Slide 1: Obtaining Patient Social Identity Data During the Workflow
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Yiscah Bracha, M.S.
Research Director Center for Urban Health
MN Community Measurement April 16, 2008
Slide 2: Goal:
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• 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
Slide 3: Issues to consider:
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• 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?
Slide 4: 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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Slide 5: Clinical vs. Administrative Staff
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• Clinical staff
Medical assistants Nurses Residents
• Administrative staff
Registrars Schedulers Clinic receptionists.
• Considerations:
Clinical staff more accustomed to asking sensitive questions, BUT: In many electronic systems, items appear in registration/scheduling screens
Slide 6: In Person vs. Telephone
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Telephone feels more anonymous & private, for both interviewer & patient
Slide 7: In Person vs. Telephone
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BUT… Telephone is difficult if not impossible for unscheduled encounters
Slide 8: Ex: Hospital admissions
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• 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)
Slide 9: Hospital admissions
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Data probably have not been obtained if pt admitted from:
Emergency Room Walk-in clinic visit
Transfer from outside facility
Other hospital Nursing home
Slide 10: Hospital admissions:
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• If unscheduled, staff must obtain data from pt, after admission • Where do these data reside in the system, compared to data obtained over telephone?
Slide 11: The Data
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• • • •
Who monitors completeness? Who monitors quality? Who extracts the data? Who transforms extracts into something meaningful?
Slide 12: 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!
Slide 13: www.CenterForUrbanHealth.org
Questions?
ybracha@CenterForUrbanHealth.org
Yiscah Bracha
