A Health & Human Services Department advisory group considered including in pending meaningful use requirements measures showing that providers were able to reduce race, ethnic and other disparities in the health of their patients.
In discussions last week, a Health IT Policy Committee panel explored this and other approaches to eliminating differences in healthcare access and outcomes through the use of health information technology.
The first stage of proposed meaningful use requirements call for providers to collect data about their patient's race, ethnicity and language. Providers must also show quality reports by race, ethnicity and language in 2011, according to panel members.
Dr. Paul Tang, co-chairman of the meaningful use workgroup, said he hoped providers will have to do more with the data in 2013 second stage meaningful use requirements to change health outcomes for underserved populations.
"The stratified quality reports combined with more standardized, granular ethnicity data, and requiring that providers be able to capture that, I think will be a way of giving [providers] the necessary tools," said Tang, who is also chief medical information officer of the Palo Alto Medical Foundation.
The work group sought ideas and technical solutions at the June 4 meeting from providers who work with underserved population groups. The committee could build on those ideas for future meaningful use requirements, panelists said.
Some of the speakers suggested that reducing healthcare disparities could be included in quality measures that providers report in order to be eligible for meaningful use incentive payments.
Incentives are important for spurring innovation, said Dr. Chris Gibbons, associate director of the John Hopkins Urban Health Institute. "Providers can use electronic health records data to evaluate and monitor reduction in specific disparities in their patients," he said.
However, very few hospitals, physicians and clinics that treat the underserved currently collect quality measures and even fewer look at them by race, ethnicity and language.
"One of the issues is that current data collections for race and ethnicity are not standardized so they can't be compared," said Dr. Gena Wilson, a physician with the Institute for Family Health in New York. She recommended the development of standard definitions and collections of this data.
For example, the Institute of Medicine earlier this year published standards on the way that race and ethnicity can be captured and listed questions that should be asked about a patient's preferred language and proficiency, Wilson said.
Dr. Neil Calman, a work group member, said that a mechanism should be put in place to monitor whether disparities increase with the wide adoption of electronic health records and other health IT. A number of the speakers at the meeting cautioned, "If we don't get this right, we're going to do damage," Calman reminded the work group members.
For example, if only a small percentage of safety net hospitals qualify for meaningful use incentives compared with other providers, "disparities will keep growing," he said. He suggested that the states monitor the percentage of Medicaid providers that establish EHRs and qualify for meaningful use incentives. Calman is also the president and CEO of the Institute for Family Health.
