Health Affairs

Health Affairs, doi: 10.1377/hlthaff.28.6.w1160 (Published online October 26, 2009) © 2009 by Project HOPE	New Online   Getting Health Reform Done   After the State of the Union   Incremental Reform   E-Health in Developing World   Most-Read Articles in 2009

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Evidence Of An Emerging Digital Divide Among Hospitals That Care For The Poor

Ashish K. Jha ^1*, Catherine M. DesRoches ², Alexandra E. Shields ³, Paola D. Miralles ⁴, Jie Zheng ⁵, Sara Rosenbaum ⁶, Eric G. Campbell ⁷

¹ Ashish Jha is an associate professor at the Harvard School of Public Health in Boston, Massachusetts.
² Catherine DesRoches is an assistant professor in the Institute for Health Policy, Massachusetts General Hospital (MGH) in Boston, Massachusetts.
³ Alexandra Shields is the director of the Harvard/MGHCenter for Genomics, Vulnerable Populations, and Health Disparities.
⁴ Paola Miralles is a senior research assistant in the Institute for Health Policy, Massachusetts General Hospital (MGH) in Boston, Massachusetts.
⁵ Jie Zheng is a senior statistical programmer at the Harvard School of Public Health in Boston.
⁶ Sara Rosenbaum is the Hirsch Professor and Chair in the School of Public Health and Health Services at the George Washington University in Washington, D.C.
⁷ Eric Campbell is an associate professor in the Institute for Health Policy, Massachusetts General Hospital (MGH) in Boston, Massachusetts.

^*Corresponding author.

Abstract

Some hospitals that disproportionately care for poor patients are falling behind in adopting electronic health records (EHRs). Data from a national survey indicate early evidence of an emerging digital divide: U.S. hospitals that provide care to large numbers of poor patients also had minimal use of EHRs. These same hospitals lagged others in quality performance as well, but those with EHR systems seemed to have eliminated the quality gap. These findings suggest that adopting EHRs should be a major policy goal of health reform measures targeting hospitals that serve large populations of poor patients. [Health Aff (Millwood). 2009;28(6):w1160-70 (published online 26 October 2009; 10.1377/hlthaff.28.6.w1160)]

Key Words: Access To Care, Business Of Health, Health Reform , Hospitals, Health Spending, Health Information Technology

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