Changes to Meditech

RegistrationA Guide for Data

Collection

Adapted Training Slides from the Cambridge Health Alliance

Before we begin…Before we begin…

Only have to collect it once, if we collect it correctly.

AgendaAgenda

What are health disparities? Why are data important? How will we collect the data? How should we address

concerns? Role Plays Resources and Questions

What are health What are health disparities?disparities?

Health disparities are differences Health disparities are differences between populations in:between populations in:

Presence of diseasePresence of disease Access to health care Access to health care Use of health care services Use of health care services Health outcomesHealth outcomes

What causes health What causes health disparities?disparities?

Social, economic, and environmental factors

Barriers to getting health care

Differences in quality of health Differences in quality of health carecare

Top Disparity for BlacksTop Disparity for Blacks

1.0

10.4

0

2

4

6

8

10

12

WhiteBlack

Odds Ratio of New Cases of AIDS for Blacks= 10.4

2005 National Healthcare Disparities Report

Top Disparity for AsiansTop Disparity for Asians

2005 National Healthcare Disparities Report

1.0

1.6

0

0.2

0.4

0.6

0.8

1

1.2

1.4

1.6

WhiteAsian

Odds Ratio of Lack of Treatment for Serious Mental Illness for Asians= 1.6

Top Disparity for HispanicsTop Disparity for Hispanics

2005 National Healthcare Disparities Report

Odds Ratio of New Cases of AIDS for Hispanics= 3.7

1.0

3.7

0

0.5

1

1.5

2

2.5

3

3.5

4

WhiteHispanics

To Eliminate Disparities, To Eliminate Disparities, We Need to Collect Better DataWe Need to Collect Better Data

Why Improve the Why Improve the Data?Data?

68%

70%

71%

77%

70%

0% 20% 40% 60% 80% 100%

Black, Non- Hispanic

White, Non- Hispanic

State

Hispanic

Asian

Percent of Mothers Breastfeeding by Race/Ethnicity, MA

35%

91%

71%

0% 20% 40% 60% 80% 100%

Cambodian

Laotian

Vietnamese

Chinese

MA TOTAL

Thai

Filipino

Korean

Pakistani

Japanese

Asian Indian

Source: Asian Births in Massachusetts: 1996-1999; Hispanic Births in Massachusetts: 1996-1999; andBlack Births in Massachusetts: 1997-2000

Why Collect the Data?Why Collect the Data?

Identify DisparitiesIdentify Disparities

Target InterventionsTarget Interventions

Improve QualityImprove Quality

What do Patients Think?What do Patients Think?

“ “It is important for hospitals It is important for hospitals and clinics to collect and clinics to collect

information from patients information from patients about their race or ethnic about their race or ethnic

background”background”– Strongly agreeStrongly agree 43%43%– Somewhat agreeSomewhat agree 37%37%– UnsureUnsure 6%6%– Somewhat disagreeSomewhat disagree 10%10%– Strongly disagreeStrongly disagree 4%4%

Study conducted at Northwestern Memorial Hospital Data shown in HRET tool kit

““It is important for hospitals It is important for hospitals and clinics to conduct and clinics to conduct

studies to make sure that studies to make sure that all patients get the same all patients get the same

high-quality care regardless high-quality care regardless of their race or ethnic of their race or ethnic

background”background”– Strongly agreeStrongly agree 93%93%– Somewhat agreeSomewhat agree 4%4%– UnsureUnsure 2%2%– Somewhat disagreeSomewhat disagree 1%1%– Strongly disagreeStrongly disagree 0%0%

Study conducted at Northwestern Memorial Hospital Data shown in HRET tool kit

““How concerned would you How concerned would you be that this data could be be that this data could be

used to discriminate against used to discriminate against patients”patients”

– Not concerned at allNot concerned at all 34%34%– A little concernedA little concerned 15%15%– Somewhat concernedSomewhat concerned 20%20%– Very concernedVery concerned 31%31%

Study conducted at Northwestern Memorial Hospital Data shown in HRET tool kit

Introduce the QuestionsIntroduce the Questions

Use Tools for Registration StaffUse Tools for Registration Staff

Distribute Patient Education MaterialsDistribute Patient Education Materials

How can we do this?How can we do this?

Tools for RegistrationTools for Registration

Reporting Race, Ethnicity Reporting Race, Ethnicity and Language: and Language:

A Guide to Helping A Guide to Helping PatientsPatients

IntroductionIntroductionAt the Cambridge Health Alliance, we At the Cambridge Health Alliance, we provide the best care possible for all provide the best care possible for all

of our patients. We are now of our patients. We are now collecting race and ethnicity collecting race and ethnicity

information from all of our patients information from all of our patients to help us know them better. We to help us know them better. We

can learn more about the can learn more about the communities we serve if we know communities we serve if we know your race and ethnicity. We can your race and ethnicity. We can better care for all patients if we better care for all patients if we know more about race, ethnicity, know more about race, ethnicity,

language and culture. This language and culture. This information will only be used to give information will only be used to give all patients the best care possible.all patients the best care possible.

IntroductionIntroductionThe Introduction should tell The Introduction should tell

patients:patients: We are collecting race and We are collecting race and ethnicity data from all patientsethnicity data from all patients We need this information to know We need this information to know more about your culture and more about your culture and languagelanguage This will only be used to better This will only be used to better meet the needs of the patients we meet the needs of the patients we serveserve

Race and Ethnicity: Race and Ethnicity: What’s the What’s the Difference?Difference?

What will change?What will change?

What is your race?What is your race?

If a patient asksIf a patient asks“What is Race?”“What is Race?”

Your Your racerace is the group or groups that is the group or groups that you identify with as having similar you identify with as having similar physical characteristics or similar physical characteristics or similar

social and geographic origins.social and geographic origins. You can You can tell me more than one.tell me more than one.

For example, please let us know if you are Asian, Black, White, etc.

Record Patient’s ResponseRecord Patient’s Response

What is your RACE?You can choose more than one.

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

Asian

Black

White

Other

Help Us Know Our Patients BetterWhen we know your race and ethnicity, we learn more about your

culture and language. This helps us to know you better and to improve the care that we give to all patients. Beginning in January

2007, we will ask for race and ethnicity information from all patients. We can better meet the needs of the communities that we serve if we know more about our patients’ race, ethnicity, culture and language.

What is your ethnicity?What is your ethnicity?

If a patient asksIf a patient asks“What is Ethnicity?”“What is Ethnicity?”

Your Your ethnicityethnicity refers to your refers to your background, heritage, culture, background, heritage, culture,

ancestry or sometimes the country ancestry or sometimes the country where you were born. You can tell me where you were born. You can tell me

more than one.more than one.For example, please let us know if you are

Haitian, Vietnamese, Brazilian, etc.

Record Patient’s ResponseRecord Patient’s Response

Are you Hispanic, Latino or Are you Hispanic, Latino or Spanish?Spanish?

If a patient asksIf a patient asks “What is meant by “What is meant by Hispanic, Latino or Hispanic, Latino or

Spanish?”Spanish?”A person is Hispanic, Latino or A person is Hispanic, Latino or

Spanish if they or their family come Spanish if they or their family come from a country in Latin America or from a country in Latin America or another Spanish-speaking country.another Spanish-speaking country.

Record Patient’s Yes or No ResponseRecord Patient’s Yes or No Response

If the response is some, partly, half, If the response is some, partly, half, or a little, please enter Yes.or a little, please enter Yes.

If a patient declines, enter No.If a patient declines, enter No.

Any other races?Any other races?

Only have to collect it once,

if we collect it correctly.

What your country of What your country of residence?residence?

If OUTSIDE of the US

Asking about Asking about LanguageLanguage

What is the primary language spoken in What is the primary language spoken in your home? “Language Spoken”your home? “Language Spoken”

In what language do you prefer to read In what language do you prefer to read health-related materials? “Written”health-related materials? “Written”

In what language do you prefer to In what language do you prefer to discuss health-related concerns? discuss health-related concerns? “Medical Care”“Medical Care”

Asking about Asking about LanguageLanguage

REMEMBERREMEMBER

You can use Phone You can use Phone Interpretation.Interpretation.

Dial 3333 and press 2 for phoneDial 3333 and press 2 for phone

Addressing Patient Addressing Patient ConcernsConcerns

If the Admissions Source on the B/AR Info tab is“Transfer from other facility”, (HOS or HOS-CHA) then an

additional field must be filled out on the Other tab.

Transfer HospitalTransfer Hospital

Role PlaysRole Plays

- What is your Race?- What is your Race?- What is your Ethnicity?- What is your Ethnicity?- Are you Hispanic, Latino - Are you Hispanic, Latino or or Spanish?Spanish?- Any other races?- Any other races?

Questions for Role Questions for Role PlaysPlays

ResourcesResources

QuestionsQuestions

Contact:Contact:Jacquelyn CagliaJacquelyn Caglia

Community AffairsCommunity Affairs617.499.6618617.499.6618

jcaglia@challiance.orgjcaglia@challiance.org

These slides were These slides were adapted by the adapted by the

Cambridge Health Cambridge Health Alliance using original Alliance using original

materials from :materials from :

MGH Disparities Solution MGH Disparities Solution CenterCenter

MA Department of Public MA Department of Public HealthHealth