Academic journal article International Journal of Child and Adolescent Health

Adolescence and Health Information Technology

Academic journal article International Journal of Child and Adolescent Health

Adolescence and Health Information Technology

Article excerpt

Introduction

Adolescents are a complicated, demanding, neglected and heterogeneous group. Their health care issues are multi-faceted and service delivery needs complex; yet, adolescents need to be healthy and productive as they are the work force of the future. The adolescent population, most of whom are enrolled in school, need to succeed in school (1). School success is dependent on the avoidance of presenteeism-lost productivity that occurs when students come to school but perform below par due to any kind of illness-as well as on decreased absenteeism. Engaging adolescents in their health and health care in ways that they can relate to is critical to improving their physical and mental well-being and their potential for success in school and the workplace.

Adolescents are the least likely population to engage in the health care system, but potentially employ riskier behavior and face social environmental barriers if they don't engage. Yet, they are likely to embrace and benefit from 21st century e-health tools. Providers who service this population, however, have not effectively and efficiently leveraged "e" strategies that adolescents use as an extension of themselves, such as texting, e-mails and YouTube, to reach this critical but not currently or sufficiently engaged population group. The specific use of m-health, mobile technologies that improve health systems performance (2), provides innovative yet familiar- to-adolescents approaches that clinicians and other providers can use to engage their adolescent patients, particularly those who are averse to, or unable to utilize, the more traditional health care settings.

To fully benefit from the opportunities health information technology (health-IT) presents in the delivery of care through use of cell phones with texting capabilities, computers, and Internet to the various segments of adolescent population, significant potential privacy, security and implementation issues related to the exchange of health information in a meaningful way must be acknowledge and addressed. Understanding the opportunities and the legal and regulatory responsibilities of using this technology is the first step to reaching better health, better care and lower costs for the health care system, the provider, the adolescent and/or his/her family (3).

Adolescents: The Population

Though some refer to "adolescence" as the second decade of life (chapter 1), ages 10 to 19 years, there is no agreement in the health care marketplace as to when adolescence ends and adulthood begins (4). For purposes of employer-based health insurance, adults under age 26 can be included under their parent's insurance, even if married, if they have no other health insurance coverage. Medicaid and the Children's Health Insurance Program (CHIP) provide publicly funded health care coverage, but define the transition to adulthood at different ages: Medicaid at age 21 and CHIP at age 19 years. As stated in another chapter, adolescents for clinical purposes are defined as ages 13 to 21 years for gastrointestinal tract, liver, gall bladder and pancreas but for physical exams are defined as ages 12 to 21. The variations add nuances to patient engagement, to decision making and to billing issues for pediatricians and other health care providers related to benefits, business processes and confidentiality. The inconsistencies create complexities in performance measurement and provider-accountability reporting.

Financing of the adolescent population

The financing of health care for adolescents is undergoing a conversion in regard to who is paying for adolescent health care and what they will be reimbursing pediatricians and other primary care providers for care. Approximately 25 percent of all children nationwide rely on Medicaid or CHIP and up to 40 percent of new births are Medicaid enrollees (5). With the passage of the Patient Protection and Affordable Care Act (ACA), these numbers will dramatically expand by 2014 (6). …

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