Each April, National Minority Health Month provides an opportunity to reflect on the progress made to improve the health and well-being of people of color and remind ourselves of the hard work still ahead to reduce health disparities and inequity. This year marks five years since the Health Information Technology for Economic and Clinical Health (HITECH) Act and four years since the monumental Patient Protection and Affordable Care Act (ACA) were signed into law. We are more certain than ever that we are on the right track and more hopeful than ever that all people can achieve and maintain their optimal health status.
The HITECH Act and ACA are designed to improve healthcare access and quality of care for all people living in the United States, but will benefit women of color in particular. Women of color experience negative reproductive health outcomes at greater rates than their white counterparts, in part because of lack of access to quality health care. Women of color are more likely to experience an unintended pregnancy, suffer from pregnancy-related diseases and adverse outcomes, contract sexually-transmitted infections (STI) including HIV, and detect cancer at later stages. Fortunately, because of ACA and HITECH, more women of color are able to access important health services and use technology to manage their care and track their progress.
The reproductive health field is a poignant example of where HITECH and ACA are working together to help people achieve the health they want. Within ACA, the no-copay contraceptive coverage requirement ensures that all women are able to access contraception and related services at no additional cost through their health insurance. So far, 5.4 million people who didn’t have coverage before now have health insurance. The Guttmacher Institute reports that the percentage of women who obtain pills and contraceptive vaginal rings at no cost has increased from 15 percent to 40 percent and from 23 percent to 52 percent, respectively. It’s working to improve access! Of course, that’s a great thing - research shows that when women are able to access important health care like contraception, they are better able to achieve their education, career, and economic goals – all of which are important factors that influence health and well-being of individuals, families, and communities.
While ACA has been working to expand financial access to health care, HITECH has helped providers and patients better manage patient care, enhance quality, and improve health outcomes through electronic health records (EHR) and other health information technologies. For women, this means being able to view lab results (like STI testing) online in a timely fashion, track appointments and prenatal progress, and request refills for birth control electronically – this tool is of particular importance for busy women who are juggling multiple responsibilities. For providers, it means keeping better track of important health information and coordinating care for patients who have more than one care provider.
Moreover, health information technology and telemedicine have great potential to improve access to quality care for the millions of women living in rural or underserved areas. For example, the Antenatal Neonatal Guidelines, Education, and Learning System (ANGELS) network, based at the University of Arkansas, connects family practitioners and patients with maternal, fetal, and neonatal medicine specialists they may not have had access to otherwise. By building a bridge to share information and resources, technologies such as telemedicine, HIT, and EHR enhance the ability of health systems to provide timely, quality, and comprehensive health care.
This month, we should pause to celebrate the progress made without losing sight of the work that needs to continue. We must continue reaching for full participation in programs offered by the HITECH Act to make the most of existing health information technology. We must also push for full implementation of the ACA. For example, expanding Medicaid eligibility requirements is critical for improving access to quality care, but it’s optional. A state can choose whether or not to make changes that would allow more low-income people to enroll in the Medicaid program. Almost half of states - many of which are home to large populations of people of color, people with lower incomes, and people living in rural areas - have not taken any action to implement Medicaid expansion. These states must expand their Medicaid eligibility requirements as soon as possible so that their residents can start benefitting from high quality health care. It’s working for millions of people right now, and it can work for millions more.