NOTE: In responding to at least two posts, offer suggestions and considerations about engaging the community that may not have been considered in the original post. Your peers will appreciate your feedback as they work to finalize their analysis and recommendations for the final project.

Response one PHM-07

Adverse childhood events (ACE) or traumatic events experienced by a child, have long-term medical and psychological consequences. Because of the nature of the trauma (abuse, neglect, living in a family dealing with mental illness or substance abuse), these events do not occur in a vacuum but are part of a family dynamics.

Although interventions geared toward minimizing the impact of toxic stress from ACE are specifically focused on the affected child, the holistic approach to treat and prevent reoccurrence of symptoms involve treatment of the whole family and at times the whole community (Burke Harris, 2018). Indeed, what would be the benefit of preventing the injuries from toxic stress if the insult of ACE were to continue.

The interventions to stop the repeated occurrences of ACE have to target the need of the community in order to be effective (Shi & Johnson, 2014). The most effective strategy undertaken by Doctor Burke Harris in combating the harmful effects of ACE was the creation of the Center for Youth Wellness.

In this center.a multidisciplinary team tackles the medical and psychological effects of toxic stress on youth but also involves the community in classes on nutrition, exercise, parenting, healthy relationships and others. The above interventions were successful in reaching many family members and proved that addressing ACE as part of a community effort was essential (Burke Harris, 2018)

References

Burke Harris, N. (2018). The deepest well. London: Bluebird.

Shi, L. & Johnson, J. (2014). Public health administration. Burlington, MA: Jones & Bartlett Learning.

RESPONSE TWO PHM-07

From the analysis that I have done so far for my final project, one public health challenge that I mentioned is the access of personal health information. As stated previously in my project, the overall privacy of the information is an issue that is of utmost importance and should not be taken lightly.

Basic patient information, such as identification numbers, patient names, and telephone numbers (among others), is extremely limited to professionals involved in the care of the patients under the Standards for Privacy of Individually Identifiable Health Information (Richards, 2009). The Genetic Information Nondiscrimination Act (GINA) was passed in 2008 as it pertains to requesting/accessing genetic information.

In Title I of the act, group and individual health insurers are prohibited from acquiring information in underwriting as it pertains to genetics (Rothstein &Talbott, 2017). In Title II of the act, a particular employer who purchases, requests, or requires genetic-related information with respect to a family member of the employee or the employee in general is considered to be committing an unlawful employment practice (Rothstein &Talbott, 2017). Another challenge that was not mentioned but still has relevance to the project is the quality of data. Medical errors are common in the documentation of data within an electronic medical record (EMR) system. As a matter of fact, "missing elements and inconsistencies are common" (Paul, Greene, Newton-Dame, Thorpe, Perlman, McVeigh, &Gourevitch, 2015, p. 213).

Behavioral variables (i.e., smoking, alcohol/drug use), contextual factors (i.e., employment history, housing status, income level, literacy, marital status, etc.), and demographic variables (i.e., race and ethnicity) are data elements that are collected in an uneven manner when placed in an EMR system (Paul et al., 2015). Diet and physical activity are just some of the many behaviors that are missing in the system altogether (Paul et al., 2015). As far as physical/mental health care and social factors are concerned, there must be further innovation needed to document all of the information needed to document all of the information properly (Paul et al., 2015).

In order to address these challenges, one strategy that I will use to engage the community is educating the residents within the community on how to utilize their health information in a manner that is extremely confidential, private, and secure (Venkatraman, Bala, Venkatesh, & Bates, 2008). I would also inform them that they have the absolute right to "request that certain uses and disclosures of their PHI [public health information] be limited" (Richards, 2009, p. 553).

After all, the residents are the consumers, and they must take advantage of seeing their own health information for themselves. They also have the right to gather information related to their conditions (Venkatraman et al., 2008). I would also persuade the residents to inform their primary care providers about correcting/documenting all of the necessary health information that is vital to them; this means all of the aforementioned categories. The primary care providers must do so in a proper and effective manner. Simply put, an EMR system is of substantial benefit to a community, which is the overall essence of population health.

References

Paul, M. M., Greene, C. M., Newton-Dame, R., Thorpe, L. E., Perlman, S. E., McVeigh, K. H., &Gourevitch, M. N. (2015). The State of Population Health Surveillance Using Electronic Health Records: A Narrative Review. Population Health Management, 18(3), 209-216. doi:10.1089/pop.2014.0093

Richards, M. M. (2009). Electronic medical records: Confidentiality issues in the time of HIPAA. Professional Psychology: Research and Practice, 40(6), 550-556. doi:10.1037/a0016853

Rothstein, M. A., &Talbott, M. K. (2017). Compelled Disclosures of Health Records: Updated Estimates. Journal of Law, Medicine & Ethics, 45(1), 149-155.

Venkatraman, S., Bala, H., Venkatesh, V., & Bates, J. (2008).Six Strategies for Electronic Medical Records Systems. Communications of the ACM, 51(11), 140-144. doi:10.1145/1400214.1400243