Well-designed IT systems could reduce health disparities
Well-designed health IT systems not only hold the key to better quality of care, but also can play a role in reducing health disparities among low-income and minority communities, according to a recent report.
Written by the California Pan-Ethnic Health Network, the Asian & Pacific Islander American Health Forum, Consumers Union and the National Council of La Raza, the report states that financial incentives through the HITECH Act provide an opportunity to improve equity in care. But as full implementation of healthcare reform and EHRs is expected between 2014 and 2016, efforts must be undertaken to ensure that communities of color, those who do not speak English well and immigrants do not experience further disparities, the report stated.
The report advanced several recommendations to harness the potential of HIT without exacerbating the existing “digital divide.”
The authors suggested that providers capitalize on mobile technologies to increase access to health information and services. A limited number of Latinos (55 percent) and African Americans (25 percent) have home internet connections, but standard cell phone use is commonplace. Evidence that a growing number of Latinos and African Americans are accessing the internet through smartphones shows potential for better outreach, education, communication and engagement for underserved populations through this technology, the report stated.
A simplified online enrollment application process that recognizes mixed-status households, and differences in language, culture and health literacy, also is crucial. These forms should request only required information and guarantee protection of health information. According to the report, a number of states have launched online enrollment applications, including Wisconsin’s Forward Health interChange.
Other important considerations include making systems backwards-compatible, so older computer systems can run the programs, and simplifying the websites so they do not take long to load. Community health workers also can take advantage of mobile technologies to enroll people they meet during outreach.
While EHR systems improve quality of care, the report noted providers should collect demographic data so they can design targeted programs. Other beneficial HIT practices include documenting primary language in the EHR, which is especially critical when issuing prescription instructions, and developing an online library of materials in multiple languages.
Coordination with public health departments to provide aggregate, stratified health data also was recommended. Such information exchange “will enable public health professionals not only to identify any disparities but also the need for a focused public or community health response.” One example given was a San Francisco Department of Public Health text messaging service to combat sexually transmitted diseases.
Security and confidentially of data to ease patients’ concerns are essential, the report stressed.
“Health data should not be used to deny or restrict insurance or health care services, to engage in deceptive marketing to patients and consumers, or to deny or restrict a patient’s rights under the laws, including immigration laws,” the authors stated.