According to a recent study published by Health Affairs, hospitals in which racial and ethnic disparities exist are less likely than other hospitals to have adopted electronic health records (EHRs). Researchers surveyed 2,368 hospitals about their use of electronic systems for 24 functions. The hospitals that served the most Medicaid, African American and Hispanic patients had lower rates of EHR adoption compared to hospitals that served less of these patients.
Due to less financial viability, hospitals caring for the underserved may be trailing behind the health IT movement. In this study, hospitals providing care to the greatest number of poor patients were 22% more likely to cite lack of capital as a major barrier to adopting EHR systems compared to hospitals caring for patients with more financial resources.
“Hospitals with a high proportion of Medicaid patients or uninsured patients are less financially viable than hospitals with a higher-paying patient mix,” said Romana Hasnain-Wynia, PhD, director of the Center for Healthcare Equity at Northwestern University’s Feinberg School of Medicine in Illinois. “This study shows that financial factors play a big role in hospitals being either resource-constrained or resource-rich and that this does in fact have an outcome that relates to the quality of care.”
This study reflects the need for careful planning and consideration when the federal government is awarding funds promulgated by the HITECH Act. Perhaps physician offices and hospital systems serving the underprivileged communities should have priority over those medical facilities with more affluent patient populations. Often, the goals of utilizing EHR software are to increase quality, safety, efficiency, and profitability of healthcare delivery. There should be another noun included in this list: equality.
I like this quote by Irving Kristol: “Democracy does not guarantee equality of conditions – it only guarantees equality of opportunity.” While conditions that perpetuate health disparities may exist, healthcare systems should do all in their power to deliver healthcare that is of equal opportunity. This study should open eyes to the notion that while health IT may increase the quality, safety, and efficiency of healthcare delivery, it should be offered equitably to reduce, and not perpetuate, health disparities.