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Racial Disparity in Clinical Alert Overrides
1Informatics Institute, University of Alabama at Birmingham, Birmingham, Alabama.
AMIA ... Annual Symposium Proceedings. AMIA Symposium
|March 21, 2022
Summary
This study examined racial disparities in clinical alert overrides at UAB Hospital. While some differences were found, alert override rates did not show widespread systemic racial bias in health informatics.
Area of Science:
- Health Informatics
- Health Equity
- Clinical Decision Support
Background:
- Systemic racism in US healthcare is recognized, but informatics' role is understudied.
- Clinical guidelines and alerting systems may embed or perpetuate racial bias.
- Clinician response to alerts could introduce discriminatory practices.
Purpose of the Study:
- To investigate if patient race influences clinical alert logic at UAB Hospital.
- To analyze racial disparities in clinical alert override rates and reasons.
Main Methods:
- Analysis of 5,120,114 alert events at UAB Hospital.
- Examination of alert override rates and reasons stratified by patient race.
- Statistical analysis of observed differences.
Main Results:
- Overall alert override rates were similar for Black or African American (82.27%) and White (81.30%) patients.
- Statistically significant differences in override rates by alert were generally small.
- Override patterns varied by clinician, but stated reasons for overrides showed little racial disparity.
Conclusions:
- Findings suggest that racial bias in clinical alert overrides is not widely systemic within this health informatics context.
- Variability in individual clinician behavior warrants further investigation into potential disparities.
- Deeper analysis is needed to confirm if observed variations are racist in nature.
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