David Blumenthal, National Coordinator for HIT, published a letter today calling on the EMR vendor community to provide EMR opportunities to physicians and other healthcare providers “working within underserved communities of color.”
Dr. Blumenthal also says:
We are writing to solicit your assistance in making sure that we are not creating a new form of “digital divide” and want to make sure that health IT vendors include providers who serve minority communities in their sales and marketing efforts.
I must admit that I’d rarely considered the idea of EMR adoption being a racial issue. I’d certainly put some thought into the community health care initiatives that serve poor communities. I’ve given some thought to the challenges of EMR in a rural health setting. I haven’t given much thought to it being a racial issue. Now that I’ve read this, I’ll certainly be considering this possible “digital divide” more.
My initial reaction is to question why there’s this disparity. I know a lot of EMR vendors and I’m quite sure that they’d be MORE than happy to sell their EMR software to a clinic with no regard to their color or ethnicity. I think it’s reasonable to say that most EMR software companies aren’t deliberately choosing not to serve these “communities of color.” So, it begs the difficult to answer question of why these communities aren’t seeing the adoption of EHR at the same level of other communities.
The other question worth considering is if EMR vendors are missing out on a real opportunity to grow their business if they focused their sales and marketing efforts on these minority communities.
These are definitely not easy questions to answer, but I’m glad that Dr. Blumenthal started the discussion. I know it will be on mind more now.
Dr. Blumenthal’s comment puzzles me somewhat. I’m not sure what he’s trying to imply. Is he saying that EHR vendors don’t care to sell to minority groups? Is he saying that minority groups aren’t interested in EHR technology? Does he think they lack the technical skills and education to implement EHR? Or, is he perhaps inferring that they don’t have the necessary economic resources, so EHR vendors should give them free or discounted systems?
Some good questions worth considering. It’s a hard issue to address. I don’t think Dr. Blumenthal necessarily knew the answer to those questions. I think his was just a clarion call to try and address all of the possible issues. Hopefully someone from ONC is still reading this blog and will tell us his purpose.
Blumenthal’s comments would have been better directed to RECs … not the vendors.
Dr. Blumenthal’s comments are certainly concerning. I wonder if Dr. Blumenthal examined the insurance makeup of the patients in the communities that he is concerned about. Depending on the insurance coverage of the patients in these areas, the providers may not be able to afford to invest in an EHR system. EHR systems are expensive, and the “insurance mix” definitely affects the financial health of a provider’s practice and the ability for significant capital expenditures. Unless there are explicit examples of racially motivated denials, I suspect that “class”, as reflected in the insurance coverage, may be the more significant factor. Whatever the underlying causes of this disparity, this is a major issue that needs to be addressed – how can you create a comprehensive national healthcare infrastructure if the network and technology is not available everywhere.