Health Information Technology and the Safety Net

Health care reform has led to widespread implementation of health information technology, and safety net healthcare systems in particular are undergoing a transformation. Incentives from the 2009 Health Information Technology for Economic and Clinical Health Act have triggered widespread implementation of electronic health record systems in safety net settings. Meanwhile, Medicaid expansion prompted by the 2010 Patient Protection and Affordable Care Act is projected to increase insurance coverage of medically and socially complex chronic disease populations, including those with limited health literacy (LHL) and limited English proficiency (LEP). These changes offer new opportunities to deploy health information technology (HIT) to improve the quality of care for LHL and LEP populations with chronic medical conditions, which have traditionally faced communications barriers leading to disparities in their experience of care, quality of care, and health outcomes. Patient portals and mobile health platforms - integrated with new electronic health records - have the potential to engage patients with linguistically and culturally concordant self-management support. Increased clinician computer use may affect the quality and content of clinician-patient communication, as well as clinician satisfaction with their work. However, these changes raise new challenges: how do we tailor HIT tools for limited literacy, limited English proficiency, diverse populations? What communication strategies can improve patient-provider interactions when there is a computer in the room? How can we harness patient’s connectivity, whether it is via mobile phone or internet, to support positive health behaviors?

The UCSF Center for Vulnerable Populations conducts practice-based research to understand how this transformation is affecting the quality of communication and care in safety net settings and to implement health information technology interventions that will improve patient-centered care by a sustainable safety net workforce.

This program is directed by Dr. Urmimala Sarkar.