May 21

Despite HIT progress, Who’s Still Left Out? Can Anyone Say Latinos?

As new HIT makes ever greater inroads into the nation’s healthcare system, there is bound to be an expanding array of stories that highlight the advantages HIT brings to patients and doctors alike.

But rather than taking too much comfort as favorable evidence piles up, policymakers should regularly wonder what percentage of the population is still not reaping the benefits.

Take this story from San Francisco. For HIT proponents, it just doesn’t get much better.  A single mother with a sick child on her hands uses all available hi-tech tools to get the boy’s situation diagnosed so that, much to his chagrin, he can get back to school without missing a single class.

The story goes on to describe how doctors and patients are communicating via videoconferencing, IM, e-mail, Facebook, and Twitter, and the result, particularly for those patients with EHRs, is a system brimming with convenience, new efficiencies and improved care.

But here’s the question that should nag at policymakers no matter how many of these stories they read: What percentage of the population are we not reaching with all our new tools?

On the one hand, there will never be a time for a definitive answer to that question, because HIT will keep evolving and the healthcare system will have to evolve with it. On the other hand, however, policymakers should already be trying to figure out how to measure, at least roughly, who’s using HIT beyond the healthcare providers who are making the up-front investment.

For purposes of comparison, at least when it comes to patient use of HIT, they might want to take a look at how the “digitizing” of the nation’s school systems has changed or not changed the relationship between parents and teachers. With three kids in school and a veteran teacher for a wife, our admittedly unscientific hunch is that HIT runs the risk of being used much like “Edu-IT” is being used. That is, those who are plugged in general are plugged in when it comes to their children’s education. They access their grades on-line, for example, and they communicate regularly with their teachers via e-mail.

But ask a teacher, and you may well hear the lament that the parents who really need to be more engaged in their kids’ education aren’t using the latest technologies to plug in, and the chances are they won’t be any time soon.

So will the same divide develop as HIT becomes more prevalent? Obviously, there’s no way to know for sure. The question, however, should be one of the first things policymakers think of whenever they read another HIT success story.

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