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The Role of Health IT in Measuring and Reducing Disparities

Garth N. Graham, MD, MPH Deputy Assistant Secretary for Minority Health

Office of Minority HealthOffice of the Secretary

Department of Health and Human Services

September 14, 2009

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• Established 1986, U.S. Department of Health and Human Services (HHS)

• Mission - To improve and protect the health of racial and ethnic minority populations

• Develop health policies and programs that promote the elimination of health disparities

• Advise the HHS Secretary and the Office of Public Health and Science (OPHS) on public health activities affecting American Indians and Alaska Natives, Asian Americans, Blacks/African Americans, Hispanics/Latinos, Native Hawaiians, and other Pacific Islanders

Background on the Office of Minority Health

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• 1985- “Report of the Secretary’s Task Force on Black and Minority Health”

• Institute of Medicine (IOM)—Unequal Treatment

• Healthy People 2010 and now 2020 National Health goals for the nation—including the elimination of health disparities and now moving toward Health Equity

• Agency for Healthcare Research and Quality-National Healthcare Disparities Reports-Annual reports cards on the health status of racial/ethnic minority populations

Health Divide

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• Increasing the use of internet, cell phones, text messaging, e-health, and other information technologies among racial and ethnic minority populations

• Increasing the adoption of information technologies by safety net providers

• Use of these technologies have the potential to facilitate behavior change, improve health care, and enhance health outcomes

Health Information Technology – A Tool to Reduce Health Disparities

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•Trust

•Privacy

•Culture Differences

•Language

•Limited Access to Technology

•Literacy

•Education

Types of Challenges for Racial Ethnic Communities

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BusinessWeek* reported “in the past two years, African Americans have been devouring broadband technology – and the digital divide has shrunk significantly… Some of the closing of the racial divide can be traced to falling prices and rising availability of new technology.”

– The share of black households with a cable modem, DSL, or satellite Internet connection climbed to 40% this year. That’s almost twice as fast as the growth of broadband penetration for the general population, which grew to 47%.”

Source: BusinessWeek - “Equal Opportunity Speedway” May 21, 2007

African-Americans – Closing the Digital Divide

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Review of published and unpublished literature on underserved and health information technology.

• Health IT is not a magic bullet– Technology must be part of a broader initiative to address root causes and structural

barriers

• External barriers for the underserved and their provider persist– Slow provider adoption stems from constrained finances– Underserved families face myriad daily challenges

• Digital divide is diminishing but still a factor– Income and internet access correlation is less direct, but persistent– Most have internet access, even lowest economic groups

http://aspe.hhs.gov/sp/reports/2009/underserved/index.shtml

Findings from NORC Environmental Scan

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Vision

An interconnected public and private health system where all consumers have access to high quality, affordable care and to the information and technology resources required to maximize their access and effective use of health care services.

Purpose

Reduce and ultimately eliminate health disparities experienced by medically underserved areas and populations through the use of advances in health IT.

Incorporate experience from both the public and private sectors to improve the health of communities and populations that have historically had the worst health outcomes and the least access to care.

http://www.shireinc.org/nhit/

Next meeting Monday, September 21, 2009

HIT Collaborative for the Underserved

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Recommendation 6-1b:

HHS and the Office of the National Coordinator for Health Information Technology (ONC) should adopt standards for including electronic health records the variables of race, Hispanic ethnicity, granular ethnicity, and language need identified in this report.

http://www.iom.edu/CMS/3809/61110/72796.aspx

IOM Report: Race, Ethnicity, Language Data Standardization for Health Care Quality Improvement (released August 31, 2009)

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“Life is filled with golden

opportunities, carefully disguised

as irresolvable problems.”

--John Gardner

former Secretary of Health,

Education and & Welfare

A Future of Opportunities

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Garth Graham, MD, MPHDeputy Assistant Secretary for Minority HealthHHS/Office of Minority HealthRockville, MD (240) 453-2882www.omhrc.gov

Contact Information