Closing the Gap Initiatives

• Prevention and Control of Hypertension and Diabetes in an Underserved Population Through Community Outreach and Disease Management: A Plan of Action - Joseph C. Gerber, RPh, PhD, and David L. Stewart, MD, MPH

  The Baltimore Alliance for the Prevention and Control of Hypertension and Diabetes was established in January 1998 to promote care to the underserved community of West Baltimore, Maryland, and to improve outcomes of hypertension and diabetes. Based at the University of Maryland School of Medicine, the Baltimore Alliance comprises a community health worker program, a church-based education and screening effort, managed care and pharmaceutical company (Hoechst Marion Roussel) partners, a health policy and services research group, and inpatient/ outpatient clinical care sites in the health system.

• Soft Touch with High Tech

  Caring for Medicaid and other low income patients is often expensive, due to their high incidence of disease; internal and external barriers; stressful environments; and unfamiliarity with the importance of prevention, early reporting of symptoms and compliance with therapy. However, a strategic plan with "Soft touch and High tech" includes trained community health workers to work directly with clients; culturally designed health education programs in key areas such as breast feeding, self breast examination, smoking cessation; and case management programs for adult on-set diabetes, hypertension, and cholesterol etc. A critically important high tech tool is an interactive computerized registry to track and monitor outcomes for immunizations; hypertension; diabetes; CHD; smoking cessation; and other patient outcomes with a variety of patient negative and positive behaviors, diseases and disorders.

• The Urban Health-NET

  The Urban Health-NET will focus on providing health education to the residents of the urban underserved communities; training community health workers (CHW) through a distance leaming (DL) program: tracking health concerns; and generating health data profiles. The network would also give doctors and staff in area hospitals and health centers the connectivity that would ultimately result in an integrated medical record for over 200,000 Medicaid recipients and low-income citizens of Baltimore's Empowerment Zone. One of the major goals of the project is to provide the clinical professionals, serving the most disadvantaged citizens of our community, access to the Internet, E-mail, clinical information systems, library information, patient information and medical research data bases.

• The Urban Technology Initiative

  The Harlem Park - Lafayette Square Technology Initiative is a new concept in vocational training. It is a collaborative effort to design, develop and implement a comprehensive system of recruiting, screening, educating and counseling with selective interventions to motivate and train youth in basic survival skills, personal presentation, motivational skills, Internet applications and the latest high technology.