(OAKBROOK TERRACE, Ill. – October 17, 2011) Differences in the quality and safety of medical treatment that minorities receive could be reduced through the better use of health information technology (HIT), according to a new article published in the October 2011 issue of The Joint Commission Journal on Quality and Patient Safety™. An accompanying editorial calls for automating and standardizing the data collection about a patient’s race, ethnicity, and language to identify and address inequities in the quality of care for minorities.
The article, “Bridging the Digital Divide in Health Care: The Role of Health Information Technology in Addressing Racial and Ethnic Disparities,” contends that the U.S. health care system is not well designed to provide equitable care. The authors—led by Lenny López, M.D., M.Div., M.P.H., assistant in health policy at the Mongan Institute for Health Policy, and faculty at the Disparities Solutions Center, Massachusetts General Hospital in Boston—urge development of an HIT infrastructure that addresses disparities in care from the start. Specifically, Dr. López and colleagues recommend that health care organizations take the following steps:
- Automate and standardize the collection of race/ethnicity and language data.
- Prioritize use of the data for identifying disparities and tailoring quality improvement efforts.
- Focus HIT efforts to address fragmented care delivery for racial/ethnic minorities and limited-English-proficiency patients.
- Develop focused computerized clinical decision support systems in clinical areas with significant health disparities.
- Include input from racial/ethnic minorities and those with limited English proficiency in developing patient HIT tools.
The recommendations are intended to address the root causes for disparities in care for minority patients. Among the root causes are health care system factors such as patients having difficulty navigating the health care system, provider factors such as language barriers or cultural beliefs that hamper doctor-patient communication, and patient factors such as mistrust of the medical system.
“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,” says Dr. López. “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.”
In an editorial, “Health Information Technology and the Collection of Race, Ethnicity and Language Data to Reduce Disparities in Quality of Care,” Adil H. Haider, M.D., M.P.H., FACS, and Peter J. Pronovost, M.D., Ph.D., at Johns Hopkins University School of Medicine, note that making transparent the disparities in health care quality by race, ethnicity and primary language can be accomplished only by using HIT to routinely collect these data.
“As hospitals roll out new health information technology systems and expand the useof electronic health records, automatic and standardized collection of race/ethnicity/language data should be incorporated to help identify otherwise invisible disparities and inform appropriate interventions,” says Dr.Haider.
The Joint Commission, The Institute of Medicine and the National Quality Forum have all highlighted the importance of race, ethnicity and language data collection and reporting in order to address disparities in health care. The Joint Commission specifically requires accredited hospitals to document patients’ race and ethnicity and released new and revised standards in 2010 for patient-centered communication as part of an initiative to advance effective communication, cultural competence, and patient- and family-centered care. These standards are designed to improve the safety and quality of care for all patients and to inspire hospitals to adopt practices promoting better communication and patient engagement.
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