1. Changes to Meditech Registration A Guide for Data Collection Adapted Training Slides from the Cambridge Health Alliance

2. Before we begin… Only have to collect it once, if we collect it correctly.

3. Agenda What are health disparities? Why are data important? How will we collect the data? How should we address concerns? Role Plays Resources and Questions

4. What are health disparities? Health disparities are differences between populations in: Presence of disease Presence of disease Access to health care Access to health care Use of health care services Use of health care services Health outcomes Health outcomes

5. What causes health disparities? Social, economic, and environmental factors Barriers to getting health care Differences in quality of health care Differences in quality of health care

6. Top Disparity for Blacks Odds Ratio of New Cases of AIDS for Blacks= 10.4 2005 National Healthcare Disparities Report

7. Top Disparity for Asians 2005 National Healthcare Disparities Report Odds Ratio of Lack of Treatment for Serious Mental Illness for Asians= 1.6

8. Top Disparity for Hispanics 2005 National Healthcare Disparities Report Odds Ratio of New Cases of AIDS for Hispanics= 3.7

9. To Eliminate Disparities, We Need to Collect Better Data

10. Why Improve the Data? Percent of Mothers Breastfeeding by Race/Ethnicity, MA

11. Source: Asian Births in Massachusetts: 1996-1999; Hispanic Births in Massachusetts: 1996-1999; and Black Births in Massachusetts: 1997-2000

12. Why Collect the Data? Identify Disparities Identify Disparities Target Interventions Target Interventions Improve Quality Improve Quality

13. What do Patients Think?

14. “It is important for hospitals and clinics to collect information from patients about their race or ethnic background” “It is important for hospitals and clinics to collect information from patients about their race or ethnic background” – Strongly agree43% – Somewhat agree37% –Unsure6% –Somewhat disagree10% –Strongly disagree4% Study conducted at Northwestern Memorial Hospital Data shown in HRET tool kit

15. “It is important for hospitals and clinics to conduct studies to make sure that all patients get the same high- quality care regardless of their race or ethnic background” – Strongly agree93% – Somewhat agree4% –Unsure2% –Somewhat disagree1% –Strongly disagree0% Study conducted at Northwestern Memorial HospitalData shown in HRET tool kit

16. “How concerned would you be that this data could be used to discriminate against patients” –Not concerned at all34% –A little concerned15% – Somewhat concerned20% – Very concerned31% Study conducted at Northwestern Memorial Hospital Data shown in HRET tool kit

17. Introduce the Questions Introduce the Questions Use Tools for Registration Staff Use Tools for Registration Staff Distribute Patient Education Materials Distribute Patient Education Materials How can we do this?

18. Tools for Registration Reporting Race, Ethnicity and Language: A Guide to Helping Patients

19. Introduction At the Cambridge Health Alliance, we provide the best care possible for all of our patients. We are now collecting race and ethnicity information from all of our patients to help us know them better. We can learn more about the communities we serve if we know your race and ethnicity. We can better care for all patients if we know more about race, ethnicity, language and culture. This information will only be used to give all patients the best care possible.

20. Introduction The Introduction should tell patients: We are collecting race and ethnicity data from all patients We are collecting race and ethnicity data from all patients We need this information to know more about your culture and language We need this information to know more about your culture and language This will only be used to better meet the needs of the patients we serve This will only be used to better meet the needs of the patients we serve

21. Race and Ethnicity: What’s the Difference?

22. What will change?

24. What is your race?

25. If a patient asks “What is Race?” Your race is the group or groups that you identify with as having similar physical characteristics or similar social and geographic origins. You can tell me more than one. For example, please let us know if you are Asian, Black, White, etc. Record Patient’s Response

26. What is your RACE? You can choose more than one.  American Indian or Alaska Native  Native Hawaiian or other Pacific Islander  Asian  Black  White  Other Help Us Know Our Patients Better When we know your race and ethnicity, we learn more about your culture and language. This helps us to know you better and to improve the care that we give to all patients. Beginning in January 2007, we will ask for race and ethnicity information from all patients. We can better meet the needs of the communities that we serve if we know more about our patients’ race, ethnicity, culture and language.

27. What is your ethnicity?

28. If a patient asks “What is Ethnicity?” Your ethnicity refers to your background, heritage, culture, ancestry or sometimes the country where you were born. You can tell me more than one. For example, please let us know if you are Haitian, Vietnamese, Brazilian, etc. Record Patient’s Response

29. Are you Hispanic, Latino or Spanish?

30. If a patient asks “What is meant by Hispanic, Latino or Spanish?” A person is Hispanic, Latino or Spanish if they or their family come from a country in Latin America or another Spanish-speaking country. Record Patient’s Yes or No Response If the response is some, partly, half, or a little, please enter Yes. If a patient declines, enter No.

31. Any other races?

32. Only have to collect it once, if we collect it correctly.

33. What your country of residence? If OUTSIDE of the US

36. Asking about Language What is the primary language spoken in your home? “Language Spoken” In what language do you prefer to read health-related materials? “Written” In what language do you prefer to discuss health-related concerns? “Medical Care”

37. Asking about Language REMEMBER You can use Phone Interpretation. Dial 3333 and press 2 for phone

38. Addressing Patient Concerns

40. If the Admissions Source on the B/AR Info tab is “Transfer from other facility”, (HOS or HOS-CHA) then an additional field must be filled out on the Other tab. Transfer Hospital

41. Role Plays

42. - What is your Race? - What is your Ethnicity? - Are you Hispanic, Latino or Spanish? - Any other races? Questions for Role Plays

43. Resources

44. Questions

45. Contact: Jacquelyn Caglia Community Affairs 617.499.6618 jcaglia@challiance.org

46. These slides were adapted by the Cambridge Health Alliance using original materials from : MGH Disparities Solution Center MA Department of Public Health