The Role of Health IT in Eliminating Health Disparities

Abstract

As we shift from documenting health-care disparities to implementing solutions to eliminate them, health information technology will play a critical role. Health information technology can alert physicians to deviations from evidence-based guidelines, improve clinical decision-making at the point-of-care, and support population-based management of health care (Custodio et al., J Health Care Poor Underserved 20:301-7, 2009). Telemedicine applications can improve access to specialist care for patients in remote and underserved areas (Fricton and Chen, Dent Clin N Am 53:537-48, 2009). Novel devices can provide close monitoring for high-risk populations. In short, health information technology (IT) can drive our efforts to monitor and reduce health-care disparities. The 2009 American Reinvestment and Recovery Act's (ARRA) HITECH provisions contain over $2 billion in programs and over $20 billion in incentives to support the adoption and "meaningful use" of Health Information Technology (Blumenthal, N Engl J Med 362:382-5, 2010). The Recovery Act also includes over $7 billion in grants to improve the availability of broadband technology in underserved areas. Together, these programs will lay the foundation for America's health IT infrastructure. They will also give us a new modality to monitor, manage, and correct health disparities. As with the diffusion of any new technology, there is always the risk that uneven access to electronic health records (EHR) by certain types of patients and providers will create new disparities in health. While the current data do not indicate that providers or patients of particular ethnic or racial groups are more or less likely to adopt or have access to electronic health records, careful attention must be paid to ensure that underserved patient populations are the beneficiaries of the clinical improvements that health information technology can enable. This chapter summarizes our current state of knowledge about health IT adoption among underservedcommunities and outlines a vision for how broad adoption and use of healthinformation technology can limit or correct health-care disparities. It describes the federal HITECH Act programs and also addresses how the federal government is working to ensure that the benefits of health IT are widely distributed to underserved populations.