Battling Bias in Primary Care Encounters: Informatics Designs to Support Clinicians

Abstract

Although clinical training in implicit bias is essential for healthcare equity, major gaps remain both for effective educational strategies and for tools to help identify implicit bias. To understand the perspectives of clinicians on the design of these needed strategies and tools, we conducted 21 semi-structured interviews with primary care clinicians about their perspectives and design recommendations for tools to improve patient-centered communication and to help mitigate implicit bias. Participants generated three types of solutions to improve communication and raise awareness of implicit bias: digital nudges, guided reflection, and data-driven feedback. Given the nuance of implicit bias communication feedback, these findings illustrate innovative design directions for communication training strategies that clinicians may find acceptable. Improving communication skills through individual feedback designed by clinicians for clinicians has the potential to improve healthcare equity.

Equitable Research PRAXIS: A Framework for Health Informatics Methods

“…For example, scholars have drawn attention to the folly of studying racial disparities by measuring individual race [30]. Countering this, informatics researchers have investigated stigmatizing language about African-American patients in clinical notes [31,32] and provided feedback to healthcare providers about biases in patient interactions [33]. Structural competence aids in selecting the "level" of society at which interventions should operate [20].…”