Where should an organization start in reducing disparities in care?

Aswita Tan-McGrory, MBA, MSPH; Deputy Director, Disparities Solutions Center at Massachusetts General Hospital

Everyone always runs to the interventions, because that’s, you know, exciting, and it’s a great thing to report on. But the truth is it really starts — the foundation really starts — with data collection, and it’s not very sexy. But race and ethnicity data collection is really key to addressing disparities because it’s about monitoring your progress. So if your organization, at the bottom line, can’t rely on the quality of your data, then you won’t know if you are actually making any changes.

The other part is that in order to sort of transform your organization, to understand disparities and to get the leadership buy-in, data is really your best friend. People respond to data.

What are the barriers to collecting data on race, ethnicity, and language?

I think it’s really overwhelming for people to think about, “Oh, I’m going to have to ask the patient the sensitive question.” People say, “I get a lot of resistance from my registrars on how to ask people what their race and ethnicity is.” It’s such a loaded topic in our society. So there is a little resistance there.

The other piece is that it’s overwhelming in our current time with EHRs, and Epic, and all those. How do you implement it, how do you roll it out, how do you manage all the different race/ethnicity categories? The effort of race/ethnicity data collection and measuring and reporting that data is a multi-tier, multi-department effort. You really have to have leadership buy-in at the top in order to be really effective.