Race/ethnicity data: Put stop to guesswork

Convey reason information is needed

Do your registrars use their own judgment to determine patients’ race and ethnicity because they’re too embarrassed to ask the person standing in front of them?

This behavior is happening in registration areas at some hospitals, according to Mitch Mitchell, president of T.T. Mitchell Consulting, a Liverpool, NY-based consulting firm specializing in revenue cycle and technology. Mitchell says he has done site visits at hospitals that instruct registrars to use their best guess as to a patient’s race and ethnicity because managers are afraid of offending patients.

“It’s a question that should be asked because we can’t look at someone and know what they are, or what they want to classify themselves as,” says Mitchell. “It’s important to get it right, and it could save someone from getting into an uncomfortable position because of their assumption.”

Previously, staff members often were afraid to ask about race and ethnicity, and were asking the question in various inconsistent ways, says Sylvia C. Motta, manager of pre-registration and the call center at Cambridge Health Alliance in Medford, MA.

“Obtaining race and ethnicity data from patients is a difficult task,” says Motta. ‘It involves educating staff in order to lessen patient dissatisfaction and improve vital healthcare data collection.”

When patients asked for clarification, some registrars didn’t know how to respond because they had no idea themselves why the information was needed. “It is important for staff to understand the reason why this data is needed, so they are prepared to ask the questions and not guess what the answers should be,” Motta says.

The pre-registration department at the Cambridge Health Alliance places a high priority on obtaining accurate race and ethnicity data collection, says Motta. Patient access employees are told that they collect this data for these reasons:

• The data helps to identify the population served by the hospital and helps the hospital enhance care provided to a vulnerable, diverse population.

• The Cambridge Health Alliance is a teaching public hospital, and the quality of research depends on the collection of accurate information such as race and ethnicity.

• The information is used by the Department of Public Health to help build healthier communities.

Registrars are encouraged to take an online course about how to collect data on race, ethnicity and language, which was developed internally by the hospital’s information technology department. The course covers how to enter information into systems, how to ask the questions, and how to respond when a patient asks why the information is needed, and it provides definitions of race, ethnicity, and identifying language.

“I took it myself, and found it very helpful,” says Motta. “The course illustrates how to enter more than one response if a patient considers themselves to be part of more than one race, ethnicity, or speak more than one language.”

Ask respectfully

It is important that staff ask questions in a professional, respectful manner without offending patients or making them resistant to giving information, Motta underscores.

“For some people, being asked their race and ethnicity is a sensitive issue,” she explains. “They feel they might be treated differently if they identify this statistical feature about themselves.” Registrars say the following statements to patients before they ask any questions: “The pre-registration department helps in registering an appointment by collecting demographic, guarantor/billing, and insurance information over the phone. By doing this before your date of service, it will help expedite waiting time on the day of your visit. By pre-registering in advance, we can help prevent any billing issue that may occur, and also ensure accurate data collection.”

Motta says, “Providing a script that has an introduction as to why we are going to ask the next few question has helped collect the necessary information with less hassle.”

She reminds registrars that patients always have the right to refuse to answer, and she instructs staff not to push for the information. Instead, they enter “declined to answer” as a response in these cases.

“We also assure patients that the information collected is for statistical reasons only, and that it is to help improve the care of the community around us,” she says.


For more information on collecting race and ethnicity data, contact:

Sylvia C. Motta, Manager, Pre-Registration & Call Center, Cambridge Health Alliance, Medford, MA. Phone: (617) 665-2532. Email: smotta@challiance.org.

• For information on standards from The Joint Commission regarding collection of race and ethnicity data, go to http://bit.ly/15y9HbP.