Expert workshop discusses disparities in health care quality and role of health IT in underresourced settings
Research Activities, March 2011, No. 367
Six papers from the workshop, "Reducing Disparities in Healthcare Quality in Underresourced Settings Using HIT and Other Quality Improvement Strategies," were published in a supplement to Medical Care Research & Review 67(5 Suppl.). The workshop of invited experts was sponsored by the Agency for Healthcare Research and Quality. The six articles highlight two key issues of great importance in improving the quality of the Nation's health care system: expanding the use of health information technology (IT) and reducing disparities in health care delivery.
The first article discusses the overall context of the meeting and the five subsequent articles focus on various populations seeking health care in underresourced settings in the United States, including black, Hispanic, and Asian-American patients as well as low-income children. The health IT strategies address a variety of health issues, including diabetes outcomes, prenatal care, and preventive services. The articles are briefly described here.
Gibbons, M.C., and Casale, C.R. "Reducing disparities in health care quality: The role of health IT in underresourced areas," pp. 155S-162S.
This article outlines the process, findings, and key recommendations of this expert workshop. The recommendations and research themes fall into five general categories: the health care delivery setting; research and evaluation methodologies; patients and target populations; technology applications and platforms; and providers and clinicians.
Baig, A.A., Wilkes, A.E., Davis, A.M., and others. "The use of quality improvement and health information technology approaches to improve diabetes outcomes in African American and Hispanic patients," pp. 163S-197S.
Health IT is widely viewed as an essential component of health care quality improvement and may be useful in decreasing diabetes disparities in underresourced settings. This article updates an earlier literature review by reviewing 18 articles published between 2006 and 2009 on the effectiveness of health care interventions using health IT to improve diabetes process of care and intermediate diabetes outcomes in black and Hispanic patients.
Lu, M.C., Kotelchuck, M., Hogan, V.K., and others. "Innovative strategies to reduce disparities in the quality of prenatal care in underresourced settings," pp. 198S-230S.
Based on a literature review and key informant interviews, the authors identified 17 innovative strategies that have been or can be used to increase access to timely prenatal care, improve the content of prenatal care, and enhance the organization and delivery of prenatal care.
Ngo-Metzger, Q., Hayes, G.R., Chen, Y., and others. "Improving communication between patients and providers using health information technology and other quality improvement strategies: Focus on Asian Americans, pp. 231S-245S.
Disparities in provider-patient communication have been shown to exist among Asian Americans. The authors conducted a systematic review of the literature as well as in-depth interviews with key informants, but found little published literature on interventions focused on Asian Americans. They call for more research using new health IT strategies to improve care for Asian Americans.
Ngo-Metzger, Q., Hayes, G.R., Chen, Y., and others. "Improving communication between patients and providers using health information technology and other quality improvement strategies: Focus on low-income children," pp. 246S-267S.
The authors conducted a systematic review of the literature on studies of communication surrounding the care of low-income children, with an emphasis on interventions and health IT. They identified gaps between the existing literature and clinical practice and suggested that future research should focus on the specific impact of health IT on pediatric medicine.
Millery, M., and Kukafka, R. "Health information technology and quality of health care: Strategies for reducing disparities in underresourced settings, pp. 268S-298S.
The authors performed a literature review on health IT and quality outcomes that identified 15 studies including underresourced settings (URSs) and 8 focusing on URSs. Most evidence was available for quality impact of computerized order entry, clinical decision support systems, and computerized reminders. Ninety percent of the studies focused on the microsystem level of quality improvement.