Jean-Francois Beda, Bailey Lash Tiffani, Dagher Rada K, Green Parker Melissa C, Han Sacha B, Lewis Johnson Tamara
Division of Scientific Programs, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA.
Division of Health Informatics Technologies, National Institute of Biomedical Imaging and Bioengineering, Bethesda, Maryland, USA.
J Womens Health (Larchmt). 2021 Feb;30(2):274-279. doi: 10.1089/jwh.2020.8889. Epub 2020 Nov 18.
Health information technology (health IT) potentially is a promising vital lever to address racial and ethnic, socioeconomic, and geographic disparities in maternal morbidity and mortality (MMM). This is especially relevant given that approximately 60% of maternal deaths are considered preventable. Interventions that leverage health IT tools to target the underlying drivers of disparities at the patient, clinician, and health care system levels potentially could reduce disparities in quality of care throughout the continuum (antepartum, intrapartum, and postpartum) of maternity care. This article presents an overview of the research (and gaps) on the potential of health IT tools to document SDoH and community-level geocoded data in EHR-based CDS systems, minimize implicit bias, and improve adherence to clinical guidelines and coordinated care to inform multilevel (patient, clinician, system) interventions throughout the continuum of maternity care for health disparity populations impacted by MMM. Telemedicine models for improving access in rural areas and new technologies for risk assessment and disease management (, regarding preeclampsia) also are discussed.
健康信息技术（health IT）有可能成为解决孕产妇发病率和死亡率（MMM）方面的种族和族裔、社会经济及地理差异的一个有前景的关键手段。鉴于约60%的孕产妇死亡被认为是可预防的，这一点尤为重要。利用健康信息技术工具针对患者、临床医生和医疗保健系统层面差异的根本驱动因素进行干预，有可能减少整个孕产妇护理连续过程（产前、产时和产后）中护理质量的差异。本文概述了关于健康信息技术工具在基于电子健康记录（EHR）的临床决策支持（CDS）系统中记录社会经济地位低下和社区层面地理编码数据、最大限度减少隐性偏见以及提高对临床指南的依从性和协调护理的潜力的研究（以及差距），以为受MMM影响的健康差异人群在整个孕产妇护理连续过程中的多层次（患者、临床医生、系统）干预提供信息。还讨论了改善农村地区医疗服务可及性的远程医疗模式以及（关于子痫前期的）风险评估和疾病管理的新技术。
