HIT system to help clinics serve medically underserved populations

Researchers at the University of Pittsburgh have developed an IT system to improve the health and well-being of medically underserved populations through personalized interventions.

Called imHealthy, the system—which includes a mobile app, open source EHR and web portal—was specifically designed by a multidisciplinary research team for the FOCUS Pittsburgh Free Health Center. However, researchers are hoping the solution will serve as a model for free clinics in other major cities across the country.

According to Leming Zhou, assistant professor in the Department of Health Information Management at the University of Pittsburgh, he and his colleagues intended imHealthy to be a user-friendly, scalable, easy-to-use system to help clinics provide a comprehensive well-being assessment for those living in medically underserved communities.

“The system we created has a well-being questionnaire delivered via a mobile app that sends the data to a database, and then we have an algorithm to do the data analysis,” says Zhou, who adds that the assessment results and personalized intervention recommendations are then delivered to caregivers through a web portal that manages the information “anywhere at any time.”

The system’s genesis and capabilities are described in an article in the latest issue of Perspectives in Health Information Management, the online research journal of the American Health Information Management Association.

“The imHealthy system is designed to collect and integrate multidimensional data on well-being from multiple sources and perform statistical analysis and modeling, in order to generate quantitative and solid well-being assessment results,” state the article’s authors. “Personalized interventions can then be recommended by caregivers (e.g., clinicians) and delivered to people in medically underserved communities. These personalized interventions may include clinical and behavioral healthcare, housing, job training, community activities, resilience training, educational workshops, and exercise programs.”

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The system leverages an open source EHR, called OpenEMR, which is certified by the Office of the National Coordinator for Health IT. Nonetheless, the EHR needed extensive customization to meet the needs of the FOCUS Pittsburgh Free Health Center, including:

• Modulating a number of typical steps in patient communications
  
• Making all documented data and lab test results convenient for query purposes
  
• Expanding the fields stored in the demographic area to collect data on employment, housing situation (socioeconomic status) and spirituality
  
• Itemizing certain fields needed in the information integration step, such as doctor’s diagnosis, treatment plan and medications in the prescription section
  
• Creating reminders and alerts specific to the patient community
  
• Formatting the history and physical examination section with specific tabs for ease of use in documentation
  

Still, Zhou contends that the EHR is optional and not a mandatory component for the imHealthy solution. “Some free health clinics do not have electronic health records, but even without that we can still do well-being assessments,” he says.


At the same time, he cautions that researchers have yet to conduct an overall system evaluation of imHealthy, which will take place after all of the separate components have been extensively tested. “We are doing the testing,” Zhou concludes. “We have the system in place. We did the test on the mobile app and now we’re doing a test on the web portal.”