Report from the Quint Chapter Meeting in Denver, October 12-16, 2014

Hella Bluhm-Stieber

Hella Bluhm-Stieber

 

This year’s Joint Meeting was a great success. It had excellent speakers and programs.

Dr. Claire Pomeroy was the first plenary speaker and spoke about how to create a healthier world by addressing the social determinants of health. She said that we have a value problem in health, that there is a

disconnect between cost and outcome. We have persistent access problems. How can it be possible that 25% Hispanics are uninsured, a higher percentage than other groups, and that higher educated patients live longer? She said that we need to move from sick care to health care, from reactive to proactive, from acute intervention to primary care based, from hospital to population based medical model. She showed statistics about different health outcomes depending on where you live, e.g. worse outcomes in the Central Valley than in Marin County. Dr. Pomeroy also mentioned that 23.5 million Americans live in food desert. She advocates community grocery stores and gardens.
She also mentioned the US poverty rate which is 23%, and that we spend more on health care but less on social services compared to other countries. Medical respite programs for homeless are cost effective.

She recommended two articles dealing with these issues:
1. Dumont DM, Allen SA, Rich JD.(2014). Sesame Street goes to jail: physicians should follow. Annals of Int. Medicine, 161(7), 522-3. PMID: 25285543;
2. Sayer C1, Lee TH.(2014). Time after time–health policy implications of a three-generation case study. New England Journal of Medicine, 371, 1273-6. PMID: 25271599

She stated that we do not collect data on social determinants in the Electronic medical record, and that addressing social determinants will require new skill sets, where we as librarians can help.
She mentioned the Blue Ridge 2010 report, AAHC toolkit, Robert Wood Johnson Foundation, http://www.rwjf.org/, county by county health statistics, social justice components, fiscal components…).
She told us that the University of New Mexico requires a certificate in Public Health for each medical student. Florida International University has a similar requirement.

Dr. Pomeroy ended her talk with a call for action: that health should be considered and integrated into all policies and programs, and that we need a collaborative approach to deal with these issues.
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The 2nd plenary speaker was Spero M. Manson, PhD, from the Centers for American Indian and Alaska Native Health, at the University of Denver.
He talked about the major health issues for American Indians and Alaska Natives. One of them is diabetes, which was not existent in 1940s. He stated that the USDA Commodity food programs lead to the shift away from traditional foods.
This lead to an increase in chronic diseases. In 2009 the diabetes rate for American Indians was 16.1%, and the death rate 34%, double of whites. There is also an increase in cardiovascular disease.
In 1998 special diabetes programs for Indians were started: the healthy hearts program and a diabetes prevention program. The goals were to increase physical activity, healthier eating, and to grow your own gardens. Participants had lifestyle coaches and used photo voice digital stories.

There are two databases on native American health:
1. The Native Health Database at http://hsc.unm.edu/community/cnah/nhd.shtml which was developed by the University of New Mexico.
2. The Arctic Health website at http://arctichealth.nlm.nih.gov/ which includes grey literature, climate change, traditional healing, media.
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The 3rd Plenary Speaker was Dr. CT Lin, from the University of Colorado Hospital.
He was busting the myths of personal health records.
He talked about the traditional relationships in the hospital where the doctor is in the center and has control. With internet, patients now have access. Many doctors feel threatened since the relationships are changing.
What do patients want? In 2001: 87% us adults had Internet, 90% of online patients want to email their doctor, 56% of online patients say email access would influence choice of doctor.

MYTH 1: The flood gates will open, if patients can email doctor.
Reality: patients can reach me, no telephone tag.
Dr. Lin ran a controlled trial for 6 months. The results were:
24% improvement in message sending,
19% improvement in appointments requests.
There were also improvements in prescription refills.
In the online group, most messages were sent after hours. Only 27% were sent during clinic hours.
81% patients said, that it saved them phone call.
33% said, it saved them clinic visit.
There was no e-mail flood, but there was more patient satisfaction, the volume was modest.
Myth busted.

Myth 2: Releasing test results online will confuse patients.
They did a randomized trial called SPPARO project in 2002 with 100 congestive heart failure patients.
After 12 months, there were only minor problems.
Patients felt more empowered, trusted, understood.
There was no overuse by patients or misunderstanding.
Nursing saw it as an education tool.
After 6 years of lobbying, they launched MyMedicalRecord in 2008.
They put in delays for certain test results, so that doctor can call first before the patients sees the results online. They had 2 incidents where the patients saw the test results before the physicians could contact them.
Myth busted

Myth 3: Showing patients doctor’s Notes will lead to litigation, etc.
Myth Busted
Article: Delbanco T, Walker J, Darer JD, Elmore JG, Feldman HJ, Leveille SG, Ralston JD, Ross SE, Vodicka E, Weber VD (2010). Open notes: doctors and patients signing on.
Ann Intern Med., 153(2):121-5. PMID: 20643992

Myth 4: Social media can be used as a force for better patient care
Here comes everybody, Clay Shirky ( book)
Healthvault, Google Health was discontinued.
Colorado quitline, online support to quit smoking
Acor.org, Web personality who was helped through this, Daily strength, Patientslikeme
Medicare is releasing more and more data.
Doctor ratings, patient satisfaction
Myth is plausible

Facit: there are more online transactions, but less phone calls.
At the end he showed us a Youtube video called: Hospital of the Raising Sun at:
https://www.youtube.com/watch?v=FG1FPigUaYw

The contributed papers and lightening talks dealt with many different issues, like “the no book at the reference desk: revisiting no-answers”, weeding a library to make room for collaborative spaces, finding open educational resources for international programs, creating info-literacy resources, embedded librarian, changing roles of librarians, creation of a digital library for public health, creating a brochure for children visiting the MICU, Information security for libraries, etc.
Many of the posters and contributed papers are available at: http://quintessential2014.sched.org/(The posters are under the poster link, and then Drop box link. The paper links are at the end of each paper description.)

I really enjoyed the conference and would like to thank MLGSCA for supporting me with a grant that made it possible for me to attend.

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