Download - Race and Ethnicity Data During Different Workflows

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MN Community MeasurementApril 16, 2008

Obtaining Patient Social Identity Data During the Workflow

Yiscah Bracha, M.S.Research Director

Center for Urban Health


Goal:

• Establish method to query patients about: Race, ethnicity, language, religion Other personal demographic characteristics

• Qualities of method: Respectful towards patients Quick & easy for interviewer/patient pair

• Obtain data that support: Detection of clinically important differences Reporting using OMB classification


Issues to consider:

• Who asks the questions?• Given the entire encounter

trajectory, when do the questions get asked?

• What are the subsequent opportunities to ask if the first opportunity is missed?


System constraints affecting decisions:

• Electronic records or paper records?• If electronic, what staff typically visit

the screens on which the Qs appear?• Are clinical encounters scheduled?• What are the system’s mechanisms

for: Training, supervising and following up

with staff who ask the questions? Reviewing data completion & quality?


Clinical vs. Administrative Staff

• Administrative staff Registrars Schedulers Clinic receptionists.

• Clinical staff Medical assistants Nurses Residents

• Considerations: Clinical staff more accustomed to asking

sensitive questions, BUT: In many electronic systems, items appear

in registration/scheduling screens


In Person vs. Telephone

Telephone feels more anonymous & private,

for both interviewer & patient


In Person vs. Telephone

BUT…Telephone is difficult if not impossible for unscheduled

encounters


Ex: Hospital admissions

• Data may already have been obtained if pt admitted from system’s own:

Outpatient clinic (scheduled appt) Ambulatory surgical center (scheduled appt) Nursing home ED (if pt gave info on presentation)


Hospital admissions

Data probably have not been obtained

if pt admitted from:

Emergency Room

Transfer from outside facilityOther hospital

Nursing home

Walk-in clinic visit


Hospital admissions:

• If unscheduled, staff must obtain data from pt, after admission

• Where do these data reside in the system, compared to data obtained over telephone?


• Who monitors completeness?• Who monitors quality?• Who extracts the data?• Who transforms extracts into

something meaningful?

The Data


• What goes in is never exactly what comes out. Implication…. Obtain data in manner that is easiest

for patients and people who interview them;

Extract & transform data to meet reporting & analysis requirements.

Be aware of the relationship, but DON’T CONFUSE THE TWO TASKS!

Data


Questions?Questions?Yiscah BrachaYiscah Bracha

[email protected]@CenterForUrbanHealth.org