Health IT Czar Pushes EHR For Minority Communities

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In an open letter, national health IT czar Dr. David Blumenthal is urging the health IT vendor community to help bolster e-health record adoption rates among healthcare providers in underserved, minority communities.

The letter, co-signed by Blumenthal and Dr. Garth Graham, director of the office of minority health, cited a Centers for Disease Control and Prevention National Ambulatory Medical Care survey indicating that EHR adoption rates “remain lower among providers serving Hispanic or Latino patients who are uninsured or relied upon Medicaid.”

While the HITECH Act of the American Recovery and Reinvestment Act is providing more than $20 billion in federal incentives to encourage the deployment and meaningful use of health IT systems, the letter was written “to solicit your assistance in making sure we are not creating a new form of digital divide.”

The letter said the CDC survey data also shows that “EHR adoption rates among providers of uninsured non-Hispanic Black patients are lower than for providers of privately insured non-Hispanic White patients.”

A CDC National Ambulatory Medical Care report found that in 2005 and 2006, EHR adoption among primary care physicians (PCP) serving privately insured patients was higher than those serving Medicaid patients. EMR adoption rates among PCP serving Medicaid patients was about 8.3%, compared with an adoption rate of 13.2% among primary care doctors serving Medicaid patients.

That study also found that the percentage of Latino or Hispanic Medicaid patients with primary care physicians using EHRs was only 5%, compared with 14% for non-Hispanic White patients who are privately insured.

The use of EHRs can help healthcare providers in the delivery and management of care to patients, including those with chronic conditions. The systems can also bolster decision making by providing clinicians with more comprehensive patient data, as well as help eliminate medical errors and reduce costs associated with unnecessary or redundant tests.

“Racial and ethnic minorities remain disproportionately affected by chronic illnesses, a contributing factor to intolerably high mortality and morbidity rates,” said the letter. “Electronic health records possess the ability to help improve both the quality and efficiency of medical care accessible by minorities, so that perhaps rates of chronic illness, mortality and morbidity decrease within these communities.”

Slideshow: Who's Who In Healthcare IT

The letter urges health IT vendors and Regional Extension Centers, which provide EHR selection and implementation support services to healthcare providers, “to work together and focus substantial efforts on these priority populations.”

Some EHR vendors said they’re already making the effort to reach doctors who care for patients in underserved communities.

“Providers who serve minority communities are a vital component of the eClinicalWorks vision, and we support them with product customization and affordable product pricing,” said Girish Kuma Navani, CEO and co-founder of eClinicalWorks, in an email interview with InformationWeek.

In addition, eClinicalWorks has “created a department to customize implementation to meet the specific needs of these primary care physicians,” he said.

To date, eClinicalWorks has implemented its EHR for “thousands of physicians in New York City that serve the Medicaid population of the city.” Also, three community health centers using eClinicalWorks have won Davies Awards for their use of IT.

It’s not just our business to serve these providers -- it’s our mission,” Navani said.

Besides the Office of National Coordinator asking in its letter that e-health vendors work to increase EHR adoption rates among healthcare providers in underserved communities, the federal government’s stimulus program is aiming to boost EMR use by clinicians who provide care for lower-income Medicaid patients.

Clinicians who provide care for Medicaid patients and meet the government’s meaningful use criteria for health IT are eligible to receive a larger financial reward than clinicians who treat patients covered by Medicare.

Under the HITECH Act, clinicians whose patient volume consists of 30% Medicaid patients and who meet the federal government’s requirements for the meaningful use of health IT are eligible for financial rewards of up to $63,750 between 2011 and 2014.

The maximum meaningful use financial reward between 2011 and 2014 for clinicians who treat Medicare patients is $44,000.