A new article published in the Joint Commission Journal on Quality and Patient Safety finds that differences in the quality and safety of medical treatment received by minorities could be reduced through the better use of health information technology.

An editorial accompanying the article, meanwhile, 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.

[See also: Joint Commission confronts deadly miscommunications.]

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. healthcare system is not well designed to provide equitable care.

The authors – led by Lenny Lopez, MD, assistant in health policy at the Mongan Institute for Health Policy, and faculty at the Disparities Solutions Center at Massachusetts General Hospital in Boston – urge development of a health IT infrastructure that addresses disparities in care from the start.

Specifically, Lopez and his colleagues recommend that healthcare 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 healthcare system factors such as patients having difficulty navigating the healthcare 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 healthcare have been consistently documented in the diagnosis, treatment and outcomes of many common clinical conditions," said Lopez.

"There has been an acceleration of health information technology (HIT) implementation in the United States, with healthcare reform legislation including multiple provisions for collecting and using health information to improve and monitor quality and efficiency in healthcare," he added. "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."

[See also: Joint Commission urges IT adoption, major changes for hospital of the future.]

In an editorial titled "Health Information Technology and the Collection of Race, Ethnicity and Language Data to Reduce Disparities in Quality of Care," Adil H. Haider, MD, and Peter J. Pronovost, MD, at Johns Hopkins University School of Medicine, argued that making transparent the disparities in healthcare 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 use of 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," said Haider.