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Study Found Negative Patient Descriptors Used in Black Patient EHRs, Documenting Racial Bias

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Very little is known about how racism and bias may be communicated in the medical record. A new study,  published in Health Affairs, used machine learning to analyze electronic health records (EHRs) from an urban academic medical center and to investigate whether providers’ use of negative patient descriptors varied by patient race or ethnicity. Researchers analyzed a sample of 40,113 history and physical notes (January 2019–October 2020) from 18,459 patients for sentences containing a negative descriptor (for example, resistant or noncompliant) of the patient or the patient’s behavior. They found that 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. Their findings raise concerns about stigmatizing language in the EHR and its potential to exacerbate racial and ethnic health care disparities.

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