Disparities in digital information exchange and interoperability among family medicine physicians in the United States

Objective This study examines disparities in the use of interoperability features within the EHR among family medicine physicians in the United States, particularly in areas with higher social deprivation index and rural settings. Materials and Methods Using data from the 2022 American Board of Family Medicine Continuous Certification Questionnaire, we assessed the association between self-reported interoperability and social deprivation. Results Adjusting for other confounders, there is a noticeable trend of declining odds to report utilizing key interoperability features associated with higher social deprivation, including receiving and sending information, and having patient information available that are external to their organization. Family medicine physicians are more likely to report sending electronic information when collaborating with local public health agencies (OR = 1.573). They also have higher odds of reporting the integration electronic information when partnering with behavioral health agencies (OR = 1.838) and schools (OR = 1.742). Exploratory analyses show that rural family medicine physicians may have significantly lower odds of reporting sending (OR = 0.0891), searching (OR = 0.362), and having external patient encounters available (OR = 0.0774) compared to urban physicians, though the small sample size (n = 6) limits estimate stability and generalizability. Discussion Providers serving populations with higher social deprivation and practice in rural areas may face unique challenges regarding digital information exchange and interoperability. Programs and structures should facilitate community collaborations, such as partnerships with local public health agencies, schools, and behavioral health organizations, that were associated with improved odds of interoperability. Conclusion Seamless information exchange is crucial for reducing health disparities and improving care coordination, particularly within family medicine as a frontline point of patient care. Further research should examine how family physicians can leverage funding and partnerships to enhance interoperability and digital access, and assess their impact on reducing disparities.