In particular, 2011 marks a period of great opportunity to increase the rate of electronic health record (EHR) adoption because of recent policy and program initiatives and because of ongoing partnerships between the public and private sectors to make EHR adoption a reality throughout the United States. The federal commitment is highlighted in President Obama’s promise to the nation that every American will have the benefit of an EHR by 2014. The Department of Health and Human Services (DHHS) has led a multitude of federal initiatives to enhance the quality of patient care through the use of health information technologies (HIT), and is committed to leading and promoting this effort in 2011 and beyond. Federal and non-federal entities have been working closely together since early 2010 to improve EHR adoption.
The implementations of the American Recovery and Reinvestment Act (ARRA) and the Health Information Technology for Economic and Clinical Health (HITECH) Act further demonstrate the federal government’s understanding of and commitment to the needs of healthcare providers and their patients. Policymakers within DHHS and its Office of Minority Health (OMH) recognize the time constraints and complexities that confront healthcare providers on a daily basis as they seek to offer quality and timely healthcare to their clients. Many providers must balance healthcare provision with managing the administrative nuances of a clinical practice. In most cases, providers have neither the time nor expertise to analyze and apply current technologies that could increase the effectiveness and efficiency of their practices. To meet this need, DHHS programs (such as regional extension centers) offer the necessary expertise and support directly to the door of healthcare providers.
In any ongoing effort to improve the quality and utilization of HIT and EHRs, all involved constituencies, whether federal or state personnel, federal grantee, EHR vendor, community leader, or healthcare provider must work diligently and cooperatively to ensure that these technologies arrive at the doorsteps of all healthcare providers, including both minority providers and providers who practice within underserved communities of color. Moreover, it is the responsibility of healthcare providers and researchers who practice within underserved communities of color to share with all stakeholders their strategies for success in the application of HITs—as well as their failures in achieving desired outcomes. Only through this type of open communication can evidence-based practices emerge and become broadly implemented.
This issue of Perspectives in Health Information Management marks a critical point in the ARRA/HITECH era. DHHS agencies are currently orchestrating community-based and technological interventions that promise to increase the adoption of HIT within underserved communities of color.
OMH and the National Health Information Technology Collaborative (NHIT) have taken a community-based approach by leading education and outreach efforts within many underserved communities of color through deploying a “boots on the ground” intervention. NHIT has produced “teach-ins” within several communities in order to educate healthcare providers on the merits of using EHRs. Importantly, NHIT has worked in tandem with Regional Extension Centers in several states by literally traveling door-to-door, helping to educate and recruit healthcare providers on a practice-by-practice basis, and guiding them through the EHR adoption process.
The Office of the National Coordinator has launched several programs that help make the proliferation of these technologies possible within underserved communities of color. The Regional Extension Centers program, the Health IT Workforce Development Program, and the creation of Beacon Communities all strive to provide improved HIT resources to underserved communities of color. They offer access to experts who can expedite EHR adoption with the aim of creating a more robust workforce that can become an HIT resource to these communities, and to create clinical services that will provide the highest standard of care and technological expertise.
The federal Health Resources and Services Administration, and the Centers for Medicare and Medicaid have also deployed programs and incentives to encourage the adoption of EHRs. The Agency for Healthcare Research and Quality has developed a portfolio of work that will analyze the adoption and use of these technologies within underserved communities.
These various examples provide an overview of the DHHS commitment to improvement and dissemination of HIT and EHRs. However, reaching national adoption goals and continuing to improve and develop innovative HIT practices and capabilities will require the cooperative effort of stakeholders throughout the country and across sectors.
OMH believes it is of utmost importance to the success of HIT implementation that healthcare providers within underserved communities of color share their successes as well as their failures in deploying and using HIT in their practices and communities. This special issue of Perspectives in Health Information Management provides a forum for communicating such experiences. For example, articles include stories of the deployment of a statewide telehealth network and implementation of an urban diabetes telehealth self-management intervention. In this issue, healthcare providers share their ideas and experience, as well as a sense of urgency to develop HIT programs that improve health service access and quality of care for individuals residing within medically underserved areas.
There is no greater time than the present to exercise innovation and expertise in response to the ethical imperative that all Americans—regardless of race or ethnicity, rich or poor, young or old—receive the highest quality of healthcare services possible. OMH thanks the authors of this edition for helping to inspire what will hopefully become a legion of stakeholders who will work together in 2011 and beyond to improve the care of the underserved. We hope that healthcare providers, policy analysts, and other stakeholders take the time and effort to study these examples of HIT innovation and practice and will be inspired to complement their medical and healthcare expertise with the added capabilities of new technologies in their continuing resolve to improve healthcare outcomes for all Americans.