A new study published yesterday in Health Affairs finds that hospitals that disproportionately care for low-income patients are falling behind in adopting electronic health records (EHRs). This is the first paper to use national data comparing EHR adoption between acute care providers primarily caring for the poor and those serving more general populations.

Ashish Jha of the Harvard School of Public Health and coauthors surveyed the 3,747 acute care nonfederal U.S. hospitals with available DSH (Medicare disproportionate-share hospital) indices and received responses from 2,368, a response rate of 63.2 percent. They found that for many of the functions examined, hospitals that served a higher proportion of poor patients had modestly lower levels of adoption of health information technology (IT). In addition, the results suggest that EHR systems could help improve the quality of care delivered, and that hospitals serving a larger proportion of poor patients cited cost as a major barrier to EHR adoption.

Since the 2009 stimulus bill authorized nearly $30 billion to establish a national health IT infrastructure, an important health care policy consideration is whether the stimulus bill IT reforms will be implemented in ways that will help close the “digital divide” and improve the overall quality of care in hospitals. Concluded the authors, “While the Obama administration and Congress seek to craft effective policies to stimulate the adoption and use of health IT, it will be critical to ensure that institutions that care for the most vulnerable Americans are not left behind.”

The research for this study was supported by the Office of the National Coordinator for Health Information Technology in the U.S. Department of Health and Human Services and by the Robert Wood Johnson Foundation.