Hospitals with Many Poor Patients are Slower to Adopt EHRs

Other concerns include the return on investment, cost of maintenance, resistance from physicians, and concerns about lack of future support.

Through the American Recovery and Reinvestment Act of 2009, the federal government is earmarking $30 billion to establish a national health IT infrastructure that uses financial incentives through Medicare and Medicaid to promote EHR by hospitals and physicians.

"Although there is broad support for helping healthcare providers adopt EHRs, some worry that such efforts might exacerbate existing disparities in care by creating a new healthcare 'digital divide' between providers that disproportionately care for the poor and those that do not," the authors said.

They pointed to the need to address a "central policy question" about whether the ARRA will be used to reduce this gap.

"Given the potential of EHRs to improve the efficiency and effectiveness of care, these providers' ability to furnish high-quality healthcare may be further compromised if they lag in EHR adoption."

The report was authored by Ashish Jha, associate professor of the Harvard School of Public Health in Boston and colleagues at Massachusetts General Hospital's Institute for Health Policy; the Harvard/MGH Center for Genomics, Vulnerable Populations and Health Disparities; and George Washington University in Washington, D.C.