Feedback with respect to this value in the value set for Observation.method:Feedback with respect to this value in the value set for Observation.method:• “observed” – Given that one cannot always reliably determine race or ethnicity on the basis of observing the patient, this value is problematic.
We understand that this option is included because, in current practice, assumptions about race or ethnicity are sometimes made on the basis of observing the patient. Therefore, omitting “observed” as an option for this required data element might force the use of another method when the actual method was “observed”. We acknowledge that this specification will help gather data as to the frequency with which race/ethnicity are “observed”. However, including "observed" as an option for this data element will lead to bad data (i.e., data collected about race based on observation is unreliable as it is often incorrect). Should "observed" be included in STU2, Gravity should provide guidance to implementers cautioning about the lack of quality and reliability of such data. The guidance should advise implementers to use such fields only for internal improvement purposes (i.e., asking why clinicians do not ask patients to self-report race and ethnicity and instead enter observations. Overall, implementers should be discouraged from using “Observed” as a method).