Health disparities and health information technology (IT). Those two issues aren’t linked very often, but they should be, and National Health IT Week presents a great opportunity to talk about why. Health information technology is a valuable tool we can use to reduce disparities for millions of Americans and improve the quality of health care.
Disparities are a pervasive and devastating problem in this country. The National Healthcare Disparities Report 2012, produced by the Agency for Healthcare Research and Quality (AHRQ), found last year that “health care quality and access are suboptimal, especially for minority and low-income groups” and that “racial and ethnic minorities and poor people often face more barriers to care and receive poorer quality of care when they can get it.”
The annual AHRQ report, which is mandated by Congress, is a disturbing litany of unequal care that has dangerous consequences and carries enormous human and financial costs. Perhaps most concerning of all, the 2012 AHRQ report includes lists of measures for which the quality of care and disparities are actually getting worse.
But a new Disparities Action Plan from the Consumer Partnership for eHealth (CPeH) offers real hope to realize the potential value of health IT. Led by the National Partnership for Women & Families, CPeH is a national coalition of more than 50 consumer, patient and labor organizations working to advance health IT policies and practices that deliver tangible benefits to patients and families. After conducting a year-long review of scientific literature and collaborating with experts on disparities and health IT, CPeH produced the Disparities Action Plan, which provides recommendations for adopting and using health IT systems in ways that will reduce health disparities.
Since 2009, the government has invested considerable resources in bringing the country’s health information system into the 21st Century with a program that encourages doctors and hospitals to adopt and use electronic health records (EHRs) and information exchange in meaningful ways. This is often called the “Meaningful Use” program. On the eve of the third and final stage of incentive payments (Stage 3), it is clear the program isn’t doing all it could to reduce health disparities. The new Action Plan would change that; it offers ways that Stage 3 policy and implementation can improve identification, build understanding and help reduce health disparities.
In one example, the new Action Plan details how improved data collection and use can help doctors and hospitals identify disparities in health and health care and better understand how to reduce them. At present, the Meaningful Use program requires only a basic level of race, ethnicity, and gender data collection based on standards created by the Office of Management and Budget. The Action Plan recommends transitioning to the more rigorous data collection standards designed by the U.S. Department of Health and Human Services, similar to what the Census uses, to help providers better recognize, track, understand and address disparities and expand data collection to include disability status, sexual orientation and gender identity.
In another example, the Action Plan recommends that EHRs have the ability to stratify patients’ specific conditions by variables such as race, ethnicity, language, gender identity, sexual orientation, socio-economic status, and disability status. This would allow health care providers and researchers to identify patterns – for example, whether Hispanic or African-American patients experience a higher rate of a health condition than non-Hispanic White patients.
The Action Plan also recommends greater use of patient data collected and shared through devices such as smartphones, which are an important point of access to health care information for those in underserved communities. And for the 58 million Americans who speak languages other than English at home and the 56 million who have a disability, the Action Plan aims to make health information accessible in the languages patients speak, in plain language for patients with low literacy, and in ways that accommodate the needs of patients with disabilities.
CPeH has submitted the Action Plan to the Health IT Policy Committee, with a request that committee members consider and act on its recommendations. They should do so, to ensure that the country doesn’t squander the opportunity to implement health IT in ways that will reduce health disparities.
The new Action Plan is a bold, yet achievable, blueprint for including criteria in Stage 3 of the Meaningful Use program. It can help reduce disparities and advance the patient- and family-centered care, better outcomes, and lower costs the country so urgently needs.
Every American deserves an equal chance at a full, healthy life. Policymakers should recognize that health IT offers a way to provide just that, and use CPeH’s roadmap to bridge gaps in policy. We can, and must, use health IT to address health disparities.
