HealthShack.info
The door is always open…
HealthShack.info
PRESENTERS:
• Aaron Amos, Kevin Johnson - Youth Health Ambassadors
• JD Rudometkin - HealthShack Project Manager
• Catrina Virata, MPH - UC Davis HealthShack Data Evaluation
Team
• Tirza Cannon - HealthShack Resource Liaison
HealthShack.info
COMMUNITY PARTNERS:
•
•
•
•
•
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WIND Youth Services
Follow Me Inc.
Linkage to Education
Sierra Health Foundation
CSU Sacramento - Division of Nursing
Youth & Young Adult Clinic at UC Davis Children's Hospital
What is HealthShack.info?
HealthShack.info is a youth-controlled,interactive, online
Personal Health Information System (PHIS). Designed for
and by marginalized and homeless youth.
•Web-based
•Secure & HIPAA compliant
•Youth-friendly tools &
resources
•Social networking
Personal Health Information
System (PHIS)
•
•
•
•
•
•
Stores health information
Provides health information and resources
Youth client portal for updates and personal use
Clinician portal for professional entry
Youth-controlled confidentiality
Private
Why a PHIS is Important for
Marginalized Youth
• Medical records are non-existent or stored in a variety of places
•Youth lack acceptable forms of identification
• Gives youth a sense of stability and responsibility
• Inconsistent or non-existent medical care
• Lack of medical home, continuity of care
• Gaps in preventive services
• Youth do not have safe place to keep
important documents including medical history
The Goal of HealthShack.info:
To improve the holistic health of marginalized and
homeless youth by:
• Facilitating the continuity of medical care
• Encouraging self-empowerment
• Linking youth to local, youth-approved
resources
How did HealthShack.info Begin?
HealthShack.info began as an expansion and adaptation of MiVIA
- a patient “owned” Personal Health Record originally designed by
Follow Me, Inc. for migrant agricultural workers.
Funding:
• Initial - Sierra Health Foundation
• Secondary - United Pacific Care
Development:
•Focus Groups - assessing the needs of homeless and
marginalized youth
•Follow-up Interviews - how to adapt MiVIA to homeless and
marginalized youth population
•Recruitment of Youth Health Ambassadors
WIND Youth Services
"WIND Youth Services engages youth experiencing homelessness who need
safety from the streets and access to resources to help them move from crisis to
healthy functioning and independence."
Serves marginalized and homeless transition aged youth in
Sacramento, CA
Provides individualized case management services with the
goal of assisting youth in gaining their independence
Health Ambassadors
Keeping a youth’s perspective in the development of HealthShack.info
• Formally marginalized and previously homeless
youth ages 16 to 22
• Expert advisors
• Link to youth
• Add “youth” legitimacy
• Examples of positive change
What We Do…
• Recruit youth to HealthShack.info
• Explore & Research Resources
• Site Visits
• Videos
• Blogs
• Participate in Community
Collaborations and Events
Commonly Addressed
Youth Concerns
• Intake is a doctor’s appointment
• It’s not confidential
• Don’t feel comfortable talking to the Public Health Nurses
• Worried about the time an intake will take
• Feel that HealthShack is “just another program that doesn’t do
any good”
• Don’t recognize the benefits beyond linkage to
health care.
Public Health Nurses
A consistent link to health services & an advocate for health needs
• PHNs Assist youth with creating a HS account
• Perform a comprehensive health and health-needs assessment
• Enter personal data
• Inform youth about confidentiality issues relating to healthcare
and self-management of health records.
• Identify gaps in preventive services and acute care needs
• Provide health assessments, health education, and
confidential health counseling on an on-going drop-in basis
• Coordinate care with WIND staff, community clinics, and other
local health and service resources
• Advise on health related issues for HealthShack.info
development
• Follow-up visits with youth
Clinician Patient Record
Personal Information
Confidentiality Controls
HealthShackResources.inf
o
http://www.healthshackresources.info/
HealthShackResources.inf
o & assess local
• Health Ambassadors identify
resources
• Presentation of resource (pick one to link to)
–Write up
–Videos
–Pictures
• Philosophy
–Include “first-steps”
–Determine youth-friendliness
–Utilize existing assets
Additional Features
• Blog
– Add link/screen for presentation
• Physician’s Tip
–Add link for presentation - show video clip?
• Social Networking
– Facebook
– MySpace
• Resume Builder
– Add screen shot for presentation
Ongoing Research & Evaluation
Data as of 02/04/2010
Enrollment: 133
Demographics
Gender
Total
Age
Male
Female
67
66
9 - 13
14 - 17
18 -21
22 - 25
>25
17
47
57
8
4
Total
Screened for Interview & Completed Initial & Follow Up Interviews
Total
Screened
Completed
Initial
Completed
Follow-Up
62
27
16
Ongoing Research & Evaluation
Data as of 02/04/2010
Enrollment: 77
Demographics
Age
Gender
Total
Male
Female
67
66
Total
9 - 13
14 - 17
18 -21
22 - 25
>25
17
47
57
8
4
Race
Total
Not
Identified
African
American
Asian
Caucasian
Hispanic/
Latino
Other
2
31
4
21
10
9
Ongoing Research & Data
Evaluation
as of 02/04/2010
Medical & Health Background
Medical Insurance Status
Total
Without
Insurance
With
Insurance
Unknown
Status of
Insurance
21
33
23
Medical Insurance Providers
Total
Aetna
Blue
Cross
Medi-Cal
Family
PACT
Kaiser
Kaiser
Medi-Cal
Medi-Cal
Tri-West
1
5
1
3
3
19
1
Primary Care Physician Status (PCP)
Total
Without PCP
With PCP
Unknown
Status of PCP
18*
19
40
* 4 clients were referred to PCP & 2 declined referral. 3 clients were not referred to PCP
Ongoing Research & Data
Evaluation
as of 02/04/2010
Medical & Health Background
Medical Services Received by Client in Past 12 Months
Total
PCP
Preventive
Care
Mental
Health
Emergency
Room
10
12*
3
5**
* 6 from PCP, 4 from a clinic, 1 from dental office, 1 from Juvenille Hall
** # of visits ranged from 1 - 3
Medical Services Received by Client in the Past
Total
Mental Health
Dental Care
8*
8**
* 3 clients received services in past 12 months
** 3 had dental insurance, 1 reported dental insurance - but received no services
Knowledge of Immunization Records (IR)
Total
Don’t Know
Where IR is
Know Where IR
is
Unknown
Status of IR
16
15
45
Remaining Challenges
• Youth remembering login and password
• Not using a wallet, no place to put ID card
• Having consistent health care services to refer
youth to
• Educating local health care providers about
HealthShack.info
Future Directions
• Youth and provider education and training on
how to utilize HealthShack.info
• Outreach to vulnerable youth prior to exiting
systems (emancipating foster youth and probation
youth)
• Expansion to other communities
• Creating an online community
Acknowledgments
• Jasmine Edwards & Vivek Anand
(WIND Youth Services - Health Ambassadors)
•Elizabeth Miller, MD, PhD (UC Davis School of Medicine)
• Ellyne Bell, Uylous Ingram, Youth Advocates (WIND
Youth Services)
• Diane Littlefield (Sierra Health Foundation)
• Kim Whitney, Michelle Dang (Public Health Nurses)
• Cynthia Solomon, Heidi Stoval (Follow Me)