218366 Increasing health communication resources increase documentation and usage in the Indian Health Service

Monday, November 8, 2010

Christopher Lamer, PharmD, MHS, BCPS, CDE , Office of Information Technology and Health Education, Indian Health Service, Franklin, NC
Aneel Advani, MD, MPH , Office of Information Technology, Indian Health Service, Rockville, MD
Background: Health education and collaborative goal setting are essential in the management of chronic disease but are often not documented as discrete data elements. Purpose: The purpose is to provide tools within the clinical information system (CIS) to promote health communication and the ability to document these activities by clinicians through the Electronic Health Record and one day by patients through the Personal Health Record, to increase health communications through patient-provider communication, health literacy, and patient engagement. Methods: The Indian Health Service (IHS) has unique data elements in the CIS and clinical decision support tools that capture patient education and collaborative goal setting activities that are provided by clinicians. Patient education consists of protocols and a standardized data set which collects information on the disease state or condition and topic discussed, the patient's level of understanding, readiness to learn, barriers to learning (including low health literacy), learning preferences, and goal setting. There is a personalized patient-oriented report that can be generated on demand to provide access to medical record information and a short description of what their information means. Patient materials such as handouts that align with the education codes are retrievable by clinicians at the point of care from a database accessed from within the EHR. Results: Increase in documentation of patient education from 777,000 visits in fiscal year (FY) 2004 to 2,223,704 in FY 2007 and there are thousands of “hits” to the patient handout website. Clinicians requested additional tools & enhancements and there is a new goal setting component and handouts in development. Discussion: Health information technology can assist in capturing and promoting patient education and goal setting activities. Integrating patient education materials and documentation tools with the clinical information system has resulted in an increase in health communication; however further assessment on the clinical outcomes needed.

Learning Areas:
Administer health education strategies, interventions and programs
Assessment of individual and community needs for health education
Chronic disease management and prevention
Communication and informatics
Implementation of health education strategies, interventions and programs

Learning Objectives:
1) Discuss the tools the Indian Health Service has implemented to promote health communications and collaborative goal setting 2) Demonstrate improved use of tools over time and with the increase of technology (such as the electronic health record) 3) Assess organizational ability to integrate some of the tools or lessons learned by the IHS into their work environment

Keywords: Health Communications, Patient Education

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: my educational background and work experience
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.