Do our EHR actions reveal our unconscious biases? A recent study of EHR engagement suggests that this might be the case.
Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit., your weekly dose of commentary on a new medical study. I'm Dr F. Perry Wilson of the Yale School of Medicine.I'm primarily a clinical researcher, so much of what I do is looking at statistical software, or, more recently, writing grant applications. But even when I think of my clinical duties, I see that computer screen.
The EHR records everything — not just the vital signs and lab values of our patients, not just our notes and billing codes. Everything. Every interaction we have is tracked and can be analyzed. The EHR is basically Sting in the songResearchers are leveraging that panopticon to give insight into something we don't talk about frequently: the issue of racial bias in medicine.
What factors would predict higher engagement? Well, at Vanderbilt there was less engagement with the EHRs of patients who identified as Black, Hispanic, or"other" race. Similar differences were present at Northwestern, except among Black patients who actually got a bit more engagement. But we need to be careful here, because engagement in the health record is not random. Many factors would lead you to spend more time in one patient's chart vs another. Medical complexity is the most obvious one. The authors did their best to account for this, adjusting for patients' age, sex, insurance status, comorbidity score, and social deprivation index based on their zip code. But notably, they did not account for the acuity of illness during the hospitalization.
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