Report: Health IT can help improve blood pressure care for all racial groups
Researchers investigating racial/ethnic disparities among patients receiving care that utilizes varying degrees of health IT determined healthier overall blood pressure regardless of race for those receiving care from providers using both EHRs and clinical decision support (CDS), according to a report published Jan. 9 by the Archives of Internal Medicine.
Researchers conducted a nationally representative sample, analyzing data from 17,016 visits included in the 2007-2008 National Ambulatory Medical Care Survey, which was administered by the National Center for Health Statistics.
Patients enrolled in the study had an average age of 51 years old; 33 percent were male, 15 percent had diabetes, 34 percent had hypertension, 64 percent were non-Hispanic whites, 14 percent were non-Hispanic blacks and 15 percent were Hispanic.
Of the visits studied, 15 percent were to providers using only EHRs, 27 percent were to providers using both EHRs and CDS and 48 percent were to providers using neither.
Results of the analysis showed that, with blood pressure control defined as visits with blood pressure below 140/90 mm/Hg:
“In fully adjusted analyses stratified by EHR and CDS use, we found improved blood pressure control for all racial/ethnic groups among patients receiving care from providers using both EHRs and CDS,” wrote corresponding author Lipika Samal, MS, MD, of Brigham and Women’s Hospital in Boston, and colleagues.
“Significant differences in rates of blood pressure control between non-Hispanic black and non-Hispanic white patients persisted in only one category[:] the visits where providers used neither EHRs nor CDS,” they continued.
The researchers also wrote that analyses showed additional differences between certain subgroups, but that they were not statistically significant. Although they asserted their findings suggest that primary care implementation of EHRs with CDS may mitigate blood pressure control disparities between whites and blacks, which may in turn reduce racial/ethnic disparities in morbidity and mortality from cardiovascular disease, they admitted limitations to their study design and suggested additional research on the subject.
Researchers conducted a nationally representative sample, analyzing data from 17,016 visits included in the 2007-2008 National Ambulatory Medical Care Survey, which was administered by the National Center for Health Statistics.
Patients enrolled in the study had an average age of 51 years old; 33 percent were male, 15 percent had diabetes, 34 percent had hypertension, 64 percent were non-Hispanic whites, 14 percent were non-Hispanic blacks and 15 percent were Hispanic.
Of the visits studied, 15 percent were to providers using only EHRs, 27 percent were to providers using both EHRs and CDS and 48 percent were to providers using neither.
Results of the analysis showed that, with blood pressure control defined as visits with blood pressure below 140/90 mm/Hg:
- As a whole, 71 percent of non-Hispanic black patients had blood pressure control compared to 76 percent of both Hispanic and non-Hispanic white patients;
- When limited to hypertensive subgroups, 53 percent of non-Hispanic black patients had blood pressure control compared to 60 percent of non-Hispanic whites;
- When limited to patient visits where the provider used both an EHR and CDS, 78 percent of non-Hispanic whites had blood pressure control compared to 85 percent of Hispanics; and
- When limited to patient visits where the provider used neither, 69 percent of non-Hispanic blacks had blood control compared to 75 percent of non-Hispanic whites.
“In fully adjusted analyses stratified by EHR and CDS use, we found improved blood pressure control for all racial/ethnic groups among patients receiving care from providers using both EHRs and CDS,” wrote corresponding author Lipika Samal, MS, MD, of Brigham and Women’s Hospital in Boston, and colleagues.
“Significant differences in rates of blood pressure control between non-Hispanic black and non-Hispanic white patients persisted in only one category[:] the visits where providers used neither EHRs nor CDS,” they continued.
The researchers also wrote that analyses showed additional differences between certain subgroups, but that they were not statistically significant. Although they asserted their findings suggest that primary care implementation of EHRs with CDS may mitigate blood pressure control disparities between whites and blacks, which may in turn reduce racial/ethnic disparities in morbidity and mortality from cardiovascular disease, they admitted limitations to their study design and suggested additional research on the subject.