Health information technology and disparities in care: Improving the quality of data collection

Issue: Financial incentives promoting electronic health record (EHR) systems are expected to improve access to and provide better care to Americans. EHR systems have the capability of building a knowledge base for physicians to make clinical decisions for the best treatment of patients. This study analyzes prostate cancer patients in the state of Florida by ethnicity to determine if current data collection is conducive to decision support systems (DSS).Study design: Prostate cancer inpatients in the State of Florida for general acute care and specialty care hospitals were stratified by clinical, demographic and hospital characteristics. Groups were compared and z-scores were calculated on the number of observations showing costs for procedures without procedure code documentation between White and AA patients. Results: African Americans (AA) were more likely to have higher percentages of missing procedure codes than Whites in all categories except for those patients seen in specialty cancer hospitals, and those that were discharged to hospice care or died. Only 2.2% of White patients and no AA patients in specialty hospitals were missing codes. General acute care hospitals had missing codes for 15.6% of AA and 6.7% for White patients (z=11.5, p<.001). Recommendations: If treatment codes are consistently documented fewer times for AAs, best practices cannot properly be established for this population. General hospitals can learn lessons from the specialty cancer hospitals on assuring proper documentation of procedures to contribute to DSS.