Slide 1 Center for Equal Health Overcoming Health Disparities with Innovation and Technology Dr. Kevin B. Sneed Dean, USF College of Pharmacy Presented by: The Community Engagement and Outreach Core Slide 2 Health Disparities Institute of Medicine Report, 2002 * The evidence is “overwhelming” * Disparities exist even when insurance status, income, age, and severity of conditions are comparable * Minorities are less likely than whites to receive needed services * Well over 600 scientific publications documenting racial and ethnic disparities in health and health care. * This study represents the nation’s potential to ameliorate a set of problems that are over 394 years old for the Native American community, 382 years old for the African-American community, is a growing problem in various Hispanic communities and is becoming more of a problem in various Asian/Pacific Islander communities.” * Institute of Medicine (IOM). 2002. Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare. , Washington, DC: National Academy Press Slide 3 * Health Disparities cannot solely be attributed to race-related differences in patient compliance, or “subliminal bias or discrimination” among physicians. IN-SCHAPE (Dr. Sneed) ¨ * Partnerships must be created between community stakeholders, health-professions students, and academic clinicians and researchers that will create activities that address health disparities directly with people in our communities. Slide 4 Health Disparities * “Single strongest predictor of our health is our position on the class ladder” * Even people in the “middle” are twice as likely to die an early death as those at the top * Of note, however, is that ethnic differences can persist even after socioeconomic factors are taken into account Slide 5 A little background information .... (image of various pieces of media) (logo - Center for Equal Health) Slide 6 Why do minorities have a low participation rate in clinical trials? * The reasons are complex and numerous. Physicians may not discuss the availability of trials with minority patients, and there is a lack of information in the community about the potential benefits of participating in clinical trials. * In addition, there aren’t enough trials in community settings where people affected by disparities often live. Another problem is the design of clinical trials themselves — the eligibility criteria are very rigorous, are standardized, and may exclude patients with multiple health problems, many of whom are minorities. ¨ * Minorities are 200 percent more likely to perceive harm coming from participating in research * Belmont Report; Tuskegee Study http://benchmarks.cancer.gov/2006/09/minority-participation-in-clinical-trials/ http://abcnews.go.com/Health/Healthday/story?id=4510048&page=1 (logo - Center for Equal Health) Slide 7 Participation of minorities in clinical research- CEH Community Research Council (CRC) MISSION * The Community Research Council is a group of community members established to advocate for and oversee clinical and translational research activities within the various minority and medically underserved communities in the tri-county Tampa Bay area. OBJECTIVES * Strengthen the relationship between researchers and the community; * Provide oversight, protection, and advocacy for community participants involved in research; ¨ * Create and enhance clinical research opportunities for underrepresented communities; ¨ * Empower underrepresented communities; ¨ * Enhance and expand trust between academic and clinical institutions and the community. (logo - Center for Equal Health) Slide 8 RACE (or Ethnicity?)… Becoming Non-existent in current scientific process ? Slide 9 What is the Impact of (a Lack of) Technology in our Communities? Slide 10 Who has a cell phone? • 88% of US adults are now cell phone owners. 46% are smartphone owners while 41% own a cell phone that is not a smartphone. • Of smartphone owners - 20% describe their phone as an Android - 19% describe their phone as an iPhone - 6% describe their phone as a Blackberry • Every demographic experienced an uptick in smartphone penetration over the last year. However, there was a very modest growth in seniors and those without a high school diploma. • Smartphone penetration amongst African Americans and Latinos is 49% in each case. Source- American Heart Association Created by Kate Sawa, APR sr. communications director & affiliate digital strategy manager March 2012 Slide 11 Demographic patterns around app downloads • African Americans are more likely than their white counterparts to downloads apps that help them communicate with friends and family, and those that help the user shop or make purchases. • App downloaders who have attended college are more likely than those who have not to download apps that provide updates about news, weather, sports or stocks, apps that help the user learn about something he/she is interested in, and those that help with related work tasks. • Young adults (18-29) are more likely to download apps that help them communicate with family and friends, while 30-49 year-olds are the leading age group for downloading apps that allow the user to watch movies or TV shows online. Source- American Heart Association Created by Kate Sawa, APR sr. communications director & affiliate digital strategy manager March 2012 Slide 12 The Future 2011-2018 By 2018 the worldwide market for mobile health technology will reach $11.8 billion in comparison to just $1.2 billion in 2011; 30% smartphone users are likely to use "wellness apps" by 2015; By the end of 2016, the number of home monitoring systems with integrated communication capabilities to reach 4.9 mn; 2.47 mn medical devices with integrated cellular connectivity will be tuilt by 2016 Slide 13 What does Patient-Centered Care look like? My Doctor My Family My Pharmacist My Nurse My Gynecologist http://www.healthit.gov/buzz-blog/health-innovation/animated-video-explains-advancements-technology-giving-tools-access-information-manage-health/ Slide 14 Top Ten Medical Uses of the iPhone Posted by admin/december 14, 2012 (Source: John Bennet MD www.internetmedicine.com) December 15, 2012 The creation and widespread use of the iPhone has impacted many industries, and now has affected Medicine in many ways. In many cases the iPhone applifies the power of the device to which is attached by its computing power in some, it uses it powerful photographic and optic powers to affect change. We will examine the Top Ten Medical Uses that we fee has and will have, a deep impact on the practice of healthcare. Slide 15 4) The iPhone as a GLUCOMETER : IBGStar What is called a "Killer App" will be the c reation of a non-invasive way to measure serum glucose That day has not arrived y et. at least none has been approved by the FDA, but that day will soon come, and AL T APURE says they will be the fi rst Until then we have peripheral devices as on this page IBGStar is a blood g lucose meter plug-in for the iPhone There is a an iBGStar Diabetes Manager App that tracKs blood glucose carbohydrate intaKe and insulin dose The benefit of this peripheral is to manage your regimen of care of the diabetes, by posting alerts, Keeping log etc. Finger sticKs with the lancet are st ill required There are other devices on the hori2on of the digital revolution that will avoid being stucK to checK glucose Slide 16 9) iPhone to Measure BLOOD PRESSURE: Withings Blood Pressure Monitor measure access track (Source) This iPhone peripheral blood pressure cuff does readings and the app is programmed to record the readings, time of day, and keeps a log_ Also allows you to send your record to whereever you wish, including to your doctor This device allows a truer measure of blood pressure avoiding "white-coat hypertension" or having falsely high readings at a doctor's office The important part of a device such as this, is that allows for neat. easily retrievable records to be kept. made into graph forms by the software and will make the patient more concious of the trends of the blood pressure There is also the option of using Microsoft® HealthVaultTM , which keeps all your health records in one place Slide 17 10) iPhone as SPIROMETER andBREATHALYZER SpiroSmart iPhone App Accurately Estimates Lung Air Volume iPhones will soon take the place of the spirometer At the University of Washington Medical Center an iPhone App has been developed to make an algorithm with the audio portion of an expiration and there is a 5% difference in studies performed compared against the ole spirometer. Researchers built the program based on the audo as seen in the following video· This sprirometer is based on the same principles of work that is being done on the early detection of Parkinsonism based on the sound waves generated by a persons voice on the phone Slide 18 2 . The iPhone as EKG: AliveCor Just recently approved by the FDA (December 201 2) the iPhone ECG is a single-lead electrocardiogram reader that attaches to the bacK of an iPhone and displays heart rate info via an app (An Android version is in the worKs ) The creator. Dr David Albert. is an OKlahoma Cardiologist. who liKes to be called an "'Inventor· Son of former SpeaKer of the House Carl Albert David believes the iPhone ECG could be used in intensive care units and used by EMTs His team is recently compiled data in June 2012. aner which his company received more funding from the powerful Qua lcomm. a big company in the wireless industry Slide 19 Informatics Tools for Patient-Centered Care LiveWell Technologies - The digital personal health solution (picture of a hand held device) Slide 20 What Does It Take (besides money!) to Get There? Slide 21 Community-Based Collaboration Academic Centers Research-based Community Organizations: USF Health, USF, FAMU, Moffitt Cancer Center,TGH Community Partners: Professional Alumni, BAMA, BNA, Health Departments, Community Ambassadors Slide 22 Thank you for your attention! (logo - Center for Equal Health) Slide 23 CEOC Team Members Co-Leaders Lee Green Clement Gwede Kevin Sneed Deanna Wathington Staff Maisha Standifer Kaylynn Brown Johnetta Goldsmith Coni Williams Lolita Dash (logo - Center for Equal Health)