Words Matter: Strategies to Reduce Bias in Electronic Health Records

October 25, 2022

A few months ago, OMH’s Office of Diversity and Inclusion shared an article from Health Affairs titled, “Negative Patient Descriptors: Documenting Racial Bias In The Electronic Health Record”. The authors analyzed a sample of 40,113 history and physical notes from 18,459 patients for sentences containing a negative descriptor (for example, resistant or noncompliant), of the patient or the patient’s behavior. Used mixed effects logistic regression to determine the odds of finding at least one negative descriptor as a function of the patient’s race or ethnicity while controlling for sociodemographic and health characteristics, they found that when compared with White patients, Black patients had 2.54 times the odds of having at least one negative descriptor in the history and physical notes. This article raised concerns about stigmatizing language in the EHR and its potential to exacerbate racial and ethnic healthcare disparities.

We would now like to share a recently released tool from the Center for Health Care Strategies, created with support from the Robert Wood Johnson Foundation (attached). This tool outlines considerations for providers on how to write EHR notes that promote patient-centered care and dignity by:

(1) trusting patients and avoiding communicating disbelief

(2) being mindful when using quotes

(3) focusing on positive themes and humanizing details

(4) learning to recognize and avoid stigmatizing language

(5) educating providers and providers-in-training.

Matthew Canuteson
Pronouns: He, Him, His
Diversity and Inclusion Officer
Office of Diversity and Inclusion
New York State Office of Mental Health