In a visit-based analysis, researchers from Brigham and Women's Hospital and Harvard Medical School found that electronic health records and electronic preventive care reminders "did not ameliorate or exacerbate racial differences in cancer screening order rates."
Among an estimated 2.4 billion U.S. adult primary care visits, orders for screening for breast, cervical or colon cancer did not differ between clinics with and without EHRs or e-reminders, according to an article published in the Journal of the American Medical Informatics Association.
Leveraging the 20062010 National Ambulatory and National Hospital Ambulatory Medical Care Surveys, researchers measured visit-based differences in rates of age-appropriate breast, cervical and colon cancer screening orders between white and non-white subjects at primary care visits with and without EHRs, as well as visits with EHRs (with and without e-reminders). Overall, they concluded that EHRs or e-reminders did not modify racial differences in cancer screening rates.
"There was no difference in screening orders between non-white and white patients for breast or cervical cancer," states the article. However, in the case of colon cancer, non-white patients were more likely to receive screening orders than white patients overall and at visits with e-reminders.
According to recommendations adopted on March 11 by the Health IT Policy Committee, in Stage 3 of the EHR meaningful program patient information would be captured and used to reduce health disparities. Capture of expanded demographic information is one of the 19 objectives in a Stage 3 proposal the advisory committee has sent to the Department of Health and Human Services.
"Reducing disparities is one of our most important objectives and we can't do it if we don't know what those disparities are," said George Hripcsak, co-chair of the HIT Policy Committee's Meaningful Use Workgroup. Capturing the information, however, should not be mandatory, he noted.
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