Addressing Health Disparities through the Lens of Public Health

At the New York City Health Department’s Primary Care Information Project (PCIP), we work to promote health equity and address the health disparities that persist across our country, not just during Minority Health Month (which was April).

Obesity by UHF in PCIP sample age adjusted and weighted by age/gender to the New York City population

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We accomplish our mission of improving population health through the use of health IT by leveraging relationships with over 10,000 providers cultivated through our Regional Extension Center, NYC REACH. Much of our work focuses on developing and implementing quality improvement initiatives that help providers deliver preventive services. Together, new health IT-focused policies and technological advances aimed at improving care and quality allow PCIP and the city to identify disease disparities in member practices. Because of the increased adoption and meaningful use of EHRs among physicians in New York City, documentation of race and ethnicity in patient medical records has improved. In 2009, documentation or collection of patient race/ethnicity data was 66%. Today, over 85% of patients have race or ethnicity recorded. This allows providers and other users of these systems to better evaluate potential racial and ethnic disparities.

Looking to the future, PCIP will continue to support the community to provide high quality care and improve patient health. With this data on disparities in care, we will be able to work with partners like accountable care organizations, managed care plans, and New York State Medicaid to ensure resources and attention are going to these underserved communities.

Fortunately, this story is not unique to New York City.  Through the Medicare and Medicaid EHR Incentive Programs, doctors from Maine to Guam have the tools to instantly evaluate their patient populations. The Office of National Coordinator for Health IT has spearheaded the development of this health IT infrastructure through federal pilot programs that promote new care delivery models. We are starting to see the growth of a foundation to the nation’s health system that rewards providers for providing the highest quality of care, and ensures no patient is left behind.

Although health IT alone cannot improve patient outcomes, it enables the health care community to identify issues through better data analysis. With the continued adoption and use of health IT, efforts to reduce disparities that impact health outcomes for these underserved patients and populations can be accelerated. As noted by NYC Health Department Deputy Commissioner Dr. Amanda Parsons, “understanding and addressing health disparities are difficult tasks. EHR data acts as another tool in our toolbox to inform, target and measure interventions for underserved populations.”

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