Barriers to collecting patient race, ethnicity, and primary language data in physician practices: an exploratory study.

BACKGROUND: Experts recommend that physician practices collect and use patient race, ethnicity, and primary language data to document and address health care disparities and improve health care quality for diverse populations. Little is known about demographic data collection in small practice settings. OBJECTIVE: To conduct an exploratory study to examine demographic data collection in physician practices to reduce disparities and provide qualitative descriptions of facilitators and barriers to data collection. DESIGN: Semistructured telephone interviews. SETTING: Medical practices with 5 or fewer physicians. PARTICIPANTS: Practice managers, nurse managers, and physicians from 20 practices nationwide. RESULTS: Of the 20 practices interviewed, 9 reported collecting demographic data. Only 1 practice feature facilitated demographic data collection: use of an electronic medical record (EMR) system (7 of 10 practices with an EMR collected data). Participation in pay-for-performance programs, cultural competency training, and measuring clinical quality did not facilitate data collection. One practice linked demographic and quality data. A few used the data to track language service needs. The main perceived barriers to demographic data collection included concerns about privacy, the legality of collecting the information, possible resistance from patients and staff, difficulty recording the data, and uncertainty about whether the data would be useful. CONCLUSIONS: Few small practices use data to track or address disparities in health care. Most perceived barriers to data collection can be surmounted. There is hope for improved collection and use of data through the spread of information technology with comprehensive national health reform.

Pediatric resuscitation: questioning DNAR legitimacy and offering an alternative decision-making model.

The views expressed in this paper are those of the author and do not necessarily represent those of the American Medical Association.