Health Information Technology: Addressing Health Disparity by Improving Quality, Increasing Access, and Developing Workforce

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This is a review of an article by Custodio et al, Health Information Technology: Addressing Health Disparity by Improving Quality, Increasing Access, and Developing Workforce [1]


Evidence of racial and ethnic health disparities associated with socioeconomic differences is remarkably consistent across chronic illnesses and health care services. In 1985, the U.S. Dept. of Health and Human Services released the Secretary's Task Force on Black and Minority Health.1 This report was one of the first federal documents to highlight disparities in health and health care between the majority and racial and ethnic minority populations. Subsequent research demonstrates an increased burden of disease for our vulnerable homeless, impoverished rural, migrant, and public housing communities, which suffer greater morbidity and mortality than the general population.2 Health care reform efforts targeted toward these diverse under served populations must capitalize on advances in health information technology (HIT) and best practices.


Managing the complex health needs in vulnerable populations is a labor intensive endeavor for both the patient and the clinician. Many such patients require a multiple medication regimen; frequent monitoring of vitals and laboratory studies; lifestyle changes in diet, exercise, stress management, smoking cessation; and encouragement to schedule and adhere to medical appointments and diagnostic tests. With lives complicated by poverty, unemployment, violence, hunger, instability and loss, the priority of managing their health falls to the bottom of or off their list completely until symptoms scare them back into the health care system. As clinicians, we have found that health records can assist in promoting self-management and self-empowerment through improved communication with clinical staff and support outreach which leads to improved health outcomes.


Health IT is a vital tool in achieving the goals of health care reform to increase health care access, improve care delivery systems, engage in culturally competent outreach and education, and enhance workforce development and training. The first national survey of federally funded community health centers shows that although 26% reported some electronic health record (EHR) capacity and 13% have the minimal set of EHR functionalities, the centers serving the most poor and uninsured patients were less likely to have a functional EHR system.3 Community health centers, free clinics and other safety net organizations aim to deliver evidence-based, patient-centered, culturally competent, efficient, high quality health care to underserved populations. Electronic health records can help the health delivery system achieve those goals.



  1. Custodio, R., Gard, A. M., & Graham, G. (2009). Health information technology: Addressing health disparity by improving quality, increasing access, and developing workforce. Journal of Health Care for the Poor and Underserved, 20(2), 301-7. Retrieved from