E-reminders, EHRs fail to influence racial differences in cancer screening

Electronic health records (EHRs) and electronic preventive care reminders do not modify or exacerbate racial differences in cancer screening order rates, according to a study published online March 17 by the Journal of the American Medical Informatics Association.

Cancer screening rates vary drastically across races, leading to troubling racial disparities. Health information technology and EHRs have been adopted by clinical practices to better preventive care across different racial and ethnic patient groups. However, many question if this technology will improve or exacerbate disparities.

Authors Rebecca G. Mishuris, MD, and Jeffrey A. Linder, MD, MPH, FACP, of Brigham and Women’s Hospital in Boston, analyzed cancer screening order rates by EHR and e-reminder status, the extent of racial disparity in the orders, and the degree to which the health information technology affected the disparities.

After measuring the differences in rates of breast, cervical, and colon cancer screening orders between white and non-white subjects at primary care visits, Mishuris and Linder found that these orders for screening did not differ between clinics with and without EHRs or e-reminders. Additionally, differences were not seen in screening orders between non-white and white patients for breast or cervical cancer.

Non-white patients, however, were more likely to receive screening orders for colon cancer than white patients at primary care visits with EHRs and e-reminders. The researchers concluded that EHRs and e-reminders did not alter racial differences in cancer screening rates.

“Given that EHRs are soon to be universally available, we should build systems that support equality in orders and also equality in examination completion,” wrote Mishuris and Linder. “Advances in the use of HIT, together with patient involvement and care management, have the potential to improve the quality of care and outcomes for all patients.”