Hospitals in pursuit of excellence

Updating Electronic Medical Records to Include Race, Ethnicity and Language Data

San Mateo Medical Center
San Mateo, CA
307 Beds

The Problem
San Mateo Medical Center has collected demographic data for many years. Due to a cumbersome framework for collection as required under state and federal guidelines and inefficient screening practices, the data has been unreliable and not very useful to the hospital’s quality and leadership teams. Furthermore, they knew that integrating race, ethnicity, and language (REAL) data into the organization’s electronic medical record would require a costly upgrade to the existing IT system.

The Solution
San Mateo Medical Center is using recommendations from the California Health Care Safety Net Institute to simplify and focus its data collection practices. For example, although the number of race categories is dictated by federal reporting guidelines, the ethnicity categories were expanded to reflect the diversity of its specific patient communities. The medical center also created a multidisciplinary team, including managers from the IT department, health information management, quality department staff and training supervisors for the clerical staff to oversee and coordinate the changes. With the support of executive management, the REAL data project was included as a goal in the package of Delivery System Reform Incentive Payments for the medical center’s Medicaid waiver, which rewards hospitals for improving quality performance. This advancement will also allow the medical center to eventually load REAL data directly into the electronic medical record.

The Result
Patients are able to self-report their ethnicity, language, and race from a preselected, abbreviated list of categories created by the hospital and aligned with community demographics. Patient registration team members then input the data into the electronic medical record. The medical center is beta testing the new system with its quality team to incorporate this information and ensure the right data is collected. One goal of the changes is the availability of REAL data to identify and address potential disparities for at least 90 percent of patients encountered by late 2012.

Contact Information
Jonathan Mesinger
jmesinger@co.sanmateo.ca.us

This case study was originally featured in the HPOE guide: "Eliminating Health Disparities: Implementing the National Call to Action Using Lessons Learned," published February, 2012.