MN Community Measurement April 16, 2008 Obtaining Patient Social Identity Data  During the Workflow Yiscah Bracha, M.S. Re...
Goal:  <ul><li>Establish method to query patients about: </li></ul><ul><ul><li>Race, ethnicity, language, religion </li></...
Issues to consider: <ul><li>Who asks the questions? </li></ul><ul><li>Given the entire encounter trajectory, when do the q...
System constraints affecting decisions:  <ul><li>Electronic records or paper records? </li></ul><ul><li>If electronic, wha...
Clinical vs. Administrative Staff <ul><li>Administrative staff </li></ul><ul><ul><li>Registrars </li></ul></ul><ul><ul><li...
In Person vs. Telephone  <ul><li>Telephone feels more  </li></ul><ul><li>anonymous & private,  </li></ul><ul><li>for both ...
In Person vs. Telephone BUT… Telephone is difficult if not impossible for unscheduled encounters
Ex:  Hospital admissions <ul><li>Data may already have been obtained if pt admitted from system’s own: </li></ul><ul><ul><...
Hospital admissions Data probably have  not  been obtained  if pt admitted from: Emergency  Room <ul><ul><li>Transfer from...
Hospital admissions: <ul><li>If unscheduled, staff must obtain data from pt, after admission </li></ul><ul><li>Where do th...
<ul><li>Who monitors completeness? </li></ul><ul><li>Who monitors quality? </li></ul><ul><li>Who extracts the data? </li><...
<ul><li>What goes in is never exactly what comes out.  Implication…. </li></ul><ul><ul><li>Obtain data in manner that is e...
Questions? Yiscah Bracha [email_address]
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Race and Ethnicity Data During Different Workflows

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Issues raised in obtaining social data from patients in the outpatient, emergency and inpatient settings. Presented at MN Community Measurement, April 08.

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Race and Ethnicity Data During Different Workflows

  1. 1. MN Community Measurement April 16, 2008 Obtaining Patient Social Identity Data During the Workflow Yiscah Bracha, M.S. Research Director Center for Urban Health
  2. 2. Goal: <ul><li>Establish method to query patients about: </li></ul><ul><ul><li>Race, ethnicity, language, religion </li></ul></ul><ul><ul><li>Other personal demographic characteristics </li></ul></ul><ul><li>Qualities of method: </li></ul><ul><ul><li>Respectful towards patients </li></ul></ul><ul><ul><li>Quick & easy for interviewer/patient pair </li></ul></ul><ul><li>Obtain data that support: </li></ul><ul><ul><li>Detection of clinically important differences </li></ul></ul><ul><ul><li>Reporting using OMB classification </li></ul></ul>
  3. 3. Issues to consider: <ul><li>Who asks the questions? </li></ul><ul><li>Given the entire encounter trajectory, when do the questions get asked? </li></ul><ul><li>What are the subsequent opportunities to ask if the first opportunity is missed? </li></ul>
  4. 4. System constraints affecting decisions: <ul><li>Electronic records or paper records? </li></ul><ul><li>If electronic, what staff typically visit the screens on which the Qs appear? </li></ul><ul><li>Are clinical encounters scheduled? </li></ul><ul><li>What are the system’s mechanisms for: </li></ul><ul><ul><li>Training, supervising and following up with staff who ask the questions? </li></ul></ul><ul><ul><li>Reviewing data completion & quality? </li></ul></ul>
  5. 5. Clinical vs. Administrative Staff <ul><li>Administrative staff </li></ul><ul><ul><li>Registrars </li></ul></ul><ul><ul><li>Schedulers </li></ul></ul><ul><ul><li>Clinic receptionists. </li></ul></ul><ul><li>Clinical staff </li></ul><ul><ul><li>Medical assistants </li></ul></ul><ul><ul><li>Nurses </li></ul></ul><ul><ul><li>Residents </li></ul></ul><ul><li>Considerations: </li></ul><ul><ul><li>Clinical staff more accustomed to asking sensitive questions, BUT: </li></ul></ul><ul><ul><li>In many electronic systems, items appear in registration/scheduling screens </li></ul></ul>
  6. 6. In Person vs. Telephone <ul><li>Telephone feels more </li></ul><ul><li>anonymous & private, </li></ul><ul><li>for both interviewer & patient </li></ul>
  7. 7. In Person vs. Telephone BUT… Telephone is difficult if not impossible for unscheduled encounters
  8. 8. Ex: Hospital admissions <ul><li>Data may already have been obtained if pt admitted from system’s own: </li></ul><ul><ul><li>Outpatient clinic (scheduled appt) </li></ul></ul><ul><ul><li>Ambulatory surgical center (scheduled appt) </li></ul></ul><ul><ul><li>Nursing home </li></ul></ul><ul><ul><li>ED (if pt gave info on presentation) </li></ul></ul>
  9. 9. Hospital admissions Data probably have not been obtained if pt admitted from: Emergency Room <ul><ul><li>Transfer from outside facility </li></ul></ul><ul><ul><li>Other hospital </li></ul></ul><ul><ul><li>Nursing home </li></ul></ul>Walk-in clinic visit
  10. 10. Hospital admissions: <ul><li>If unscheduled, staff must obtain data from pt, after admission </li></ul><ul><li>Where do these data reside in the system, compared to data obtained over telephone? </li></ul>
  11. 11. <ul><li>Who monitors completeness? </li></ul><ul><li>Who monitors quality? </li></ul><ul><li>Who extracts the data? </li></ul><ul><li>Who transforms extracts into something meaningful? </li></ul>The Data
  12. 12. <ul><li>What goes in is never exactly what comes out. Implication…. </li></ul><ul><ul><li>Obtain data in manner that is easiest for patients and people who interview them; </li></ul></ul><ul><ul><li>Extract & transform data to meet reporting & analysis requirements. </li></ul></ul><ul><ul><li>Be aware of the relationship, but </li></ul></ul><ul><ul><li>DON’T CONFUSE THE TWO TASKS! </li></ul></ul>Data
  13. 13. Questions? Yiscah Bracha [email_address]

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