Evidence of an emerging digital divide among hospitals that care for the poor

Document Type

Journal Article

Publication Date



Health Affairs


Volume 28, Issue 6

Inclusive Pages



Diffusion of Innovation; Health Services Accessibility--economics; Hospitals--trends; Medical Records Systems--utilization; Poverty; Hospitals; Disparities


Some hospitals that disproportionately care for poor patients are falling behind in adopting electronic health records (EHRs). Data from a national survey indicate early evidence of an emerging digital divide: U.S. hospitals that provide care to large numbers of poor patients also had minimal use of EHRs. These same hospitals lagged others in quality performance as well, but those with EHR systems seemed to have eliminated the quality gap. These findings suggest that adopting EHRs should be a major policy goal of health reform measures targeting hospitals that serve large populations of poor patients.