Slides by Rashi Venkataraman, Executive Director, Prevention & Population Health, AHIP, presented at eHI's December 4, 2018 Healthcare Data Governance Board Executive Roundtable on putting Social Determinants of Health Data into action.

A US National Study of the Association Between Income and Ambulance Response Time in Cardiac Arrest

Our analysis demonstrated that EMS responding to low-income communities had a lower likelihood of meeting 8-minute and 15-minute national benchmarks compared with EMS responding to highincome communities and showed that the mean EMS response time, on-scene time, and transport time were longer in low-income communities, even after controlling for observable differences. Given that whether or not a patient survives cardiac arrest can depend on a matter of minutes, even small delays in EMS response times may negatively alter patient outcomes. Our findings are disturbing given that poorer neighborhoods have higher rates of disease and other structural disparities in health care access that further compound their risk for worse outcomes. Our study shows that these structural disparities begin as early as the initial EMS activation and the resulting services, which is an area previously more traditionally administered by public services and considered less vulnerable to market forces. Recent trends in the financing and delivery of prehospital care suggest that these disparities are likely to worsen unless fewer economically driven forces are introduced. Understanding where gaps exist can help guide improvements in policies and develop interventions to address prehospital care disparities and ultimately disparities in patient outcomes.

The full article can be downloaded below.  

Prevalence of and Factors Associated With Patient Nondisclosure of Medically Relevant Information to Clinicians

In this research we examined what information patients are most likely to avoid telling a clinician, with a focus on types of information that are basic and essential to health care (eg, medication use, health behaviors, disagreement with recommendations, or lack of understanding of instructions). We also examined the characteristics that are associated with withholding information from clinicians and the reasons for this nondisclosure, distinguishing between, for example, nondisclosure due to embarrassment vs privacy reasons.

The full article can be downloaded below.  

Building More Trust Between Doctors and Patients

The general lesson that we have learned from these experiences is that building an empathetic, trust-based relationship with patients is not a nice-to-have but a must-have.  It creates the possibility of identifying underlying hidden conditions whose treatment prevents the occurrence of overt symptomatic conditions that cause distress to patients and place huge strains on the capacity of healthcare services.  Empathy saves not only lives but also money and time.  It’s time to build a place for it in the clinical process.

The full Harvard Business Review article can be viewed at this link. 

Rural Individuals’ Telehealth Practices: An Overview

Telehealth—i.e., health services or activities conducted via phone, Internet, and other technologies—has emerged as a new way for consumers to meet their health care needs. The benefits of telehealth may be greater in rural areas, where remoteness and provider shortages may make accessing health care more difficult for rural residents. Using detailed 2015 household data, the report analyzes three basic telehealth activities as practiced by consumers age 15 or older: (1) online health research; (2) online health maintenance (communication with health providers, including communicating with medical practitioners, maintaining records, and paying bills); and (3) online health monitoring via devices that exchange data remotely with medical personnel. Rural residents were less likely than urban people to engage in the telehealth activities, with 17 percent of rural people conducting online health research, 7 percent engaging in online health maintenance, and 1.3 percent using online health monitoring (compared with 20 percent, 11 percent, and 2.5 percent of urban residents, respectively). Use of all of these telehealth activities increased among individuals with higher levels of education. Generally, use increased among individuals with higher household income, but income’s effect varied across the telehealth activities.

The full report from the U.S. Department of Agriculture's Economic Research Service can be downloaded below.  

Why Doctors Hate Their Computers

Digitization promises to make medical care easier and more efficient. But are screens coming between doctors and patients?  This in-depth article provides doctors perspectives on how technology has changed their workplace.

The full article from the New Yorker can be viewed at this link.  

Plugging the Gaps in the Continuum of Care

As the U.S. population ages, it becomes increasingly important to keep seniors from falling into the gaps in the continuum of care. With 86 million people expected to reach the age of 65 and beyond by 2050, private sector and community organizations will have to find new ways to collaborate and work together to help care for them.

Continuum of care is a concept involving the overarching system that guides and tracks patients during their life journey through the healthcare system. It spans all levels and intensity of care. There are seven basic categories of continuum services:

1. Extended care
2. Acute hospital care
3. Ambulatory care
4. Home care
5. Outreach
6. Wellness
7. Housing organizations

In a perfect world, the hand-off between each of these organizations and providers would be seamless. This would reduce the chance of hunger and neglect among seniors, of hospital readmission, and of the mismanagement of chronic and acute medical conditions.

The full Forbes article can be viewed at this link.  

Presentation slides and recording from 10.25.18 webinar.

As the healthcare industry moves into a more value-based market, consumer engagement is becoming an important factor. Patients who are more active in their own care, health, and well-being have lower healthcare costs and better health outcomes. In holistic, population focused-models, understanding and anticipating the needs of consumers is critical for patient engagement.

Combining a customer relationship management (CRM) system with a big data platform enhances consumer engagement and provides a clear picture about what affects patient care and health. These systems go beyond marketing and sales to track engagement, demographics, clinical status, behavior patterns, and preferences.

This webinar highlights the benefits of building a clinically-informed CRM solution. Speakers will share best practices on leveraging CRM technology to:

• Increase engagement and loyalty with enhanced customer experiences
• Close gaps in care and improve clinical and financial outcomes, with automated and proactive outreach
• Construct creative business efficiencies using closed-loop, integrated system