Session 1
Chair: Suzanne (Sue) Bakken, PhD, RN, FAAN, FACMI, FIAHSI (Columbia University)
Speaker: Suzanne (Sue) Bakken, PhD, RN, FAAN, FACMI, FIAHSI (Columbia University)
Alumni Professor of Nursing and Professor of Biomedical Informatics
Interim Vice Dean for Research
Executive Director, Center for Community-Engaged Health Informatics and Data Science
Co-Director, Reducing Health Disparities Through Informatics Pre- and Postdoctoral Training Program Columbia University
Editor-in-Chief, Journal of the American Medical Informatics Association
Title: Health Disparities and the Social Factors on Disease Risk and Outcomes
Abstract: Substantial literature has documented the influence of social factors, most typically characterized as social determinants of health (SDOH), on disease risk and patient-centered outcomes including health-related quality of life. The potential of biomedical and health informatics to both exacerbate and mitigate health disparities has also gained considerable attention over the last decade. Moderated by Suzanne Bakken, PhD, RN, FAAN, FACMI, FIAHSI, the session entitled Health Disparities and the Social Factors on Disease Risk and Outcomes, comprises four presentations that will address this topic from multiple perspectives (e.g._ conceptual, methodological, and level of intervention) with attention to current and future states to advance health equity. The presentations will be followed by audience discussion.
- Jessica Ancker, PhD, FACMI will discuss the phenomenon of informatics intervention-generated inequality and illustrate mitigating efforts through two current research projects.
- Bradley Iott, PhD will summarize a series of studies related to physician’s documentation and use of SDOH data in the Electronic Health Record.
- Jessie Tenenbaum, PhD, FACMI will provide a state government perspective by describing a data- driven approach to addressing SDOH in North Carolina.
- Anne Moen, PhD, RN, FACMI, FIAHSI will describe GravitateHealth, an EU project that addresses location, language, literacy levels to promote medication access and to equip and empower all citizens with digital information tools for safe use of medicines.
Speaker: Jessica Ancker, PhD, FACMI (Vanderbilt University Medical Center)
Professor and Vice Chair for Educational Affairs, Department of Biomedical Informatics
Title: How to Avoid Informatics-Generated Inequities
Abstract: As informaticists, we innovate because we want to improve health. But many informatics innovations disproportionately benefit people who are already in positions of socioeconomic advantage. For example, patients with better access to broadband Internet will benefit most from digital health tools, and patients from majority racial groups may receive the most accurate predictions from machine learning algorithms. If these risks are not recognized and addressed, informatics-based interventions will worsen health equity, a phenomenon called “intervention-generated inequality” or IGI. I will outline two exciting IGI-focused research projects, one evaluating the population impact of providing low-cost, high-speed broadband at the municipal level, and the other developing methods to protect clinicians from biased guidance in AI-based clinical decision support. These examples suggest steps toward a framework for building health equity into informatics projects.
Speaker: Bradley Iott, PhD (University of Michigan)
Research Assistant Professor
Title: Physician’s Documentation and use of Social Determinants of Health Data in the Electronic Health Record
Abstract: Recent policy has motivated many healthcare systems to screen patients for health-related social needs. Social needs identified during screening may be documented in the electronic health record (EHR). The sensitivity of these data, due to their potential to contribute to stigmatization of patients, suggests a need to understand how, when, and by whom these data are accessed and used in the EHR. I will discuss three recent studies which attempt to address these questions. In the first, I explore physicians’ awareness of EHR tools that allow for documentation of social determinants of health (SDOH), including identifying those characteristics associated with awareness of SDOH documentation tools. In the second, I characterize the relative frequency of clinician engagement with structured SDOH data, showing that SDH data engagement was associated with lower readmission risk. In the third study, I compare structured and unstructured SDOH data to patient self-report of their social needs to show that EHR SDOH documentation underestimates patients’ self-reported risks. Finally, I will discuss future directions for EHR SDOH documentation research.
Speaker: Anne Moen, PhD, RN, FACMI, FIAHSI (University of Oslo)
Professor, Faculty of Medicine
Title: Gravitate-Health; Levering FHIR Resources to Deliver Relevant and Understandable Medicinal Product Information (ePI) for ALL
Abstract: Gravitate-Health is an EU project that addresses location, language, literacy levels to promote medication access and safety, to equip and empower ALL citizens with digital information tools developed for them, to empower for safe use of medicines, best possible outcomes of ongoing treatment and data driven collaboration patient, support network and health professionals. We are preparing and validating innovative, easy-to-use elegant digital services that actively engage and empower citizens and their support network with access to and understanding of health information from trusted sources. These digital services leverage HL7 FHIR Implementation Guides (IG) for ePI (electronic product information/SPL (Structured Package Leadlet)) and IPS (International Patient Summary) to access trustworthy, up-to-date information that better meet personal needs and preferences.
Speaker: Jessica Tenenbaum, PhD, FACMI (Duke University)
Associate Professor of Biostatistics & Bioinformatics
Title: A Data driven approach to addressing SDOH in North Carolina: Screening, Software, Services, and Savings
Abstract: North Carolina’s Healthy Opportunities initiative comprises a range of strategies to address social determinants of health in the state. This talk will describe NCCARE360, a statewide closed loop referral system to address health related social needs, and NC Medicaid’s Healthy Opportunities Pilots (HOP), the nation’s first comprehensive program to test and evaluate the impact of providing select evidence-based, non-medical interventions related to housing, food, transportation and interpersonal safety and toxic stress to high-needs Medicaid enrollees. Preliminary findings show that service spending was, on average, $85 dollars less per participant per month than it would have been in the absence of the HOP program. Longer participation (e.g., 12 months vs. 6) was associated with greater reductions in direct service spending.
