To begin to tackle inequities in care, health systems and medical groups must understand whom they are serving, the collection of accurate sociodemographic data, such as race and ethnicity data is critical.
Start by asking, “Who is going to be involved in collecting the data?” There may be a few possibilities: medical assistants, nurses, people involved in registration of patients in a clinic or physician office, or another option.
At Henry Ford, an AMA Health System Program Partner, “the current, more rigorous, standardized data collection was a change for a lot of people,” he said. Training was not “quite half a day, but they were much longer than 20- or 30-minute sessions” that included didactic and hands-on learning.
When determining how to ask patients questions about ethnicity and race, there are different routes to take. However, Nerenz recommends saying, “We want to make sure that all our patients get the best care possible. We would like you to tell us your racial and ethnic background so that we can review the treatment that all patients receive and make sure that everyone gets the highest quality of care.”
That is because this statement “talks about how this data collection may reflect the patient or someone like him or her,” he said, adding that “when you describe it to patients or plan members—the reason for asking these questions—it’s really about quality of care and it’s about personalized care.”
“It’s not about government requirements. It’s not about some obscure backroom analysis,” said Nerenz.
Ask patients to self-report
Before the current process was put in place, “in our organizations and many others, there was a place in the registration system to record race or ethnicity, and it was very often done simply by a visual inspection of the patient,” said Nerenz. The question was not asked of the patient directly.
“You want patients to tell you this. Yes, visually it might be obvious that they belong to one category and another, but the true authorities really are the patients themselves,” he said. “Therefore, they should be asked about race and ethnicity either verbally or in the form of some kind of written document and the response options…can be offered.” There are also examples where these questions can be presented in the patient portal as part of a pre-visit questionnaire.
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