Health IT Creates Unintentional Healthcare Disparities

Health information technology (IT) can create greater healthcare disparities if all patient groups and their concerns aren't considered properly, panelists said on the first day of the annual meeting of the Office of the National Coordinator for Health IT.

While evolving health IT allows the patient more contribution to their own care, their involvement can only happen insomuch as the technology is accessible and usable by all patients regardless of socioeconomic status and what language they speak, according to panelists Annie Fine, MD, medical director of data analysis and reportable disease in the Surveillance Unit in the New York City Department of Health and Mental Hygiene, Ivor Horn, MD, medical director at the Center for Diversity and Health Equity in Seattle Children’s Hospital, and John Mafi, MD, internal medicine fellow with Open Notes and Beth Israel Deaconess/Harvard Medical School.

Dr Mafi’s Open Notes project better involves patients in their care by allowing them to read the physician notes from their visit. As a result, preliminary results have shown enthusiasm for the technology and self-reported clinical benefits. The next phase, Our Notes, allows patients and physicians to both contribute to the medical record.

Dr Horn explained that many of the patients Seattle Children’s Hospital serves are disadvantaged with not only health literacy concerns, but literacy concerns in general. Plus, many families have limited English proficiency, which could prevent them from participating in projects like Our Notes.

“If you think about disparities in healthcare with regard to race in particular, we've gotten sort of somewhat better in terms of process measures, like making sure we give aspirin for myocardial infarction, but outcomes still remain poor for nonwhite race ethnicity populations,” Dr Mafi said.

Dr Fine added that better data on these different communities will allow providers to zero in on those disparities. And this data can be as simple as where the patient lives, what’s happening in the community, their race, their socioeconomic status, and if they are or are not working.

“Putting the health outcomes together with that on a population level will be such a powerful way to understand better what’s happening and be able to target and move forward,” she said.