Stakeholders address questions related to HIT impact on healthcare disparities at invitational roundtable

A diverse group of healthcare stakeholders address questions related to health information technology's (HIT) impact on health and healthcare disparities in a two-day invitational roundtable on March 7-8, sponsored by the Kaiser Permanente Institute for Health Policy, the Agency for Healthcare Research and Quality, and AMIA, the association for informatics professionals. Participants represent the perspectives and concerns of community health centers, health systems, health plans, clinicians and other providers, and consumers.

Roundtable sponsors note that electronic medical records and Internet-enabled tools such as patient websites and personal health records hold great potential for improving care for all populations, especially those with chronic conditions like diabetes or heart disease. However, a growing body of evidence suggests that such technologies could inadvertently increase existing health disparities if the benefits are available mainly to those who have the technical access, skills, supports, and incentives to use them. Less advantaged populations, including many seniors, minorities, low-income, and physically disabled adults may be less able to take advantage of these technologies due to lack of technical access, skills, and literacy; lower health literacy; language barriers; and other issues. In addition, these same at-risk populations tend to be served by under-resourced providers who themselves lack the costly and sophisticated HIT systems that support quality improvements.

The roundtable's focus is on public and private policies and practice strategies that could mitigate potential disparities in the use of HIT; the roles of health plans and health systems in addressing the issues; and relevant research priorities, among other questions. A synthesis paper will be prepared for publication following the event.

Leaders of the sponsoring organizations strongly agree that the HIT/disparities questions merit urgent attention:

"The informatics community is highly aware that heightened use of health information technology could result in greater healthcare disparities," said AMIA President and CEO Edward H. Shortliffe, MD, PhD, FACMI. "While that unintended consequence is a possibility, AMIA is taking steps to expand informatics in public health, because we recognize that wise use of technology for health promotion and disease prevention and detection addresses the needs of the entire population, thereby lessening opportunities for disparities to develop."

Ray Baxter, PhD, Senior Vice President for Community Benefit, Research, and Health Policy at Kaiser Permanente added, "At a time when millions of lower-income, previously uninsured individuals will be gaining healthcare coverage through health reform, it is vital that both public and private delivery systems develop strategies to ensure that the great benefits of HIT systems are shared equitably. This is a social justice imperative."

"Disparities in health care are common and, unfortunately, many disparities are not decreasing. Health IT is a promising way to address disparities by increasing access to and improving quality of health care for many populations, including the rural and underserved. Efforts to ensure that patients and physicians have access to these technologies are essential to address this national problem," said P. Jon White MD, AHRQ's Director of Health IT.