title: California's digital divide: clinical information systems for the haves and have-nots.
abstract: Strong barriers prevent the financing of clinical information systems (CIS) in health care delivery system organizations in market segments serving disadvantaged patients. These segments include community health centers, public hospitals, unaffiliated rural hospitals, and some Medicaid-oriented solo and small-group medical practices. Policy interventions such as loans, grants, pay-for-performance and other reimbursement changes, and support services assistance will help lower these barriers. Without intervention, progress will be slow and worsen health care disparities between the advantaged and disadvantaged populations.
authors.affiliation: University of California, San Francisco, USA. robert.miller@ucsf.edu
authors.forename: Robert H
authors.initials: RH
authors.lastname: Miller
authors.forename: Katherine
authors.initials: K
authors.lastname: D'Amato
authors.forename: Nancy
authors.initials: N
authors.lastname: Oliva
authors.forename: Christopher E
authors.initials: CE
authors.lastname: West
authors.forename: Joel W
authors.initials: JW
authors.lastname: Adelson
mesh_terms: D017598:Efficiency, Organizational; D055991:Health Records, Personal; D006801:Humans; D017064:Process Assessment, Health Care