Health information technology and quality of health care: strategies for reducing disparities in underresourced settings.
Health information technology (health IT) has potential for facilitating quality improvement and reducing quality disparities found in underresourced settings (URSs). With this systematic literature review, complemented by key informant interviews, the authors sought to identify evidence regarding health IT and quality outcomes in URSs. The review included 105 peer-reviewed studies (2004-2009) in all settings. Only 15 studies included URSs, and 8 focused on URSs. Based on literature across settings, most evidence was available for quality impact of order entry, clinical decision support systems, and computerized reminders. Study designs were predominantly quasi-experimental (37%) or descriptive (35%); 90% of the studies focused on the microsystem level of quality improvement, indicating a need for expanding research into patient experience and organizational and environmental levels. Key informants highlighted organizational partnerships and health IT champions and emphasized that for health IT to have an impact on quality, there must be an organizational culture of quality improvement.
Millery
Mari
M
Mailman School of Public Health of Columbia University, Department of Sociomedical Sciences, New York, NY 10032, USA. mm994@columbia.edu
Kukafka
Rita
R
D019317:Evidence-Based Medicine; D054625:Healthcare Disparities; D006801:Humans; D008491:Medical Informatics Applications; D058996:Quality Improvement; D035862:Vulnerable Populations