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Healthcare Texting, HIV/AIDS EHRs, and Health Information Exchanges Focus of Three Presentations at APHA Annual Meeting

New York, NY – Leveraging advanced health information technology (IT) to improve patient care and outcomes will be the focus of three global health informatics presentations at the American Public Health Association Annual Meeting & Exposition November 6-10, 2010, in Denver, Colo.

The research, on the potential for HIV-specialty electronic health records (EHRs), barriers to health information exchange, and the ethics of texting clinical information and healthcare marketing messages, was conducted by the Healthcare Innovation & Technology Laboratory (HIT Lab), a public health information and communications technology research center.

“This is an exciting time in healthcare. Sophisticated technological tools offer so much potential for improving and standardizing care delivery, but the challenges to adopting them on a wide scale are equally significant,” said Ilene Hollin, research manager at the HIT Lab. “Our organization’s mission is to help research the challenges and the solutions for providers, vendors and policymakers to understand how they can leverage IT – often low-cost technologies – to advance patient care.”

The HIT Lab’s presentations will cover:

·         Assessing EHRs and health IT in outpatient HIV/AIDS clinics across four continents: roundtable discussion, Monday, Nov. 8 at 4:30 p.m. Presenting author: Margaret Griffin, research coordinator, HIT Lab.

·         Barriers to the creation of standards for the facilitation of health information exchange: poster presentation, Monday, Nov. 8, 4:30 p.m. Presenting author: Griffin.

·         Ethical differentiation of text messaging meta-data for critical clinical intervention purposes versus marketing functions: oral presentation, Tuesday, Nov. 9, 3:30 p.m. Presenting author: Hollin.

Improving Treatment with HIV Specialty-Specific Electronic Health Records

The global need for uniform, high-quality treatment of HIV/AIDS is profound. Using EHRs designed specifically for patients with HIV/AIDS can help improve care and eliminate treatment disparities by standardizing decision support and patient education tools, according to an analysis of EHRs and health IT infrastructure, disease prevalence, and treatment access in 20 countries worldwide.

Results showed that the diffusion of specialty EHRs can help by tracking disease-specific quality indicators (CD4, white blood cells) to efficiently gauge patients’ progress. The tools also help healthcare providers identify and reach patients that are not receiving proper treatment and spot trends within high-risk patient subpopulations. Additionally, these technologies support U.S. HIV/AIDS clinics’ funding by streamlining reporting requirements and making providers eligible for federal reimbursement.

Barriers to Health Information Exchange

EHRs hold significant promise to advance healthcare delivery – but isolated clinical data systems lead to fragmented communication and incomplete records. Despite the 1996 HIPAA provisions mandating national standards for electronic healthcare information exchange (HIE), the industry has failed to adopt a standardized means for sharing health information between provider institutions.

To uncover why standards have not flourished, researchers reviewed the literature on HIT and barriers to HIE. On the national level, contributing factors include the government’s decision to facilitate, rather than lead, the development of HIE standards. At an institutional level, issues of trust, data security and competition in an already aggressive environment further inhibits the development of standards.

Ethics of medical mobile text messaging

On the spectrum of using communication technology to share health information and influence behavior, mobile text messaging (MTM) may be viewed as a panacea – an instant delivery tool with near-ubiquitous adoption – or a vehicle for targeted and intrusive direct-to-consumer marketing from corporate interests. To find appropriate ethical lines, HIT Lab researchers analyzed the literature for data on the use of text messaging for behavioral health intervention and use of MTM for marketing by pharmaceutical companies and other private industry in healthcare.

Researchers found that text messaging can be an effective tool to support medication adherence, preventive health behaviors such as breast self-examination, and even quality assurance. For example, one campaign in Ghana enabled consumers to text a code on medication packaging to verify its authenticity. However, some text campaigns can expose consumers’ metadata – information about their phone number, address and other personal details – and possibly most critical, their health and behavior patterns, which can make them targets for unwanted marketing. To maintain consumers’ privacy, the HIT Lab recommends the use of systems to hide metadata; consumer education campaigns to raise awareness of the potential threats of text messaging; and the involvement of non-profit health organizations in text messaging campaigns.

About HIT Lab

The Healthcare Innovation & Technology Laboratory is a cross-disciplinary, research-based organization that studies thoughtfully designed healthcare technology. Using theoretical and applied public health research, the Lab develops innovative technological methods and tools that expand access and improve quality of medical care worldwide. With sponsorship from the public, private and nonprofit sectors, the HIT Lab conducts diverse research in areas such as informatics, epidemiology, genomics, economics, social development, and government policy. Based in New York, NY, the Lab’s team includes faculty, staff, students and alumni from top universities around the country. More information available at www.hitlab.org

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