New patient reporting requirements touted, hospitals want more time
JUNE 13, 2006 -- New regulations the state expects to adopt this summer would increase the volume of race, ethnicity, and home address information hospitals would need to collect from patients. Health care experts praised the proposals at a Division of Health Care Finance and Policy
hearing Tuesday morning, saying more precise information about patient demographics would
allow for better, more targeted health care.
But hospital officials say the October 1 implementation date leaves too little time to meet the state's demand for increased data collection. They requested a year's delay.
Under the new requirements, which the division plans to ratify after a public commentary period,
the set of data collected for patients admitted to Bay State hospitals would expand the number of racial options. The division wants to add a yes/no "indicator" reflecting Hispanic heritage to the current field of seven different race codings. Another field would allow patients to make "detailed choices" for ethnicity reporting, consistent with federal standards, according to division documents.
Judy Parlato, the division's clinical advisor, said the new format would lead to more thorough
analysis and "improved protocols for the increasingly diverse American population."
The more tightly targeted geographic information would allow for better small area trend analysis,
said Sylvia Hobbs, of the Office of Emergency Medical Services in the state's Department of Public Health.
"We haven't been able to provide accurate data aggregated by political boundaries . The data
that we have now with zip codes just doesn't provide the type of information that we need to
have quality outcome analysis," Hobbs said.
The division says more detailed information about patient addresses would improve "small area
analysis" and disease surveillance. "There's no practical way" for hospitals to come
into compliance on time, said Michel Regunberg, a spokeswoman for the Massachusetts Hospital Association. She said, "Massachusetts hospitals are very supportive of transparency. However, given what it will take to implement these new reporting requirements . . . the current hospital
infrastructure cannot make the changes by October 1."
Nancy Stanton, director of health information management at Mount Auburn Hospital, said some
hospitals lack the necessary infrastructure, particularly formatting and training, and will be
burdened by this fall's deadline. The new regulations, she predicted, would increase the
workload for hospital staff, and the time it takes to process patient data.
Another complication, she said, could stem from the additional attention paid to race. "We do
have some patients who take exception to being asked their race now - so it's a touchy question," Stanton said. But both James West from the DPH's Center for Health Information and Lorenz Finison from the Boston University School of Public Health said the race reporting should go farther, and allow respondents to select more than one race category. West said the second variable would
allow 95 percent of all patients with multiracial heritage to be accurately identified.
Finison called the decision not to use a second race option "a significant omission."
In addition to more patient demographic data, the new regulations call for increased reporting of
"condition present on admission" to determine whether a diagnosis preceded or followed the
admission, and more detailed tracking techniques of provider and physician.
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