Accuracy of race, ethnicity, and language preference in an electronic health record

J Gen Intern Med. 2015 Jun;30(6):719-23. doi: 10.1007/s11606-014-3102-8. Epub 2014 Dec 20.

Abstract

Background: Collection of data on race, ethnicity, and language preference is required as part of the "meaningful use" of electronic health records (EHRs). These data serve as a foundation for interventions to reduce health disparities.

Objective: Our aim was to compare the accuracy of EHR-recorded data on race, ethnicity, and language preference to that reported directly by patients.

Design/subjects/main measures: Data collected as part of a tobacco cessation intervention for minority and low-income smokers across a network of 13 primary care clinics (n = 569).

Key results: Patients were more likely to self-report Hispanic ethnicity (19.6 % vs. 16.6 %, p < 0.001) and African American race (27.0 % vs. 20.4 %, p < 0.001) than was reported in the EHR. Conversely, patients were less likely to complete the survey in Spanish than the language preference noted in the EHR suggested (5.1 % vs. 6.3 %, p < 0.001). Thirty percent of whites self-reported identification with at least one other racial or ethnic group, as did 37.0 % of Hispanics, and 41.0 % of African Americans. Over one-third of EHR-documented Spanish speakers elected to take the survey in English. One-fifth of individuals who took the survey in Spanish were recorded in the EHR as English-speaking.

Conclusion: We demonstrate important inaccuracies and the need for better processes to document race/ ethnicity and language preference in EHRs.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Documentation / standards*
  • Electronic Health Records / standards*
  • Ethnicity / statistics & numerical data*
  • Female
  • Health Status Disparities
  • Humans
  • Language*
  • Male
  • Middle Aged
  • Racial Groups / statistics & numerical data*
  • Self Report
  • Smoking Cessation / ethnology*
  • Young Adult