Abstract

Although the collection of patient ethnicity data is a requirement of publicly funded healthcare providers in the UK, recording of ethnicity is sub-optimal for reasons that remain poorly understood. We sought to understand enablers and barriers to the collection and utilisation of ethnicity data within electronic health records, how these practices have developed and what benefit this information provides to different stakeholder groups. We undertook an in-depth, qualitative case study drawing on interviews and documents obtained from participants working as academics, managers and administrators within the UK. Information regarding patient ethnicity was collected and coded as administrative patient data, and/or in narrative form within clinical records. We identified disparities in the classification of ethnicity, approaches to coding and levels of completeness due to differing local, regional and national policies and processes. Most participants could not identify any clinical value of ethnicity information and many did not know if and when data were shared between services or used to support quality of care and research. Findings highlighted substantial variations in data classification, and practical challenges in data collection and usage that undermine the integrity of data collected. Future work needs to focus on explaining the uses of these data to frontline clinicians, identifying resources that can support busy professionals to collect standardised data and then, once collected, maximising the utility of these data.

Highlights

  • Populations are becoming increasingly ethnically diverse and this is a trend that is set to continue

  • Site-specific permissions from local National Health Service (NHS) research and development offices were facilitated by the Primary Care Research Network (PCRN) and the UK Clinical Research Network (UKCRN)

  • Findings are reported in relation to the collection and utilisation of patient ethnicity data

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Summary

Introduction

Populations are becoming increasingly ethnically diverse and this is a trend that is set to continue. Ethnicity data are required to evidence compliance with anti-­discrimination legislation,[8,9] for public health monitoring and for research into health inequalities,[3,4,5,6,7] including access to care for minority groups.[10,11] Clinical practice may be informed by ethnicity, including the accommodation of cultural norms and community preferences that may impact upon healthcare delivery, such as a requirement for a same sex clinician.[12,13,14]. Most participants could not identify any clinical value of ethnicity information and many did not know if and when data were shared between services or used to support quality of care and research. Future work needs to focus on explaining the uses of these data to frontline clinicians, identifying resources that can support busy professionals to ­collect standardised data and once collected, maximising the utility of these data

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