Although there is little population-based research on the use of health IT by the underserved and those that treat them specifically, there is some evidence that the groups disproportionately represented among the underserved and those that treat them are currently less likely to use health IT compared to other groups. For example, in the paragraphs below we cite recent research that shows that lower income Americans, some ethnic and racial minorities as well as residents in rural areas are less likely to have broadband access and are less likely to use the Internet than others, that individuals who lack steady access to health care are less likely to go online to get health related information and that safety net health centers that disproportionately serve the poor and uninsured are less likely than other providers to use electronic health records. 12 1314 15
On the other hand, other research suggests that the income and education related factors are not as important in predicting Internet use as it has been in the past and that among individuals who use the Internet regularly, there is no difference by income, age or gender in the propensity to go online for communicating with providers or seeking information on health and health care.16 There is also evidence that many safety net health care providers have adopted health IT through the support of federal grants and are leaders in ambulatory health IT use. It is important to note however that adoption and access to health IT does not automatically translate to improvements in quality of care or health status.
Most of the research conducted to date has been limited in scope, looking at the potential for specific health IT interventions to improve limited aspects of quality of care for minorities or other groups represented in the underserved populations. While there has been some survey work conducted examining the use of health IT among health care providers that treat the underserved, there is almost no information on the use of patient-facing health IT applications by underserved individuals and families in the United States. This is predominantly because the extent to which PHRs are used by any group within the United States is largely unknown but considered to be limited due to the novel nature of these technologies, lack of knowledge of them among the public, and limited availability of PHRs sponsored by traditional sources of health care information for patients: providers, payers and purchasers. There are currently efforts underway sponsored by AHRQ and others to elucidate these issues.17