NORC at the University of Chicago is pleased to present this white paper entitled “The Underserved and Health Information Technology: Issues and Opportunities” for the Assistant Secretary for Planning and Evaluation (ASPE) at the U.S. Department of Health and Human Services (HHS). Due to recent advances in technology and greater attention to problems associated with quality and efficiency of health care delivery, we see new opportunities to improve the health and health care for underserved Americans through the use of emerging information technologies.
President George W. Bush announced an Executive Order in 2004 prioritizing the adoption and use of health information technology (health IT) by patients and providers as well as the use of secure health information exchange (HIE) to improve the quality, safety, effectiveness and efficiency of health care delivery in the United States, and creating the Office of the National Coordinator for Health IT (ONC). Several agencies within HHS including the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the Office of Minority Health (OMH), the Agency for Healthcare Research and Quality (AHRQ), the Centers for Medicare and Medicaid Services (CMS), the Office of Disease Prevention and Health Promotion (ODPHP), ASPE and others had been working on programs and policies to assure that the nation’s most vulnerable Americans are not left behind as the health care sector moves to adopt a more automated information driven approach to promoting health and preventing and treating illness. More recently several States have joined in these activities by sponsoring their own programs to encourage health IT adoption.
This purpose of this paper is to summarize a selected set of programs, policies and research findings that demonstrate both the potential for health IT to improve health and health care to underserved Americans as well as the challenges and barriers facing effective use of these technologies. We will attempt to cover an array of technologies including electronic health records (EHRs), e-Prescribing (eRx), chronic disease registries and clinical decision support systems (CDS) by health care providers predominantly serving the underserved. Additionally, we will examine technologies such as personal health records (PHRs), messaging and reminder systems, patient kiosks and other technologies that are “patient facing” where the theory is that IT can empower patients to take more control over their own health information and health care.
Finally, we will provide summary conclusions regarding what is known and yet to be understood regarding use of health IT among the underserved and highlight areas where further programmatic, policy or research activities sponsored by the federal government or others may be important. We begin with a brief discussion on health and health care challenges facing underserved Americans.