Designing and Using Cloud-Based Interactive Patient Experience Surveys to Assess the Effectiveness of Accessible Telecare Strategies for People with Intellectual and Developme

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Slide 1

Designing and Using Cloud-Based Interactive Patient Experience Surveys to Assess the Effectiveness of Accessible Telecare Strategies for People with Intellectual and Developmental Disabilities

David O'Hara, Ph.D
Westchester Institute for Human Development
AHRQ Meeting
September 10, 2012

Slide 2

Westchester Institute for Human Development

• One of 67 university centers for excellence in disabilities education, research, and service affiliated with New York Medical College.
• Comprehensive health care clinic for 4500 adults with I/DD: primary & specialty medical care, behavioral health, dental and rehabilitation services.
• Medicaid service coordination—health home.
• Long term care planning, consolidated services and supports—fiscal agent.
• Applied research—accessible models of telecare, direct survey response design for evaluation of patient-centered medical home for people with cognitive disabilities and to promote self-direction and choice in community living options.

Slide 3

Images: Photographs show various computer and handheld touchscreen devices.

Slide 4

Type 2 Diabetes and People with I/DD

• Data from 2006 Medical Expenditures Panel Survey:
  • Health status of working age adults with cognitive limitations compared with adults with no disability Adults with I/DD significantly higher prevalence:
    • 19.4% vs 3.8%.
  • Also significantly higher prevalence 6 other chronic health conditions.
  • Adults with I/DD and diabetes significantly more likely to have 4 or more chronic illnesses.
  • Reichard & Stolzle (June, 2011). Diabetes among adults with cognitive limitations compared to individuals with no cognitive disabilities. Intellectual and Developmental Disabilities 49 (3), p 141-154.

Slide 5

Image: The Care Model is depicted as two discs layered one above the other.  On the upper layer are:

Community:

• Resources and Policies.
• Self-Management Support.

Health Systems:

• Organization of Health Care:
  • Delivery System Design.
  • Decision Support.
  • Clinical Information Systems.

On the lower layer are:

Services:

• Patient-Centered.
• Timely and Efficient.
• Evidence-Based and Safe.
• Coordinated.

A split arrow with one head points down to "Improved Outcomes." On either side of the arrow are "Productive Interactions":

• Informed, Empowered Patient and Family.
• Prepared, Proactive Practice Team.

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Health Literacy

• Institute of Medicine workshop reports:
  • Promoting health literacy to encourage prevention and wellness (November 1, 2011):
    • Research to find better pathways to improved health literacy and better health.
  • Innovations in health literacy (March 10, 2011):
    • Health literacy and health disparities, better use of IT improve health literacy.
  • Overall nearly nine out of 10 adults have difficulty using health information to make proper health decisions.

Slide 7

Image: A photograph shows a touchscreen device that shows the time, weather, and a list of Activities for Today.

Slide 8

Image: A screenshot shows the features of the portal, including personal schedule, health information, and chat with a doctor.

Slide 9

Image: Photographs show the touchscreen device from Slide 7, and a pop-up alert reminder to "Take your blood pressure."

Slide 10

Image: Two screenshots show visual instructions on how to use a blood-pressure cuff and monitor.

Slide 11

Image: A screenshot shows the healthportal interface.

Slide 12

Image: A screenshot shows the Telehealth Portal interface.

Slide 13

Image: A screenshot shows the Learning Library.

Slide 14

Image: A screenshot shows Session 7, "Feel Good about Yourself and Others," from the Learning Library.

Slide 15

Image: A screenshot from a video shows a woman brushing her teeth.

Slide 16

Image: A photograph shows a young woman holding a toothbrush.

Slide 17

Image: A screenshot shows a sample question from the NTI Self-Determination Survey.

Slide 18

Image: A screenshot shows a sample question from the CAHPS Clinician and Group Survey.

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Image: A screenshot shows a sample question from the CAHPS Clinician and Group Survey.

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Image: Screenshots show a sample question from the Health Quest Survey.

Slide 21

Image: A screenshot shows the login page for AbleLink ATLAS Reports.

Slide 22

Image: A screenshot shows a sample page from AbleLink ATLAS Reports, listing available survey reports.

Slide 23

Image: A screenshot shows a sample page from AbleLink ATLAS Reports, listing available surveys from the NTI Self-Determination Study.

Slide 24

Image: A screenshot shows a sample page from AbleLink ATLAS Reports, showing individual responses to questions.

Slide 25

Future Projects

• Design and implement an alternative patient-centered medical home experience survey directly accessible for people with cognitive and other disabilities.
• Develop and deploy accessible health education, health promotion and wellness resources through currently available EMR's.
• Design and administer self-determination surveys to up to 10,000 individuals with I/DD who will be migrating to managed long term care community living options and supports in New York State.