Electronic Health Records Improve the Quality of Care in Underserved Populations: A Literature Review
Family Medicine, Georgetown University Medical Center, USA.Journal of Health Care for the Poor and Underserved (Impact Factor: 1.1). 08/2012; 23(3 Suppl):136-53. DOI: 10.1353/hpu.2012.0134
Organizations in underserved settings are implementing or upgrading electronic health records (EHRs) in hopes of improving quality and meeting Federal goals for meaningful use of EHRs. However, much of the research that has been conducted on health information technology does not study use in underserved settings, or does not include EHRs. We conducted a structured literature search of MEDLINE to find articles supporting the contention that EHRs improve quality in underserved settings. We found 17 articles published between 2003 and 2011. These articles were mostly in urban settings, and most study types were descriptive in nature. The articles provide evidence that EHRs can improve documentation, process measures, guideline-adherence, and (to a lesser extent) outcome measures. Providers and managers believed that EHRs would improve the quality and efficiency of care. The limited quantity and quality of evidence point to a need for ongoing research in this area.
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ABSTRACT: The Institute of Medicine highlighted the fact that the U.S. health care system does not provide consistent, high quality medical care to all people. The routine use of health information technology (HIT) that includes certain key functions may be critical in reducing such disparities. We used logistic regression analyses to examine differences when it comes to the routine use of key HIT functions that are linked to improvements in clinical care. Physicians predominantly serving Black patients were more likely than physicians predominantly serving White patients to routinely use HIT to generate reminders for clinicians and patients about preventive services. Similarly, physicians predominantly serving Hispanic patients were more likely than physicians predominantly serving White patients to routinely use HIT to access patients' preferred language. Importantly, although minority-serving institutions have lower adoption rates overall, differences exist in the routine use of key HIT functions that have the potential to reduce health disparities.
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ABSTRACT: Adoption and use of health information technology, the electronic health record (EHR) in particular, has the potential to help improve the quality of care, increase patient safety, and reduce health care costs. Unfortunately, adoption and use of health information technology has been slow, especially when compared to the adoption and use of information technologies in other industries. Additionally, little research has been done to really see how health information technology adoption and use affects quality of care, patient safety, and costs in healthcare organizations, particularly community health centers. This research study performed a secondary data analysis of the Uniform Data System (UDS). The UDS is the Health Resources and Services Administration reporting requirement for Health Resources and Services Administration’s primary care grantees that operate community health centers. The UDS is a “core set of information appropriate for reviewing the operation and performance of health centers” (U.S. Department of Health and Human Services, Health Services and Resources Administration, n.d.c, “What is the UDS?” para. 1). The publicly available, 2010 state aggregated UDS data was used to identify predictive attributes to score community health centers on their provision of quality care. The purpose of the research study was to determine if there was any association between the use of EHRs and the quality of care in community health centers. The results of the research study may help inform future EHR-adoption policy and identify organizational attributes of providers of high quality care that may be used in other organizations.
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