Accuracy of Race, Ethnicity, and Language Preference in an Electronic Health Record

Abstract

BACKGROUND: Collection of data on race, ethnicity, and language preference is required as part of the "meaningful use" of electronic health records (EHRs). These data serve as a foundation for interventions to reduce health disparities. OBJECTIVE: Our aim was to compare the accuracy of EHR-recorded data on race, ethnicity, and language preference to that reported directly by patients. DESIGN/SUBJECTS/MAIN MEASURES: Data collected as part of a tobacco cessation intervention for minority and low-income smokers across a network of 13 primary care clinics (n=569). KEY RESULTS: Patients were more likely to self-report Hispanic ethnicity (19.6 % vs. 16.6 %, p<0.001) and African American race (27.0 % vs. 20.4 %, p<0.001) than was reported in the EHR. Conversely, patients were less likely to complete the survey in Spanish than the language preference noted in the EHR suggested (5.1 % vs. 6.3 %, p<0.001). Thirty percent of whites self-reported identification with at least one other racial or ethnic group, as did 37.0 % of Hispanics, and 41.0 % of African Americans. Over one-third of EHR-documented Spanish speakers elected to take the survey in English. One-fifth of individuals who took the survey in Spanish were recorded in the EHR as English-speaking. CONCLUSION: We demonstrate important inaccuracies and the need for better processes to document race/ ethnicity and language preference in EHRs.

Implications of social media use on health information technology engagement: Data from HINTS 4 cycle 3

“…As stated previously, to our knowledge, this is the first study to examine the relationship between social [7] to 7 %. On the contrary, personal blogging decreased slightly since 2007 from 7 to 6.4 %.…”

“…A 2012 study revealed that among U.S. adult Internet users: 19 % reported using the Internet to track personal health information and 19 % reported emailing or communicating with their online healthcare providers electronically [7]. HIT engagement is more common among certain demographic groups.…”

“…HIT engagement is more common among certain demographic groups. High educational attainment [8][9][10], female gender [7,9,11], individuals with chronic health conditions such as cancer or caregivers for those with a chronic condition [12][13][14], and higher income [15] were predictors of HIT engagement. Older adults (65 years of age and older) are less likely to engage in HIT activities [15][16][17][18], including accessing personal health records electronically [16].…”

State-offered ethnically targeted reproductive genetic testing

“…Clinicians and staff frequently make errors when assigning ethnicity and ancestral origin to patients, especially if they do not rely on patient selfreport. 7 Ethnicity, religious affiliation, and location of origin are already imperfect surrogates for genetic diversity and will become even more so with increasing admixture. In addition, targeted screening runs the risk of reifying socially defined categories, while at the same time missing important genetic variation.…”

Using Patient Race, Ethnicity, and Language Data to Achieve Health Equity

“…1 In this month's issue of JGIM, Klinger et al report important inaccuracies in REL data in electronic health records (EHRs) in 13 primary care clinics. 2 For example, 3 % and 6.6 % of patients who self-identified as Hispanic and African American, respectively, were not recorded as such in the EHR, and 20 % of persons documented in the EHRs as English-speaking elected to take a survey in Spanish. Inaccuracies in REL data have clustered around the distinction between Latino and black, American Indians, and multiracial categories, and lack of granularity among Asian American and Latino subgroups.…”