Rural Areas Get Help for Health IT

Health and Human Services (HHS) announced $11.9M will be distributed to 40 rural health networks to support investment in health information technology. The news release states that each of the organizations will receive approximately $300,000 to purchase equipment, install broad band networks, and train staff.

Assistance for rural health networks that provide care to underserved communities will hopefully reduce health disparities. An article in this week’s New England Journal of Medicine by Dr. Randall Cebul and others demonstrates that among participating practices in the Better Health Greater Cleveland initiative…

“The association of type of medical record [EHR versus paper-based] with quality standards was significant across all insurance types. As in other studies, the association was stronger for care — which is largely under the direction of providers — than for outcomes, which also require supportive home and neighborhood environments, active patient engagement, and other resources that foster adherence to prescribed regimens. The association was generally weakest for the uninsured, a vulnerable group that is underrepresented in other studies of EHRs and quality of care.”

I previously blogged about this initiative when it was announced by RWJF in June 2011. The authors of the NEJM article address the major differences in the enrolled practices — a concern I raised with the preliminary report. While encouraging, there are still limitations with the results. The authors write:

“…inferring that EHRs fully account for the observed differences in quality is not warranted, in part because of the participation of exceptional EHR-based organizations, a nonrepresentative sample of paper-based organizations, and inadequate adjustment for patient characteristics.”

So… good news for rural health clinics this week and a study that seems to suggest that EHRs do lead to quality improvement. For safety net clinics, health IT may not be sufficient to overcome the influence of other factors that may negatively affect health outcomes.

This post is the personal opinion of the author and does not necessarily reflect the official policy or position of the American College of Physicians (ACP). ACP does not endorse a specific EHR brand or product and ACP makes no representations, warranties, or assurances as to the accuracy or completeness of the information provided herein.

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