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Digital Inclusion and Health: Crisis or Opportunity?
Adam T. Perzynski, PhD
Assistant Professor of Medicine and SociologyCenter for Health Care Research and PolicyThe MetroHealth System
AMY R. SHEON, PhD, MPH
Executive Director, Urban Health Initiative,
School of Medicine
http://giveahand.ru/?k=WHO++Social+determinants+of+health
Socioeconomic Disparities in Cleveland
% <125% POVERTY
%BLACK
%UNEMPLOYED
% WITH 10 MBPS INTERNET
http://www.healthdatamatters.org/
https://hdm.livestories.com/explore
Internet + Socioeconomic Disparities
0
10
20
30
40
50
60
0 10 20 30 40 50 60 70
% U
nem
plo
yed
% with 10 MBS Internet
Unemployment
0
10
20
30
40
50
60
0 10 20 30 40 50 60 70
% W
/o H
S D
egre
e
% with 10 MBS Internet
Without High School Degree %
http://www.healthdatamatters.org/
https://hdm.livestories.com/explore
0
10
20
30
40
50
60
70
80
90
100
0
10
20
30
40
50
60
701
02
90
0
11
05
01
11
15
00
11
19
02
11
25
00
11
35
00
11
49
00
11
69
00
11
74
00
11
84
00
11
92
02
11
96
00
12
02
00
10
11
01
10
14
00
10
17
00
10
22
00
10
24
02
10
31
00
10
39
00
10
51
00
10
55
00
10
64
00
10
83
01
10
97
01
11
09
01
11
24
00
11
38
01
11
47
00
11
53
00
11
58
00
11
62
00
11
67
00
11
71
02
11
77
00
11
81
01
11
89
00
11
97
01
12
05
00
12
08
01
12
12
00
12
15
00
12
21
00
12
36
03
12
61
00
10
21
01
10
35
00
10
48
00
10
62
00
10
69
00
10
78
02
11
91
00
12
31
00
12
35
01
12
36
02
12
41
00
12
45
00
10
43
00
% H
H w
ith
10
MB
PS
Inte
rnet
% N
o D
egre
e o
r U
ne
mp
loye
dTen MBPS %
Without High School Degree %
Unemployment rate
http://www.healthdatamatters.org/
https://hdm.livestories.com/explore
Internet + Social & Economic Disparities
Disparities in Health Outcomes & Behavior
HIGH BLOOD PRESSURE
DIABETES
OBESITY
NO PHYS ACTIVITY
http://www.healthdatamatters.org/
https://hdm.livestories.com/explore
More Disparities in Health Outcomes & Behavior
SMOKING ASTHMA
CORONARY NOT INHEART DISEASE GOOD HEALTH
http://www.healthdatamatters.org/https://hdm.livestories.com/explore
Internet Access & Health Status
0
10
20
30
40
50
60
70
10
29
00
11
12
02
11
18
00
11
25
00
11
41
00
11
65
00
11
74
00
11
85
00
11
94
02
12
02
00
10
12
00
10
16
03
10
22
00
10
27
00
10
38
00
10
51
00
10
56
02
10
68
00
10
97
01
11
17
00
11
36
00
11
47
00
11
54
00
11
61
00
11
67
00
11
72
02
11
79
00
11
89
00
11
99
00
12
07
02
12
12
00
12
17
00
12
23
00
12
61
00
10
21
02
10
44
00
10
62
00
10
70
00
11
88
00
12
31
00
12
35
02
12
39
00
12
45
00
10
77
01
% w
ith
Illn
ess
Ten MBPS %
Diagnosed diabetes among adults aged >=18 Years, 2014
High blood pressure among adults aged >=18 Years, 2013
0
5
10
15
20
25
30
35
40
0 10 20 30 40 50 60 70% W
ith
Dia
bet
es
% HH with 10 MBPS Internet
Diagnosed diabetes among adults aged >=18 Years, 2014
0
10
20
30
40
50
60
70
0 10 20 30 40 50 60 70
% w
ith
HB
P
% HH with 10 MBPS Internet
High blood pressure among adults aged >=18 Years, 2013
http://www.healthdatamatters.org/https://hdm.livestories.com/explore
http://giveahand.ru/?k=WHO++Social+determinants+of+health
What the Health does Internet have to do with it?
Portal
Equipment
Skills
Content Access
Telehealth Sign up for /update insurance
Social support network Comparison shop for meds
Connect with community services
Other gov’t benefits
Request transportationLearn about research studies
Find healthy food, cooking tips, nutrition info
Provide data Find recreationH
ealthR
emin
ders
Amy Sheon May 2, 2017
Low Levels of MyChart Use at MetroHealth
75.3%
24.7%
0
50,000
100,000
150,000
200,000
250,000
Do Not Use PHR Use PHR
Nu
mb
er
of
Pat
ien
ts
MyChart Use by Ethnicity and Age
30.7
19 18.7
23.6
0
5
10
15
20
25
30
35
White Black Hispanic Other
% U
sin
g P
HR
30.1
25
16.5
0
5
10
15
20
25
30
35
18-64 years 65-79 years 80+ years
% U
sin
g P
HR
MyChart Use by Broadband Access
15.2
18.6
25.5
3331.8
0
5
10
15
20
25
30
35
40
0 - 20% 20 - 40% 40 - 60% 60 - 80% 80 - 100%
% U
sin
g P
HR
Census Tract Broadband Coverage
% of total population
What are we doing about it?
MyChart Pilot
Taking the model to scale
Testing universal screening for digital skills and connectivity At MetroHealth
At United Way
Test using Community Health Workers to screen and refer
If successful: city agencies assess digital skills & connectivity? Refer or train in-house
Thank You!Adam Perzynski, Phd Amy R. Sheon, PhD, MPH
Case Western Reserve University School of Medicine
[email protected] [email protected]
Twitter: @ATPerzynski Twitter: @amysheon, @Clehealthcuy
