Bridging the Digital Divide in Health Care: The Role of Health Information Technology in Addressing Racial and Ethnic Disparities
Bridging the Digital Divide in Health Care: The Role of Health Information Technology in Addressing Racial and Ethnic Disparities
复制标题
DOI：
10.1016/s1553-7250(11)37055-9
复制
发表时间：
2011-10-01
影响因子：
2.3
通讯作者：
Betancourt, Joseph R.
中科院分区：
文献类型：
--
作者：
Lopez, Lenny;Green, Alexander R.;Betancourt, Joseph R.
背景：医疗保健方面的种族和民族差异在许多常见临床病症的诊断、治疗和结果中得到了一致的记录。美国健康信息技术 (HIT) 的实施加速，医疗保健改革立法包括收集和使用健康信息以提高和监控医疗保健质量和效率的多项规定。尽管实施情况参差不齐且普遍较低，但研究表明 HIT 有潜力提高护理质量和患者安全。如果精心设计和实施，HIT 还具有消除差异的潜力。HIT 和差异：HIT 的干预措施可以解决造成差异的几个根本原因，特别是电子健康记录方面的创新以及慢性病管理策略。有关医疗保健系统、提供者和患者因素的建议可以帮助医疗保健组织在采用、扩展和定制 HIT 系统时解决差异问题。在医疗保健系统因素方面，组织应 (1) 自动化和标准化种族/族裔和语言数据的收集，(2) 优先使用数据来识别差异和定制改进工作，(3) 将 HIT 的工作重点放在解决少数族裔/族裔和英语水平有限的患者的分散护理服务问题上，(4) 为存在显着差异的临床领域开发有针对性的计算机化临床决策支持系统，以及 (5) 纳入少数族裔/族裔和英语水平有限的人的意见熟练开发患者 HIT 工具以解决数字鸿沟。结论：在对 HIT 进行投资时，必须考虑这些创新对所有患者（包括那些经历差异的患者）的医疗保健质量和成本的影响。
Background: Racial and ethnic disparities in health care have been consistently documented in the diagnosis, treatment, and outcomes of many common clinical conditions. There has been an acceleration of health information technology (HIT) implementation in the United States, with health care reform legislation including multiple provisions for collecting and using health information to improve and monitor quality and efficiency in health care. Despite an uneven and generally low level of implementation, research has demonstrated that HIT has the potential to improve quality of care and patient safety. If carefully designed and implemented, HIT also has the potential to eliminate disparities.HIT and Disparities: Several root causes for disparities are amenable to interventions using HIT, particularly innovations in electronic health records, as well as strategies for chronic disease management. Recommendations regarding health care system, provider, and patient factors can help health care organizations address disparities as they adopt, expand, and tailor their HIT systems. In terms of health care system factors, organizations should (1) automate and standardize the collection of race/ethnicity and language data, (2) prioritize the use of the data for identifying disparities and tailoring improvement efforts, (3) focus HIT efforts to address fragmented care delivery for racial/ethnic minorities and limited-English-proficiency patients, (4) develop focused computerized clinical decision support systems for clinical areas with significant disparities, and (5) include input from racial/ethnic minorities and those with limited English proficiency in developing patient HIT tools to address the digital divide.Conclusions: As investments are made in HIT, consideration must be given to the impact that these innovations have on the quality and cost of health care for all patients, including those who experience disparities.