Can health IT adoption reduce health disparities?

Abstract

There are large and persistent racial differences in health-care utilization and outcomes for chronic conditions in the United States. The recent uptake in electronic health records in outpatient care settings could affect these disparities. This research shows that the adoption of electronic health records reduces the racial gap in outpatient care outcomes. We provide a basic conceptual framework that demonstrates some of the mechanisms that may drive these results.

Keywords:

• information technology
• health
• disparities
• electronic medical records

Acknowledgements

Any views and opinions expressed in this research belong to the authors only and are not endorsed by the Consumer Financial Protection Bureau or any other US government agency.

Notes

1 While the quality of communication may have independent effect on patient’s trust and compliance, we focus on the communication as an information channel. With complicated conditions such as chronic heart failure, even the most experienced doctor needs to spend time with the patient in order to understand her individual condition.

2 According to the AHA (American Heart Association) statistical abstract, 2007 (http://www.americanheart.org/downloadable/heart/1166711577754HS_StatsInsideText.pdf).

3 The Veterans Affairs (VA) pharmacy only fills prescriptions that were ordered by a physician within the VA healthcare system. The pharmacy keeps electronic records for all transactions, which is independent of the EMR system. Pharmacy records cover the entire medication history of the patient and are exhaustive within the healthcare system.

4 The assumptions underlying the validity of this estimation method are: (1) the error term is on average zero, E[ɛ_igt]=0; (2) the error term is uncorrelated with the other variables in the equation (a parallel trends assumption); (3) the additive nature of the model is correctly specified. We make the additional assumption that the composition of patients remains constant across EMR adoption, that is, that patients do not switch between clinics due to EMR adoption. In light of the average geographic distance between VHA outpatient clinics, this appears a reasonable assumption.