Information technology as a tool to improve the quality of American Indian health care.

Department of Health Care Policy, Harvard Medical School, Brigham and Women's Hospital, Boston, MA 02120, USA.
American Journal of Public Health (Impact Factor: 4.23). 01/2006; 95(12):2173-9. DOI: 10.2105/AJPH.2004.052985
Source: PubMed

ABSTRACT The American Indian/Alaska Native population experiences a disproportionate burden of disease across a spectrum of conditions. While the recent National Healthcare Disparities Report highlighted differences in quality of care among racial and ethnic groups, there was only very limited information available for American Indians. The Indian Health Service (IHS) is currently enhancing its information systems to improve the measurement of health care quality as well as to support quality improvement initiatives. We summarize current knowledge regarding health care quality for American Indians, highlighting the variation in reported measures in the existing literature. We then discuss how the IHS is using information systems to produce standardized performance measures and present future directions for improving American Indian health care quality.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Indigenous people are significantly underrepresented in the fields of science, technology, engineering and math (STEM). The solution to this problem requires a more robust lens than representation or access alone. Specifically, it will require careful consideration of the ecological contexts of Indigenous school age youth, of which more than 70% live in urban communities (National Urban Indian Family Coalition, 2008). This article reports emergent design principles derived from a community-based design research project. These emergent principles focus on the conceptualization and uses of technology in science learning environments designed for urban Indigenous youth. In order to strengthen learning environments for urban Indigenous youth, it is necessary, we argue, that scholars and educators take seriously the ways in which culture mediates relationships with, conceptions of, and innovations in technology and technologically related disciplines. Recognizing these relationships will inform the subsequent implications for learning environments.
    Urban Education 09/2013; 48(5):705-733. DOI:10.1177/0042085913490555 · 0.56 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Chronic diseases and injuries are now the greatest threat to health in the 21st century.(1) Racial and ethnic disparities in health status, largely attributable to chronic diseases, are widely recognized as a priority public health and civil rights challenge.(2) The articles in this supplement of the American Journal of Public Health document the substantial burden of disease borne by American Indian and Alaska Native (AI/AN) people. Addressing these issues should continue to be a major priority for public health, amplified in urgency by the legacy of social, environmental and cultural injustices that have been inflicted on these populations. (Am J Public Health. Published online ahead of print April 22, 2014: e1-e3. doi:10.2105/AJPH.2013.301602).
    American Journal of Public Health 04/2014; DOI:10.2105/AJPH.2013.301602 · 3.93 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives. We evaluated heart disease death rates among American Indians and Alaska Natives (AI/ANs) and Whites after improving identification of AI/AN populations. Methods. Indian Health Service (IHS) registration data were linked to the National Death Index for 1990 to 2009 to identify deaths among AI/AN persons aged 35 years and older with heart disease listed as the underlying cause of death (UCOD) or 1 of multiple causes of death (MCOD). We restricted analyses to IHS Contract Health Service Delivery Areas and to non-Hispanic populations. Results. Heart disease death rates were higher among AI/AN persons than Whites from 1999 to 2009 (1.21 times for UCOD, 1.30 times for MCOD). Disparities were highest in younger age groups and in the Northern Plains, but lowest in the East and Southwest. In AI/AN persons, MCOD rates were 84% higher than UCOD rates. From 1990 to 2009, UCOD rates declined among Whites, but only declined significantly among AI/AN persons after 2003. Conclusions. Analysis with improved race identification indicated that AI/AN populations experienced higher heart disease death rates than Whites. Better prevention and more effective care of heart disease is needed for AI/AN populations. (Am J Public Health. Published online ahead of print April 22, 2014: e1-e9. doi:10.2105/AJPH.2013.301715).
    American Journal of Public Health 04/2014; DOI:10.2105/AJPH.2013.301715 · 3.93 Impact Factor


Available from