Inequality related to race, ethnicity, and socioeconomic status is one of our nation’s most vexing problems, and it affects health status, access to health care, and health care quality.

Unfortunately, health disparities in access to quality care are common. The Agency for Healthcare Research and Quality’s (AHRQ) 2011 National Healthcare Disparities Report indicates that:

• Blacks received worse care than Whites for 41% of quality measures and Hispanics received worse care than non-Hispanic Whites for 39% of measures
• Uninsured individuals aged 64 and under were far less likely to have a usual source of primary care than individuals with insurance
• Low-income individuals received worse care than high-income people for almost half of the quality measures

New ONC Report: Understanding the Impact of Health IT in Underserved Communities and those with Health Disparities

What our research at ONC has found, however, is that health information technology has the potential to alleviate these inequalities.

ONC recently issued a report that looks at how communities and providers are using health IT to address the specific needs of populations experiencing disparities in access, quality of care, and health outcomes.  The report was based on previous work:

• A briefing paper that explored the impact of Health IT in Underserved Communities summarized our existing knowledge in this area. The paper focused on:
  • The nature of health disparities
  • Potential impact of health IT
  • Current uses of health IT in communities with health disparities and the underserved, and
  • Challenges providers have serving populations experiencing health disparities.
• Nine Health IT and Health Disparities case studies highlight the technologies and practices of communities and providers using health IT to meet the needs of the underserved.
  • A case study of how personal health records connected at-risk youth to health and socials services, an approach piloted by Wind Youth Services in Sacramento, California.
  • Another case study of how to use multi-modal health IT tools to improve quality and delivery of care to patients with diabetes, which highlights Howard University Hospital’s work in Washington, D.C.

Key findings from the report Understanding the Impact of Health IT in Underserved Communities and those with Health Disparities:

• Health IT has the potential to affect the health of populations experiencing health disparities. 
  Health IT can enable effective redesign of health care systems that can advance elements of the mulit-part aim: improving the quality of care and the health of populations, while controlling the per capita cost of health care.
• Programs are encouraging the uptake of health IT in underserved communities. 
  National efforts to encourage health IT adoption to improve the quality of service delivery by safety-net providers were taking place before the HITECH Act was implemented. HITECH supported new and expanded efforts by providing technical assistance to providers and clinics adopting health IT.
• To be effective in underserved settings, stakeholders should tailor health IT. 
  Underserved groups face unique challenges, as do the providers who serve them. Examples of issues that providers must address include meeting the needs of patients facing with limited health literacy or English proficiency.

ONC’s work accelerating and supporting health IT adoption and information exchange will lead to reduced disparities
ONC is leading efforts to accelerate adoption and optimization of health IT and health information exchange in underserved communities and for populations experiencing disparities. A critical piece of the strategy is ONC’s Regional Extension Center (REC) Program, which is charged with supporting primary care providers operating in small or medically underserved settings to implement EHR systems and achieve Meaningful Use.

How RECs are supporting the reduction of health disparities

• Critical Access Hospitals and small rural hospitals are vital components to the health care system in rural and other underserved areas.
  Learn more about how Regional Extension Centers are providing EHR and MU education and technical assistance to more than more than 60% of these hospitals and provides details on these hospitals’ progress towards Meaningful Use of EHRs.
• Federally Qualified Health Centers (FQHCs) provide primary and comprehensive healthcare services to underserved communities and populations.
  RECs are working with approximately 83% of these grant recipients to promote Meaningful Use of EHRs. Learn more about FQHC provider progress towards EHR adoption and meaningful use.
• The REC program serves as a unique opportunity to address the health information technology needs of PCPs working in underserved areas. REC enrollment rates are highest in rural areas and were also found to be highest in counties with the greatest health professional shortages. Read more about REC enrollment rates and other health disparities statistics.

ONC’s future work to reduce health disparities
ONC’s research demonstrates the progress being made to assist and support clinicians who serve vulnerable populations through health IT. We will maintain our focus on this important problem and continue to highlight the benefits these communities continue to enjoy as a result of the technology in an effort to help attack the problems.

ONC’s strategic plan includes objectives focused on promoting health IT to track and reduce health disparities, which requires us to help accelerate health IT adoption and information exchange for populations with unique needs.

We would love to hear your stories of how you’ve seen health IT work around America to reduce health disparities. Please leave your comment below.