use• Clinician portal for professional entry• Youth-controlled confidentiality• Private

Why a PHIS is Important for Marginalized Youth

• Medical records are non-existent or stored in a variety of places

•Youth lack acceptable forms of identification

• Gives youth a sense of stability and responsibility

• Inconsistent or non-existent medical care

• Lack of medical home, continuity of care

• Gaps in preventive services

• Youth do not have safe place to keep important documents including medical history

The Goal of HealthShack.info:

To improve the holistic health of marginalized and homeless youth by:

• Facilitating the continuity of medical care

• Encouraging self-empowerment

• Linking youth to local, youth-approved resources

How did HealthShack.info Begin? HealthShack.info began as an expansion and adaptation of

MiVIA - a patient “owned” Personal Health Record originally designed by Follow Me, Inc. for migrant agricultural workers.

Funding:• Initial - Sierra Health Foundation • Secondary - United Pacific Care

Development:•Focus Groups - assessing the needs of homeless and marginalized youth

•Follow-up Interviews - how to adapt MiVIA to homeless and marginalized youth population

•Recruitment of Youth Health Ambassadors

WIND Youth Services"WIND Youth Services engages youth experiencing homelessness who need safety from the streets and access to resources to help them move from crisis to healthy functioning and independence."

Serves marginalized and homeless transition aged youth in Sacramento, CA

Provides individualized case management services with the goal of assisting youth in gaining their independence

Health Ambassadors

• Formally marginalized and previously homeless youth ages 16 to 22

• Expert advisors • Link to youth

• Add “youth” legitimacy

• Examples of positive change

Keeping a youth’s perspective in the development of HealthShack.info

What We Do…• Recruit youth to HealthShack.info

• Explore & Research Resources

• Site Visits

• Videos

• Blogs

• Participate in Community Collaborations and Events

Commonly Addressed Youth Concerns

• Intake is a doctor’s appointment • It’s not confidential • Don’t feel comfortable talking to the Public Health Nurses

• Worried about the time an intake will take

• Feel that HealthShack is “just another program that doesn’t do any good”

• Don’t recognize the benefits beyond linkage to health care.

Public Health Nurses• PHNs Assist youth with creating a HS account

• Perform a comprehensive health and health-needs assessment• Enter personal data• Inform youth about confidentiality issues relating to healthcare and self-management of health records.

• Identify gaps in preventive services and acute care needs

A consistent link to health services & an advocate for health needs

• Provide health assessments, health education, and confidential health counseling on an on-going drop-in basis • Coordinate care with WIND staff, community clinics, and other local health and service resources • Advise on health related issues for HealthShack.info development

• Follow-up visits with youth

Clinician Patient Record

Personal Information

Confidentiality Controls

http://www.healthshackresources.info/

HealthShackResources.info

HealthShackResources.info• Health Ambassadors identify & assess local

resources

• Presentation of resource (pick one to link to)–Write up–Videos –Pictures

• Philosophy–Include “first-steps”–Determine youth-friendliness–Utilize existing assets

Additional Features• Blog

– Add link/screen for presentation

• Physician’s Tip–Add link for presentation - show video clip?

• Social Networking– Facebook– MySpace

• Resume Builder– Add screen shot for presentation

Ongoing Research & Evaluation

Male Female

Total 67 66

Demographics

Age9 - 13 14 - 17 18 -21 22 - 25 >25

Total 17 47 57 8 4

Gender

Enrollment: 133

Screened for Interview & Completed Initial & Follow - Up Interviews

Screened Completed Initial

Completed Follow-Up

Total 62 27 16

Data as of 02/04/2010

Ongoing Research & EvaluationData as of

02/04/2010

Gender

Enrollment: 77Demographics

Male Female

Total 67 66

Age

9 - 13 14 - 17 18 -21 22 - 25 >25

Total 17 47 57 8 4

RaceNot Identified

African American

Asian CaucasianHispanic/ Latino

Other

Total 2 31 4 21 10 9

Ongoing Research & Evaluation

Medical & Health BackgroundData as of 02/04/2010

Medical Insurance StatusWithout Insurance

With Insurance

Unknown Status of Insurance

Total 21 33 23

Medical Insurance Providers

AetnaBlue Cross Medi-Cal

Family PACT

KaiserKaiser Medi-Cal

Medi-Cal Tri-West

Total 1 5 1 3 3 19 1

Primary Care Physician Status (PCP)

Without PCP With PCP Unknown Status of PCP

Total 18* 19 40

* 4 clients were referred to PCP & 2 declined referral. 3 clients were not referred to PCP

Ongoing Research & EvaluationData as of

02/04/2010

Medical Services Received by Client in Past 12 Months

PCP Preventive Care

Mental Health

Emergency Room

Total 10 12* 3 5**

Medical Services Received by Client in the PastMental Health Dental Care

Total 8* 8**

Knowledge of Immunization Records (IR)

Don’t Know Where IR is

Know Where IR is

Unknown Status of IR

Total 16 15 45

Medical & Health Background

* 6 from PCP, 4 from a clinic, 1 from dental office, 1 from Juvenille Hall** # of visits ranged from 1 - 3

* 3 clients received services in past 12 months** 3 had dental insurance, 1 reported dental insurance - but received no services

Remaining Challenges• Youth remembering login and password

• Not using a wallet, no place to put ID card

• Having consistent health care services to refer youth to

• Educating local health care providers about HealthShack.info

Future Directions• Youth and provider education and training on how to utilize HealthShack.info • Outreach to vulnerable youth prior to exiting systems (emancipating foster youth and probation youth) • Expansion to other communities

• Creating an online community

Acknowledgments• Jasmine Edwards & Vivek Anand (WIND Youth Services - Health Ambassadors)

•Elizabeth Miller, MD, PhD (UC Davis School of Medicine)

• Ellyne Bell, Uylous Ingram, Youth Advocates (WIND Youth Services)

• Diane Littlefield (Sierra Health Foundation)

• Kim Whitney, Michelle Dang (Public Health Nurses)

• Cynthia Solomon, Heidi Stoval (Follow Me)