Can electronic health records erase disparities?

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Switching to electronic health records might help close health gaps between black and white Americans, researchers suggest in a new study.

They say government data on primary care visits from 2007 to 2008 show that when doctors didn’t use digital records, there was a racial gap in how many patients had High Blood Pressure. But there was no such gap among patients treated at practices with electronic record-keeping.

That could be important, because African Americans are more likely to have High Blood Pressure than whites, which might in turn explain why they also have more heart attacks, strokes and kidney disease, said Dr. Lipika Samal, who worked on the new study.

“If we really do find the tools help to reduce disparity,” she told Reuters Health, “then as a society we should incentivize people to use these tools.”

But that’s still a big ‘if,’ according to Samal, of Brigham and Women’s Hospital in Boston. Her findings are just an association, she said, and can’t prove that electronic health records by themselves get rid of health disparities.

The study is based on a survey of doctors across the U.S. It includes more than 17,000 primary care visits, during which doctors recorded patients’ blood pressure.

Fifteen percent of the doctors said they used electronic health records, with another 27 percent using special pop-up messages in addition to the digital records to help them make medical decisions.

When offices used traditional records, 69 percent of blacks were estimated to have their blood pressure relatively under control (less than 140/90) after accounting for age, insurance and who owned the office, among other factors. That number was 75 percent for whites.

At offices that had embraced the new technology, the numbers were similar for blacks and whites at 75 percent and 78 percent, respectively. And Hispanics had an even higher rate of good blood pressure control.

Samal said more research is needed to tease out why the gap between whites and blacks disappears at offices that use digital tools, but said it could be that the systems help doctors make better decisions—such as suggesting cheaper medicines for poor patients.

The government already provides incentives to physicians who switch to electronic health records. According to the latest data from the Centers for Disease Control and Prevention, 57 percent of office-based physicians used such a system in 2011.

Samal said her results might help convince more doctors to make the switch, but noted that there might still be financial, legal or technical barriers that need to be addressed.

SOURCE: Archives of Internal Medicine, January 9, 2012

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