Characterizing Identifiers for Immigrant Populations in Electronic Health Records

Area of Science:

• Health Informatics
• Public Health
• Sociology of Health

Background:

• Current methods for identifying immigrant patients in Electronic Health Records (EHRs) are not well-defined and lack standardization.
• This lack of standardization has significant implications for the clinical care and research involving immigrant populations.

Purpose of the Study:

• To identify effective, ethical, and acceptable patient identifiers for use in Electronic Health Records (EHRs) to describe immigrant patients.
• To explore the limitations of potential identifiers and the necessity of using multiple identifiers in combination.

Main Methods:

• Conducted interviews with various stakeholders to determine suitable identifiers for immigrant patients.
• Analyzed qualitative data to identify key demographic and experiential factors.

Main Results:

• Language, country of origin, duration of stay in the U.S., and race/ethnicity were identified as strong, acceptable identifiers.
• Limitations were noted for each identifier, emphasizing the need for a combined approach.
• Considerations for clinical data collection processes and ethical implications were highlighted.

Conclusions:

• There is a critical need for standardized documentation practices for immigrant patients in EHRs.
• Further research is required to validate proposed identifiers, identify additional ones, and operationalize them within EHR systems for clinical, research, and community engagement.
• A multi-identifier strategy is essential for accurate and ethical patient description in EHRs.