Adolescence is a time of physical and emotional changes and transition between the worlds of childhood and adulthood. The problem is that 25 percent of 18 million adolescents have the onset of chronic conditions such as obesity, hypertension, and schizophrenia, but at the same time, may have difficulty receiving appropriate care for their physical and mental health needs.
The brief “Investing in the Health and Well-Being of Young Adults” www.iom.edu published October 2014, by the Institute of Medicine (IOM) reports “Young adults are too rarely treated as a distinct population in policy, programs, and research but instead are often grouped with all adults.
The IOM Committee’s report emphasizes that the current policies and programs addressing young adults are too often fragmented, uncoordinated, and inadequately focused on the specific developmental needs of this population.
Many other experts in the U.S agree that emerging healthcare models may be helping adolescents to access appropriate care but yet it has been found that many needs are not being met to help adolescents receive healthcare that is affordable, appropriate, equitable, and accountable.
Leslie R. Walker, MD, Chief of the Division of Adolescent Medicine and Professor and Vice Chair of the Department of Pediatrics, at the University of Washington http://seattlechildrens.org took part in an Alliance for Health Reform www.allhealth.org briefing held December 15, 2014 on Capitol Hill to discuss what should be done to provide adolescents the best healthcare.
She emphasized the need to integrate services linked to an extended medical home with trained providers since adolescents may need multiple services such as chronic disease care, mental health care, and learn how to deal with substance abuse.
Dr Walker recommends implementing integrated physical and behavioral health medical homes specific to adolescents and the young adult population. She also wants to see resources and training increased for health providers, support for continued research with ready access to findings to promote treatment guidelines for this age group, and appropriate services provided in all communities.
Another panelist Victoria Ward, LCSW, Bronx Regional Director of Psychosocial Services at the Institute for Family Health www.institute.org also highlighted the need to integrate and coordinate physical and behavioral healthcare for adolescents. She reports that since physical and behavioral health problems often occur at the same time, integrating services to treat both yields the best results.
The Institute has been using EHRs since 2002 in an integrated care setting. For example, the Institute uses “MyChart-MyHealth”, www.institute.org, as the patient portal to the EHR. Patients can use the website to make appointments, view test results, request medical refills, send messages to their providers, and view reliable consumer health information on their conditions. The Institute is also collaborating with the New York City Department of Health and Mental Hygiene www.nyc.gov/doh, and by working together has developed and implemented a model EHR-based quality reports system organized around New York City’s public health priorities.
Other projects underway at the Institute include:
- Using registries to improve population health. So far, EHR-based registries have been created for diabetes and CHF. Primary care providers use the registries to make sure that all patients are getting the best care and to remind patients of any needed screenings or follow-up
- HRSA www.hrsa.gov funded a customized scoring system to rank patients according to their risk of developing diabetes
- HRSA provides funds to help update the patient intake process so that patients can provide detailed granular ethnicity information to help identify groups of patients experiencing health disparities
- National Library of Medicine www.nlm.nih.gov, created MedlinePlus Connect www.nlm.nih.gov/medlineplus/connect/overview.html to integrate with any EHR system. The system is able to link patient’s health information available through the patient portal to relevant health information maintained in NLM’s www.MedlinePlus.org website