15 July 2016 ~ 0 Comments

Creating Inclusive Health Care Environments To Improve Patient Demographic Data Collection

Author: mohec-admin

All Missourians should have the opportunity to make choices that allow them to live a long, healthy life, regardless of income, education, ethnicity, race, color, religion, national origin, sexual orientation, gender identity or expression, age, ability, and any other aspect of a person’s identity. Health starts in our communities — where we live, learn, work, worship and play. As we collectively work to make good health and access to health care a reality for all Missourians, the Missouri Health Equity Collaborative supports efforts to ensure all Missourians have these opportunities.

MOHEC was established in 2004 as one of the Center for Health Policy’s cornerstone projects at the University of Missouri. Supported by the Missouri Foundation for Health, MOHEC connects a vibrant network of individuals and organizations across Missouri working in the field of health disparities at various levels — academic, community and extension. MOHEC raises health disparity awareness in Missouri and creates collaborative partnerships that address community health, racial and ethnic health disparities, lesbian, gay bisexual and transgender health, mental health, and refugee and immigrant health equity. Our work has taken us throughout Missouri to Columbia, St. Louis, Kansas City, Springfield, Sikeston, Portageville, Cape Girardeau, Kennett, Senath, Milan, Cassville, Charleston, Joplin and Monett.

An essential part of understanding health disparities is an accurate portrayal of race, ethnicity, preferred language, sexual orientation and gender identity of people who seek and receive care. Accurate reflection of data is vital for health equity and for accurate reflection of health issues in underserved or vulnerable populations. Additionally, research has shown that making an appointment or going through check-in/intake can be a negative experience for traditionally underserved populations.

MOHEC is partnering with the Missouri Hospital Association (MHA), the Hospital Industry Data Institute (HIDI), the Missouri Primary Care Association, PROMO, and Services and Advocacy for Gay, Lesbian, Bisexual and Transgender Elders of PROMO Fund, to better understand how the registration and intake process, coupled with data collection practices, contributes to barriers to care, inaccurate data collection and ultimately poor health outcomes among vulnerable populations.

Working in collaboration with MHA and HIDI, we completed an evaluation of data collection practices by surveying hospitals and speaking with clinical managers and patient access and front-desk staff about the challenges in collecting data. Research indicates that health care staff often feel discomfort when asking race, ethnicity, sexual orientation and gender identity questions and may not understand the terminology. They often express concern regarding patient accuracy in reporting, question the value of collecting a large amount of data from the patient and do not understand how the data is used.

Additional challenges include inadequate or limited data collection fields in the electronic health record, limited time for data collection and the feeling that intake/registration staff are paid less with limited training and a high level of responsibility. This creates an environment where, according to the research, staff is more likely to use observation or guessing as collection methods instead of allowing the patient to self-identify. Additionally, there are challenges on the patient side, such as privacy concerns, distrust in the health system’s motivation for collecting data, fear of differential treatment, time concerns, lack of categories that accurately describe their identity and perceived offensive questions associated with data collection.ii Providers and staff are aware of these patient concerns and would like tools and resources to help patients understand how and why data are collected.

MOHEC is working with health care organizations in Missouri to reduce barriers to collecting race, ethnicity, language preference, sexual orientation and gender identity data by facilitating discussions and training staff on data collection, its legality and uses, and how to work with patients on data collection. We are working with clinic managers and front-line staff to create an understanding of the importance of collecting data and will provide guidelines and strategies for how to implement the procedures and explain the purpose to patients. Equipping staff with these skills can help organizations successfully carry out their data collection and health equity efforts. To achieve inclusive health care environments, health care providers and staff need to explore how identity and culture shape experiences in the health care setting. It also is important to learn how identity and culture underlie situations that often go unnoticed in health care workplaces. This proactive, inclusive approach empowers health care providers and staff to address health disparities and will increasingly be considered a crucial skill in the health care sector.

More information about MHA’s Health Equity Quality Initiatives can be found at: http://web.mhanet.com/Quality-initiatives-health-equity.aspx



The Case for Health Equity

2-3 p.m. Tuesday, April 5

11 a.m.-Noon, Monday, April 11


Disparities in Diabetes

2-3 p.m. Friday, May 6

11 a.m.-Noon, Wednesday, May 11


Improving Health Equity Through REaL Data Collection and Analysis

2-3 p.m. Tuesday, June 7

11 a.m.-Noon, Monday, June 13


Strategies for Cultural Competence

2-3 p.m. Wednesday, July 6

11 a.m.-Noon, Thursday, July 7

More information on health disparities efforts ca be found at: http://www.mhanet.com/mhaimages/TrajectoriesNovember2015.pdf

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