Latinos & Technology in Fight Against Diabetes
IndustryView | 2014
Alarmingly high diabetes rates have Latinos fighting against the odds for their health. The country’s largest minority group is almost twice as likely to suffer from diabetes as non-Latino whites are.
Geneticists have recently studied gene mutations that could help explain some of these predispositions. But while looking to past generations may inform us of diabetes rates today, some medical professionals are instead focusing on future generations of Latinos—by exploring the use of patient-empowering technology.
Seeing as Latinos tend to be early adopters of new technology, Software Advice set out to evaluate their willingness to use tech-based tactics to aid in diabetes prevention and treatment. We collected responses to five online survey questions from a total of 1,983 people who identified themselves as “Latino” or “Latino-American.”
More than half (60 percent) of Latinos surveyed were interested in tracking diabetes-related health risks independently by accessing their electronic health records (EHRs) online, where they could check for factors such as high blood pressure, high cholesterol and/or weight changes.
The majority (35 percent) said they would be “very interested” in doing this; 12 percent said they were “moderately interested” and 13 percent were “minimally interested.” Slightly more than one-quarter of respondents (27 percent) were “not at all interested” in tracking diabetes-related factors online, while 13 percent told us they “already do.”
Advances in EHR software have made this kind of patient engagement feasible. Cleveland Clinic, for example, offers patients secure online access through a system called MyChart to view vital signs recorded during their last 15 office visits. Patients are able to evaluate readings over time for their pulse, blood pressure, weight and more.
Nearly three-quarters of Latinos surveyed (71 percent) told us they would likely lower their diabetes risk factors by modifying their diet and/or exercise habits if their physician emailed them a personalized risk assessment.
Forty-six percent said they would be “very likely” to do so, and an additional 25 percent said they would be “somewhat likely.” Twenty-nine percent of Latinos said a personalized diabetes risk email would likely have no effect on their lifestyle.
We shared our findings with Dr. Stephen Persell, M.D., whose Northwestern University Feinberg School of Medicine study inspired this survey question. Dr. Persell and his team tested the impact of mailing patients personalized risk assessments for cardiovascular disease (CVD). He says EHRs can enable doctors to efficiently identify at-risk patients, and found the method of mailing assessments did, in fact, spur a percentage of them to curb their CVD risk factors by lowering their cholesterol.
Similarly, our survey respondents showed a strong willingness to modify unhealthy behavior based on EHR-enabled diabetes risk assessments.
“This is exciting, because it can enable a practice to monitor the care and risk for a whole population of patients,” says Dr. Persell. “It can make the information available to the right people at the right time.”
Dr. Persell says the variety of data readily available in EHRs can create opportunities for further advances in tech-based patient engagement.
“We’re still trying to learn the best ways to [apply EHR technology], but I think it’s moving quickly,” he says.
More than half of Latinos surveyed (54 percent) responded that they would likely send personal health information, such as exercise logs or blood glucose readings, electronically if their doctor recommended doing so.
The majority (37 percent) said they were “very likely” to do so, and 17 percent said they were “somewhat likely.” Thirty-one percent of respondents were “unlikely” to send electronic health information to their doctors, while 15 percent said they "already do."
These survey results have implications for both current and future diabetes care strategies aimed at tech-savvy Latinos.
Forward-thinking medical professionals will find it significant that so many Hispanic respondents are open to electronically sending personal health information to their doctor. That’s because industry leaders are closely following the developing relationship between EHR vendors and commercial mobile health apps that allow people to digitally log diet, exercise routines and more.
Some speculate these apps could eventually allow for a secure, integrated flow of patient-generated health information to physicians. Software Advice’s findings show the majority of Latinos are ready for that flow to begin, if their doctors are on board.
We spoke with co-director of the UMass Diabetes Center of Excellence, Dr. David Harlan, M.D., to give us a physician's perspective on these findings. Researchers have already found that self-reporting weight management activities better ensures long-term success, and Dr. Harlan believes this could also be a meaningful step toward curbing diabetes rates.
“Simple factors like daily exercise and weight management are very cost-effective ways of preventing diabetes and the complications that accompany the disease,” he says.
When it comes to diabetes management, Dr. Harlan and the UMass Memorial diabetes care team are already employing an EHR-integrated system that factors in patients’ self-reported health data. The MCT-Clinical for Diabetes system is a result of a partnership between a Web-based diabetes management application called MyCareTeam and software vendor Allscripts Enterprise EHR.
Uploading glucose meter data into the MCT-Clinical for Diabetes system
MCT-Clinical for Diabetes transmits blood glucose readings directly from patients’ blood glucose meters in between doctor’s office visits. Patients also submit other information, such as caloric intake and exercise, to a Web database that is connected to the patient’s EHR. User-defined alerts can then be created and routed to a nurse, primary physician or other caregiver, so they have more of the patient’s health metrics to guide treatment recommendations—potentially identifying complications such as unhealthy blood glucose levels before they escalate.
“Using the MyCareTeam-based communication tool, we find that we are able to interact with patients before glycemia extremes require urgent attention—[which] might have, in the past, required a visit by emergency medical personnel or an emergency room visit,” explains Dr. Harlan.
Software Advice’s findings on Latinos’ willingness to electronically send health data are not surprising to Dr. Harlan, as he feels nearly all—if not all—patient demographic groups would be similarly interested. He hopes medical research continues to advance tech-based treatment and prevention techniques.
“The ultimate goal of patient-friendly apps accessible through the [EHR] is that the metrics may help each individual achieve better health by providing moment-to-moment feedback,” he says.
The overwhelming majority of Latinos surveyed (81 percent) said they at least had a “fair” understanding of what it takes to help prevent and treat diabetes: 27 percent expressed an “excellent” level of understanding, 22 percent said it was “good,” 19 percent put it at “average” and 13 percent said it was “fair.” Nineteen percent of respondents had a “poor” understanding of diabetes prevention and treatment.
Being aware of diabetes prevention and treatment is the first step to curbing the disease’s hold on Latinos. While it is encouraging that so many respondents felt they were informed about diabetes prevention and treatment, it is important to note that our sample size consisted of more than twice as many males as females.
Doctors promoting diabetes education among Latino patients should consider extra outreach towards women, since a recent diabetes study that found older, female Latino patients are more predisposed to the disease. Researchers discovered the diabetes rate reached more than 50 percent for Hispanic/Latino women (overall) by the time they reached age 70, while it was 44.3 percent for men aged 70 to 74.
More than half (61 percent) of Latinos said they have easy access to medical records. Twenty-two percent said they did not, while 17 percent were not sure.
Ensuring patients have easy access to their medical records is important to federal policymakers. As such, there are a number of EHR financial incentive programs available for physicians. The percentage of Latinos who say they have easy access to their records may grow over time, as doctors take advantage of these incentives and implement patient-friendly EHRs.
These results show there are many EHR-enabled opportunities for doctors to engage Latino patients in taking a proactive role regarding diabetes prevention and/or treatment. These technology-based tactics may be relatively new or still under development, but our findings show most are willing to use them to varying degrees.
We collected 385 unique responses to each of five online survey questions from people who identified themselves as “Latino” or “Latino-American,” giving us a total of 1,983 respondents.
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