Novel Approaches to Addressing Health Disparities & Social - - PowerPoint PPT Presentation

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Novel Approaches to Addressing Health Disparities & Social - - PowerPoint PPT Presentation

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Novel Approaches to Addressing Health Disparities & Social Determinants of Health HEALTH EDUCATORS INSTITUTE CONFERENCE AMY R. SHEON, PHD, MPH EXECUTIVE DIRECTOR URBAN HEALTH INITIATIVE DisclosureAmy Sheon President and CEO, Public

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Novel Approaches to Addressing Health Disparities & Social Determinants of Health

HEALTH EDUCATORS INSTITUTE CONFERENCE AMY R. SHEON, PHD, MPH EXECUTIVE DIRECTOR URBAN HEALTH INITIATIVE

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Disclosure—Amy Sheon

President and CEO, Public Health Innovators, LLC: provides consultation to health systems, governments, philanthropic, corporate, non-profit and academic clients around digital health equity and innovation. Funding Contracts Through Case Western Reserve University:

  • Public Insight Data: Health data visualization Subject Matter Expert
  • NODE.Health/Uber Health (Evidence Base for Mobile Health)
  • Ohio Department of Medicaid (Virtual Reality SDOH Simulation)
  • Office of Cuyahoga County Executive, via Connected Insights, re digital

connectivity and health

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Learning Objectives

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Demonstrate novel data visualization techniques including mapping and storytelling to increase understanding of social determinants of health (SDOH) Describe potential value of digital medicine for public health Describe disparities in digital skills and connectivity, and frame them as a social justice issue Describe use of public health data in a medical hackathon Demonstrate use of virtual reality to increase awareness of social determinants of health and increase empathy accuracy

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Part 1: Health Disparity Data Visualization

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https://www.healthdatamatters.org

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https://www.healthdatamatters.org/

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Rationale

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Provide single place for accessing definitive data on health outcomes and social determinants of health Bring focus on health disparities and health equity, esp place-based Encourage open data movement

Spawn innovation through real-time data access

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Historic Lens: Redlining & Health

HOLC REDLINING, CIRCA 1930S

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http://guides.osu.edu/maps-geospatial-data/maps/redlining/

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Cuyahoga County: Health Status

LIFE EXPECTANCY, 2010-2015 % LIVING IN POVERTY

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Data source: Cuyahoga County Board of Health

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Power of Data Visualizations

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% BLACK

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Historic Lens: Redlining & Health

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R² = 0.1602

60 65 70 75 80 85 90

Years

Not Redlined Redlined

Redlining and Life Expectancy

Data source: Cuyahoga County Board of Health

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R² = 0.2138

50 100 150 200 250 300 350 400 450 500

Deaths/100,000

Not Redlined Redlined

Redlining and Cancer

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Part 2: Digital Medicine Technology to improve population health

AKA: Connected Health, Mobile Health

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https://www.medinaction.com/technology-revolutionizing- healthcare-the-future-is-changing-now/

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Participate in research; update health status Caregiver proxy access

What can you do with Digital Health Tools?

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7/31/2019 @AMYSHEON

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Low Levels of MyChart Use at MetroHealth

20,000 40,000 60,000 80,000 100,000 120,000 140,000 160,000 180,000 200,000

Do Not Use PHR Use PHR Number of Patients 70.9% 29.1%

N=243,248

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Journal of the American Medical Informatics Association, Volume 24, Issue 5, September 2017, Pages 927– 932, https://doi.org/10.1093/jamia/ocx020

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Public Health Lens: Look at Disparities

34.1 23.4 23.8

5 10 15 20 25 30 35 40

White Black Hispanic

30.2 25.1 16.1

10 20 30 40 18-64 years 65-79 years 80+ years

Perzynski, et al 2017

17.4% 26.5% 23.4% 39.3%

0% 10% 20% 30% 40% UNINSURED MEDICAID MEDICARE COMMERCIAL

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Public Health Lens: SocioEcologic Model of HIT Barriers

SEM Model Source: U.S. Centers for Disease Control and Prevention

Fed/State/Local broadband policies

Access to internet, training, care Provider workflow, policies

Trust, support, content, development

Language, usability, privacy, cost

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Up Upstream C Cause: e: M MyChart t Us Use b by B Broa

  • adband Ac

Acces ess

17.5 22.5 29.8 36.3 34.8

5 10 15 20 25 30 35 40

0 - 20% 20 - 40% 40 - 60% 60 - 80% 80 - 100%

% Using PHR

Census Tract Broadband Coverage % of total population

Perzynski, et al 2017

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Digital Divides As Social Justice Issue

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% With Broadband Internet

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CLEVELAND SCENE MAGAZINE

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http://guides.osu.edu/maps-geospatial- data/maps/redlining/

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% HH with no internet,

2017 ACS 5 year estimate

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% Black

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Digital Inclusion Framework

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% No Internet %HH Only Internet is Mobile

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Digital Divides Risk Widening Health Disparities

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% Has Cell Data Plan

Diabete tes P Prev evalence, e, B BRFSS 500 500 C Cities P Project 201 2015

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Computers and Broadband in Home, 7 Cities

40.0 50.0 60.0 70.0 80.0 90.0 100.0 2015 2016 2017

% of Adults with BA

40.0 50.0 60.0 70.0 80.0 90.0 100.0 2015 2016 2017

% of Adults 65+ Years

40.0 50.0 60.0 70.0 80.0 90.0 100.0 2015 2016 2017

% of HS Grads

40.0 50.0 60.0 70.0 80.0 90.0 100.0 2015 2016 2017

% of <HS Grads

40.0 50.0 60.0 70.0 80.0 90.0 100.0 2015 2016 2017

% of Unemployed Adults American Community Survey, 2015, 2016, 2017; analysis by Sheon. See: Health Data Matters LiveStories hdm.livestories.com

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Part 3: Digital Skills & Access as SDOH

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Digital Natives?

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% of Youth <18 with Broadband

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Digital Inclusion as a Social Determinant of Health

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Public Health Approach: Reframing

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“Digital Skills and Connectivity as Social Determinants of Health (SDOH)” panel

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Solution: Population-based approach

Screening, Brief Intervention, Referral to Treatment (SBIRT)

  • Screen all patients for digital skills and connectivity
  • Refer to community organizations to address gaps in

equipment, connectivity and basic digital skills

  • Train patients to use health apps
  • Train community health workers to screen, refer and train
  • “Train the Trainer” model; partner with local CHW training

programs

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Solution: Population-based approach

Screening, Brief Intervention, Referral to Treatment (SBIRT)

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Cembali, NDIA 2018 Digital Inclusion Net Summit

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Community Health Worker Model

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Addressing Disparities in Diabetes Management Through Novel Approaches to Encourage Technology Adoption and Use Amy R Sheon, Shari D Bolen, Bill Callahan, Sarah Shick, Adam T Perzynski JMIR Diabetes 2017;2(2):6751 How can health systems leverage technology to engage patients? Sheon AR, Carroll L. 2019

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Part 4: Bringing Public Health Perspective to Innovation

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Part 5: Bringing Innovation to Public Health: Neighborhood Immersion for Compassion & Empathy (NICE) VR Simulation for Medicaid Providers

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Thanks to:

Health Data Matters and Neighborhood Immersion for Compassion & Empathy teams:

  • Scott Frank
  • Matthew Kucmanic
  • Lauren Wooster
  • Alex Rothbaum
  • Bianca Wilson
  • Regime Willis

Live Stories (Adnan Mahmud) Global Health Metrics (Adam Perzynski) BioflightVR (Rik Shorten, Paul Suchy) CWRU Medicaid Equity Simulation Team

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Dan Quigg, Public Insight Data Digital Inclusion Partners:

  • Angela Siefer, National Digital

Inclusion Alliance (NDIA)

  • Bill Callahan, NDIA Policy Director

and Connect Your Community 2.0

  • Samantha Schartman, Connected

Insights

  • Adam Perzynski, MetroHealth

System

  • Wanda Davis, Ashbury Senior

Computer Community Center

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Questions

Amy.Sheon@case.edu @amysheon linkedin.com/in/amy-sheon-a1807212/

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