By Dietz, David A.
Aging Today , Vol. 33, No. 2
Reducing multiple chronic conditions, preventing avoidable rehospitalizations and creating access to quality preventive care services in underserved communities of color- these topics constitute but a small list of daily priorities for the U.S. Department of Health and Human Services (HHS), Office of Minority Health and its sister HHS agencies. However, there is one healthcare topic that transcends all in terms of potential- the application of health information technology (health IT).
In the November-December 2011 issue of Aging Today, Robert Rosenblatt penned a compelling article asking, "Is long-term-care technology keeping pace with demand?" It's a poignant question, but there remain more questions concerning health IT. For example, which health IT technologies have proven effective; which produce sustainable outcomes in improving health, healthcare and wellness; and how will it be decided who will pay for the purchase and operation of these technologies?
What Can Health IT Offer?
Health IT encompasses a broad scope of products, services, technology and specially trained personnel. Electronic health records constitute a critical component of health IT, as does telehealth, mobile health (mHealth) and an array of monitoring products Rosenblatt discussed in his article. Perhaps the latest, most innovative health technology is mHealth, which is the use of cell or smartphones to communicate education, orders or advice via text, live person (Skype or Skype-like enterprise) or through voicemail. MHealth is one possible solution for reaching underserved urban and rural communities of color, where healthcare providers are oftentimes scarce.
Mobile health is a new technology within the United States, so new that few public or private sector policies and reimbursement mechanisms exist governing its use. In late 2011, HHS formed a Text4health taskforce that produced a series of recommendations to the Secretary of Health and Human Services regarding its application, as well as suggestions to evaluate its efficacy (http://www.hhs.gov/open/initiatives/mhealth/recommendations.html). Mobile health initiatives will undoubtedly play a major role in assisting healthcare providers to reach older adults of all races, ethnicities and socioeconomic backgrounds, and several mHealth demonstration projects are now underway.
One such project examines the use of patient-activated smartphones to receive diabetes management information from certified diabetes educators. The Office of Minority Health has been working in conjunction with Baylor University, the American Association of Diabetes Educators and AT&T- which donated a sizable amount of funds and in-kind supplies to this project. The purpose of the "mHealth Diabetes Initiative" is to pilot an accredited Diabetes Self-Management Education (DSME) course that will be delivered by certified diabetes educators via Skype through smartphones to a large number of African American elders in Houston. …