Studies: Health IT has big impact on rural and minority communities

By Mike Miliard
10:31 AM
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Rural and Native Americans, ethnic minorities in poor, urban communities and Alaskan Natives often suffer negative health outcomes disproportionately due to a lack of access to various health IT tools, according to five research studies published in Perspectives in Health Information Management.

Perspectives in Health Information Management is the online quarterly journal of scholarly research from the American Health Information Management Association (AHIMA) Foundation.

Results from the five separate double-blind studies appearing in PHIM’s Winter 2011 edition links the absence of different forms of health IT – including telehealth and mobile health technologies – to inferior health outcomes for several ethnic and cultural minority populations.

The first study, A Patient-centric, Provider-assisted Diabetes Telehealth Self-management Intervention for Urban Minorities, was conducted by Ernest L. Carter, MD, PhD, Gail Nunlee-Bland, MD, and Clive Callender, MD, all professors at Howard University Hospital in Washington, D.C.

It concluded that an online diabetes self-management portal complemented by biweekly virtual visits with a nurse enabled African Americans with diabetes to improve their health outcomes and assume more responsibility for their health.

“Results indicate that treatment group participants were more likely to achieve positive outcomes in terms of lowered hemoglobin A1c and body mass index measurements than were control group members,” the study notes, adding that findings “support the development of telehealth interventions to promote effective chronic disease management in medically underserved communities.”


A separate study by Michael Christopher Gibbons, MD, MPH, associate director of the Johns Hopkins Urban Health Institute and assistant professor of Public Health and Medicine at the Johns Hopkins Medical Institutions in Baltimore, is titled Use of Health Information Technology among Racial and Ethnic Underserved Communities.

It identifies several "technical, practical, and human challenges to health IT adoption and stresses the need for the healthcare system to embrace the full spectrum of emerging health IT opportunities to address healthcare disparities." Gibbons's conclusion is based on an overview of health IT utilization among healthcare providers that notes certain characteristics that may disproportionately affect minority populations.

“Current and emerging health IT use among racial and ethnic minority populations is examined, highlighting areas in which technology use in these populations differs from that of non-minority populations and emphasizing the importance of new social media applications in healthcare education and delivery,” Gibbons writes in his study abstract. 

A third report, authored by Miguel Tirado, a professor of health and human services at California State University-Monterey Bay in Seaside, Calif. and a research associate with the Center for Telehealth and Cybermedicine Research at the University of New Mexico in Albuquerque, is titled Role of Mobile Health in the Care of Culturally and Linguistically Diverse US Populations. 

It asserts that emerging trends in the health-related use of cell phones includes the proliferation of mobile health applications for the care and monitoring of patients with chronic diseases and the rise in cell phone usage by Latino and African Americans.

Tirado's article reviews public policy in four areas – mobile health service access and the physician’s duty of care; affordability of, and reimbursement for, health-related services via mobile phone; protocols for mobile health-enabled patient health data collection and distribution; and cultural and linguistic appropriateness of health-related messages delivered via cell phone – with the goal of improving the care of patients belonging to culturally and linguistically diverse populations.

The review demonstrates a need for “policy changes that would allow for reimbursement of both synchronous and asynchronous patient-provider communication, subsidize broadband access for lower-income patients, introduce standards for confidentiality of health data transmitted via cell phone as well as amplify existing cultural and linguistic standards to encompass mobile communication, and consider widespread public accessibility when certifying new technologies as ―medical devices,” writes Tirado, as he urges federal and state governments to take prompt action to ensure that the benefits of mobile health are accessible to all Americans.


For two more studies focused on healthcare IT, see next page.

This issue of Perspectives in HIM also includes two other studies focusing on health IT's benefits to underserved communities.

One, titled A Peach of a Telehealth Program: Georgia Connects Rural Communities to Better Healthcare, is authored by Rena Brewer, RN, MA, GiGi Goble and Paula Guy, RN. The authors present Georgia’s telehealth response to some of the significant healthcare challenges and disparities facing that state’s rural citizens.

“When compared to their urban and suburban counterparts, rural communities have fewer healthcare providers, and residents must travel longer distances to reach them,” they write. As a result, Georgia’s statewide telemedicine network uses information technology to improve the efficiency and quality of healthcare and health outcomes for underserved populations in Georgia.

The other is titled, Innovation in Indian Healthcare: Using Health Information Technology to Achieve Health Equity for American Indian and Alaska Native Populations. Written by Mark Carroll, MD, Theresa Cullen, MD, Stewart Ferguson, PhD, Nathan Hogge, Mark Horton, OD, MD and John Kokesh, MD, it shows how the U.S. Indian health system utilizes a diverse range of health information technology and innovative tools to enhance health service delivery for American Indians and Alaska Natives, and provides an overview of efforts and experience using such tools to achieve health equity for American Indian and Alaska Native communities.