National Coordinator for Health IT David Blumenthal warns that health IT is creating a new digital divide.
In an open letter published on a government Web site yesterday, he writes that adoption of Electronic Health Records (EHRs) is lower among black and brown people who are uninsured or on Medicaid than for insured whites.
Electronic health records possess the ability to help improve both the quality and efficiency of medical care accessible by minorities, so that perhaps rates of chronic illness, mortality and morbidity decrease within these communities. It is critical that this administration, Regional Extension Centers and EHR vendors work together and focus substantial efforts on these priority populations.
This is no surprise. But there is something the government can do about it, something it is in fact doing about it already.
Clinics taking Medicaid patients need to be required to use EHR technology. The Centers for Medicare and Medicaid should be able to generate contracts, or demands for contracts, that would cover these folks, since it's government that is funding their health care.
Unfortunately that's not exactly how it works. Medicare and Medicaid only fund care, they don't directly provide it. The only stick government has is in the mandates under the HITECH stimulus, penalizing providers who don't automate after 2015.
The exception within the government sector is the Veterans Administration (VA), which has been using electronic records for decades under its VISTA system. Any veteran knows how dependent the VA is on technology, because whenever the system goes down everyone panics.
Reimbursement rates under Medicare are going to be under increasing pressure in the next few years, and EHRs are the only way to have any hope of meeting them. Medicaid is going the same way.
Rather than begging the market to please be nice to the uninsured, the government needs to put its foot down here. It holds the gold and needs to set the rules.