race and ethnicity data during different workflows
DESCRIPTION
Issues raised in obtaining social data from patients in the outpatient, emergency and inpatient settings. Presented at MN Community Measurement, April 08.TRANSCRIPT
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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
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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
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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?
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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?
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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
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In Person vs. Telephone
Telephone feels more anonymous & private,
for both interviewer & patient
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In Person vs. Telephone
BUT…Telephone is difficult if not impossible for unscheduled
encounters
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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)
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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
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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?
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• Who monitors completeness?• Who monitors quality?• Who extracts the data?• Who transforms extracts into
something meaningful?
The Data
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• 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
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Questions?Questions?Yiscah BrachaYiscah Bracha
[email protected]@CenterForUrbanHealth.org