Health IT: Improving Access and Driving Change in Healthcare for Communities of Color
Dominick Mack, MD, MBA and Ayanna V. Buckner, MD, MPH, FACPM | April 21, 2014
Health care providers are leveraging the benefits of the increasing interoperability and portability of health information to improve population health outcomes. For communities that have historically experienced disparities in care, the uptake of EHRs and other forms of health IT is good news – as long as the providers and patients in these communities have accessibility to the technology.
This means the technology must be available, affordable and sustainable.
Currently, national EHR adoption rates are approximately 60%, up from 16% just five years ago. While there is not much data on adoption in underserved communities, some studies show that, even with increased EHR adoption, disparities remain in the rate of health IT adoption and access among populations that have higher rates of poverty and chronic diseases. This disparity is significant as morbidity and mortality rates associated with many chronic diseases, such as diabetes, hypertension, cancer, and HIV/AIDS, are more prevalent among underserved communities of color.
The Georgia Health Information Technology Extension Center (GA-HITEC), part of the Office of the National Coordinator for Health Information Technology’s (ONC’s) Regional Extension Center (REC) program, is working to help health care providers use health IT tools to better coordinate care for patients living with many of these chronic conditions. Health IT that is successfully integrated into clinical workflow has the potential to improve patient safety and quality of care while helping to eliminate health disparities. A recent study showed that Hispanic and Black patients who receive their care from physicians who use EHRs with clinical decision support had improved blood pressure control and no disparity in outcomes compared to whites than those who received care at practices without an EHR. However, the diffusion of health care innovations to underserved communities has historically lagged behind white communities. For example, Hing et al found that Black, Hispanic or Latino patients who were uninsured or Medicaid recipients were less likely to have Primary Care Physicians with EHRs compared with privately-insured patients. Minority patients are also significantly less likely to participate with electronic patient portals (pertinent tools to improving patient education and self-management) than whites.
Health IT is also essential for emergency preparedness and response. The Ready Georgia mobile app is making emergency preparation more accessible and helping Georgia residents better prepare, plan and stay informed during emergencies. With an increased focus on health IT, communities are better prepared for disasters because patients can access their health information even if they are displaced from their homes, and health care providers can access potentially lifesaving information that aids in clinical decision-making.
One local provider, Dr. Jeffeory White, a rural pediatrician in Northwest Georgia is using an EHR to improve the processes and patient experience of his own clinic. With his EHR, he is able to quickly notify his patients about pertinent health issues like medication recalls or issue reminders about annual vaccines, and at the same time check the accuracy of their medical records. Dr. White attributes improvements in the quality of patient care in his clinic to the objectives of the Meaningful Use program and his adoption of the Patient-Centered Medical Home practice model. It is important that national HIT initiatives are effective in assuring that certified EHR and other innovative HIT tools are disseminated fairly to primary care providers who treat underserved populations for the improvement of patient engagement and clinical outcomes to help eliminate health disparities.
 Hing, E. and Burt, C. (2009). Are there Patient Disparities When Electronic Health Records Are Adopted?. Journal of Health Care for the Poor and Underserved. 20. 473-488.