Inadequate capital is a more common barrier to EHR adoption at hospitals serving poor patients than at other hospitals, the study found.
It also found that hospitals caring for poor patients that lack an EHR provide a lower standard of care. The authors call for careful monitoring of the federal economic stimulus program to ensure that hospitals serving the poor get their fair share of EHR stimulus funding.
The study, published in the online edition of the journal Health Affairs, is based on a national survey on EHR adoption at 2,368 acute care hospitals. The Robert Wood Johnson Foundation and the federal government's Office of the National Coordinator for Health Information Technology funded the study.
It was conducted by Harvard School of Public Health, Massachusetts General Hospital and George Washington University.
The study also found that hospitals with higher rates of poor patients also had lower levels of adoption of electronic clinical decision support, electronic medication lists and electronic discharge summaries.
"Health information technology is woefully inadequate throughout the health care system, but institutions that treat the most vulnerable patients have much less of it and this leads to worse care," says lead study author Ashish Jha, M.D., an associate professor at Harvard.
"This is not an isolated issue. We are talking about one in every four hospitals, and they treat millions of patients. These hospitals will need a concerted effort from both national and state policymakers to avert a serious digital divide from emerging."
To read the study, "Evidence of an Emerging Digital Divide Among Hospitals that Care for the Poor," visit www.rwjf.org.
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