Standardizing Patient Race, Ethnicity and Language Data Collection: Overview October 1, 2010 Memphis, TN Aligning Forces for Quality National Program Office

2 Why are we here? Understand key decision points in implementing standardized race, ethnicity and language (R/E/L) data collection within your organization To provide you with the knowledge and tools to train staff on the standardized collection of R/E/L data

3 What are disparities in health care quality? “Racial and ethnic minorities tend to receive a lower quality of healthcare than non-minorities” Less likely to receive: – Cancer screening – Cardiovascular therapy – Kidney dialysis – Transplants – Curative surgery for lung cancer – Hip and knee replacement – Pain medicines in the ER

4 National CABG rates Jha, NEJM, 2005 Rate per 1,000 Medicare enrollees

5 Growing U.S. minority population Population Projections, 2010 to 2050 Source: U.S. Census Bureau, 2009 National Population Projections (Supplemental) 4. Projections of the Population by Sex, Race, and Hispanic Origin for the United States: 2010 to 2050

6 Increasing legislative and regulatory attention to R/E/L data American Recovery and Reinvestment Act of 2009 – Hospitals and providers will need to collect R/E/L data to be eligible for “meaningful use” incentive payments – Race/Ethnicity categories to follow Office of Management and Budget guidelines Patient Protection and Affordable Care Act of 2010 – Health programs receiving federal money are required to collect R/E/L data Revised Joint Commission standards – Expand requirements related to the collection of patient language data, including preferred spoken language and written communication needs – New requirement to collect patient-level demographic data on race and ethnicity

7 OMB guidelines: Race, ethnicity and language categories Race Black White Asian American Indian/Alaska Native Native Hawaiian/ Pacific Islander Multiracial* Declined* Unavailable* Language English Spanish Other Declined Unavailable *This designation indicates a modification to the OMB R/E categories Ethnicity Hispanic Not Hispanic Declined* Unavailable*

8 Three steps in addressing disparities Standardized collection of self-reported R/E/L data –Categories are standardized –Patient self-reports Stratification and analysis of performance measures Use of stratified data to identify and develop quality improvement interventions targeted to specific patient populations Disparities in care represent a failure in quality

9 What is the current status of R/E/L data collection? Most hospitals collect data but not in a standardized manner – Few hospitals use data collected to drive quality improvement Few ambulatory providers collect or use data – More common in health centers and integrated health systems than in smaller physician practices

10 What change needs to happen? Develop the capacity and infrastructure to collect standardized race, ethnicity and language information from all patients This will affect: – Registration system and processes – Staff training and workflow – Patient communications – How data are used to monitor quality

11 What will we cover today? Building blocks toward equitable care –National health care disparities –Linking R/E/L data to quality –Increasing attention R/E/L data Key Decision Points –Changes at the organizational level Nuts and Bolts –Tools to train your staff Available resources