Presentation Abstract

Title: Integrating and Disseminating Information on Diabetes Prevention Into the Primary Care Setting Using Health Information Technology

Health systems are a meso-level social determinant of health (SDOH) from which diabetes disparities can emerge, in part due to differences in healthcare utilization and care quality. Several clinical informatics interventions have been shown to reduce racial and/or socioeconomic disparities in care quality. Successful approaches have included care standardization through tools such as clinical reminders, decision support, and performance feedback. Another successful approach has been population management interventions in which patients who are not meeting goals (such as for preventative screening) are identified and given supplemental services such as patient navigators. A promising area for future work is technologies which focus clinician attention on differential risk factors for diabetes in groups which experience disparities. Poor communication and lower patient satisfaction with care are also complaints that are more common in disparity groups, such as racial/ethnic minorities. Technologies hold promise for improving this through mechanisms such as shared decision-making tools, online patient communities and patient peer mentoring, and through sharing of patient-generated data. However, evidence regarding the utility of these systems for marginalized populations is scarce, and they are vulnerable to problems of inequitable uptake and adherence. Health systems are also according increasing attention to the SDOH, with the majority of healthcare organizations in the US having begun to screen patients for challenges related to SDOH. Thus far, informatics-enabled initiatives focus on primary care referrals to community services that can aid in diabetes prevention, such as food pantries. Promising areas for future work include clinical decision support tools which use SDOH information to facilitate cost-sensitive prescribing, and tailoring recommendations for diet, exercise and other health-enhancing behaviors to individual patient SDOH and the community contexts in which patients live.

About Dr. Veinot

Tiffany Veinot is an Associate Professor at the Schools of Information and Public Health and Director of the Master of Health Informatics Program at the University of Michigan.

She is the principal investigator of the $7.2 million, 5-year study funded by the Patient-Centered Outcomes Research Institute—Enhancing the Cardiovascular Safety of Hemodialysis Care: A Cluster-randomized, Comparative Effectiveness Trial of Multimodal Provider Education and Patient Activation Interventions (Dialysafe). Dr. Veinot has also held or co-held grants from the Centers for Disease Control and Prevention, U.S. Department of Veterans Affairs, Institute of Museum and Library Services, and several Canadian funders. Her published research has garnered seven publication awards from conferences, journals, and professional associations in the fields of health informatics, information science, and human-computer interaction.

Dr. Veinot is on the editorial boards of the Journal of the American Medical Informatics Association (JAMIA), International Journal of Medical Informatics, and Journal of the American Society for Information Science and Technology (JASIST). She has served on the program committees for the American Medical Informatics Association Annual Symposium and the ACM CHI Conference on Human Factors in Computing. She is also guest editor on an upcoming special focus issue of JAMIA, entitled Health Informatics and Health Equity: Improving Our Reach and Impact.

Dr. Veinot did not disclose any conflicts of interest for this workshop.