Electronic health records: Use, barriers and satisfaction among physicians who care for black and Hispanic patients

Authors

  • Ashish K. Jha MD MPH,

    1. Assistant Professor, Department of Health Policy and Management, Harvard School of Public Health; Division of General Internal Medicine, Brigham and Women's Hospital; The VA Boston Healthcare System; Harvard Medical School, Boston, MA, USA
    Search for more papers by this author
  • David W. Bates MD MSc,

    1. Professor, Department of Health Policy and Management, Harvard School of Public Health; Division of General Internal Medicine, Brigham and Women's Hospital; Harvard Medical School, Boston, MA, USA
    Search for more papers by this author
  • Chelsea Jenter MPH,

    1. Project Manager, Division of General Internal Medicine, Brigham and Women's Hospital, Boston, MA, USA
    Search for more papers by this author
  • E. John Orav PhD,

    1. Associate Professor, Division of General Internal Medicine, Brigham and Women's Hospital; Harvard Medical School, Boston, MA, USA
    Search for more papers by this author
  • Jie Zheng PhD,

    1. Senior Programmer, Department of Health Policy and Management, Harvard School of Public Health, Boston, MA, USA
    Search for more papers by this author
  • Paul Cleary PhD,

    1. Professor, Harvard Medical School, Boston, MA, USA
    Search for more papers by this author
  • Steven R. Simon MD MPH

    1. Associate Professor, Department of Ambulatory Care and Prevention, Harvard Medical School, Boston, MA, USA
    Search for more papers by this author

Dr Ashish K. Jha
Department of Health Policy and Management
Harvard School of Public Health
677 Huntington Avenue
Boston
MA 02115
USA
E-mail: ajha@hsph.harvard.edu

Abstract

Objectives  Electronic health records (EHRs) are a promising tool to improve the quality of health care, although it remains unclear who will benefit from this new technology. Given that a small group of providers care for most racial/ethnic minorities, we sought to determine whether minority-serving providers adopt EHR systems at comparable rates to other providers.

Methods  We used survey data from stratified random sample of all medical practices in Massachusetts in 2005. We determined rates of EHR adoption, perceived barriers to adoption, and satisfaction with EHR systems.

Results  Physicians who reported patient panels of more than 40% black or Hispanic had comparable levels of EHR adoption than other physicians (27.9% and 21.8%, respectively, P = 0.46). Physicians from minority-serving practices identified financial and other barriers to implementing EHR systems at similar rates, although these physicians were less likely to be concerned with privacy and security concerns of EHRs (47.1% vs. 64.4%, P = 0.01). Finally, physicians from high-minority practices had similar perceptions about the positive impact of EHRs on quality (73.7% vs. 76.6%, P = 0.43) and costs (46.9% vs. 51.5%, P = 0.17) of care.

Conclusions  In a state with a diverse minority population, we found no evidence that minority-serving providers had lower EHR adoption rates, faced different barriers to adoption or were less satisfied with EHRs. Given the importance of ensuring that minority-serving providers have equal access to EHR systems, we failed to find evidence of a new digital divide.

Ancillary