If it looks like a duck...

A new study by Zhu, published in the Journal of General Internal Medicine looking at the effects of the 2006 Massachusetts Health Reform on access to care, health status and ethnic and socioeconomic disparities in healthcare, shows that the legislation has led to improvements in insurance coverage as well as a decline in financial barriers to care. However, to date, it has not increased people’s access to a personal physician or improved their self-rated health. Neither has it reduced healthcare inequalities between ethnic or income groups. To some this may be surprising. To others it was expected. The obvious question becomes, "will we see the same results with respect to national healthcare reform? If so what should we do about it? If not, why will the national experience be any different? As daunting as this problem and these questions might be, they should never be seen as reasons not to go forward. We don't have a cure for cancer, HIV or even the common cold. Yet tens of millions of dollars each year pour into research seeking to find the cures for these ailments. Turns out they are much more complicated problems than historically anticipated. Why shouldn't we have a similar resolve around eliminating disparities in healthcare? Emerging Health IT tools and applications offer promise in helping us address disparities, in part, through 1) improving access to "care", services and information through affordable devices and/or apps eventually eliminating the vexing problem of "the hard to reach". 2) they also offer the potential of promoting, enhancing and enabling deeper and more meaningful patient activation and engagement in their healthcare than currently possible for many and 3) it will eventually enable real time, place independent, monitoring, feedback, communication and data analysis of very large numbers of patients and or data elements for the purpose of continuous quality improvement as well as benchmarking, prognostication and rapid interdiction even before problems become diseases or cases become clusters, trends, epidemics or disparities. In essence emerging Medical and consumer Health IT may usher disruptive changes in the way we understand disease, how and where medicine is practiced and what is even considered "healthcare". While it is unclear if Massachusetts healthcare reform enabled these transformations, if national healthcare reform does,(and it looks like it might) it may not only be good for disparities, it may also be "just what the doctor ordered".