Racism and Electronic Health Records (EHRs): Perspectives for research and practice

Area of Science:

• Health Informatics
• Health Equity Research
• Social Determinants of Health

Background:

• Racism in electronic health records (EHRs) implementation and use is an emerging area of informatics research.
• Existing work has begun to expose structural racism but lacks comprehensive inclusion of racism concepts.
• Racial and ethnic disparities in health are fundamentally driven by structural racism.

Purpose of the Study:

• To classify racism at individual, organizational, and structural levels within health informatics.
• To provide recommendations for future research, practice, and policy to address racism in EHRs.
• To emphasize the ethical obligation of informaticians to address racism and promote health equity.

Main Methods:

• Literature review and conceptual analysis of racism in health informatics.
• Classification of racism into individual, organizational, and structural levels.
• Development of recommendations based on identified gaps and ethical considerations.

Main Results:

• Identified a lack of inclusion of racism concepts in current EHR research.
• Proposed a three-level classification of racism (individual, organizational, structural).
• Outlined key recommendations for addressing racism in EHRs.

Conclusions:

• Informaticians have an ethical duty to confront racism in EHRs.
• Addressing structural racism requires capturing and utilizing social determinants of health data.
• Increasing workforce diversity and minority scholar participation is crucial for advancing health equity in informatics.