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Patient Demographics and Why They're Important

Max Freedman
Max Freedman

Patient demographics such as basic identifying information and insurance data help practices in numerous ways. Learn how with this guide.

  • Patient demographics include identifying information such as name, date of birth and address, along with insurance information.
  • Patient demographics streamline the medical billing process, improve healthcare quality, enhance communication and bolster cultural competency.
  • Properly collecting and tracking patient demographics is a matter of asking the right questions, following applicable laws and using medical software.
  • This article is for medical practitioners and practice owners looking to understand patient demographics and improve their collection processes.

Anyone who's ever been to a doctor's appointment has filled out registration forms detailing their name, address, biological sex and more. This information is used to facilitate higher-quality care, but that's not the whole story. Longtime healthcare practitioners know that collecting patient demographics also addresses several other concerns. Ensuring your patients' demographics are collected accurately and kept up to date is essential to running an efficient healthcare organization.

What are patient demographics?

Patient demographics are a patient's basic information. Practices collect patient demographics to provide higher-quality care and streamline the medical billing and coding process. These data overlap strongly with marketing demographics, though they aren't exactly the same. Whereas marketers use demographics to determine which consumers might be worth their attention, practitioners use patient demographics to help those already in front of them and bill payers for their services.

What do patient demographics typically include?

Patient demographics almost always include the following information:

  • Full legal name
  • Date of birth
  • Biological sex
  • Gender
  • Contact information, including address
  • Ethnicity
  • Race

Some healthcare entities also include insurance information, medical history, education and employer under the umbrella of demographic data. However, others view the first two of these items as non-demographic patient data. Medical history, in particular, may be more appropriate to include in patient medical charts than demographics. 

Did you know?Did you know? In some cases, patient demographics are defined to include insurance information, medical history, employer and education.

As for education and employer, although these data are highly useful for marketers, they may be less pertinent to healthcare outcomes. In general, though, if you're gathering certain information from a patient upon their appointment registration or check-in, you can qualify it as a patient demographic.

Why are patient demographics important?

Patient demographics matter because they:

  • Guide the billing process. Under a definition that includes insurance information, patient demographics determine the payers from which you should seek reimbursement. Demographics that include insurance information tell you where to send your final bill and how you can follow up on unpaid claims. If you fail to collect these demographics, you might experience delays in your billing process.

  • Streamline patient communications. Sending patient statements to an outdated address does your practice no favors. Collecting patient demographics is a surefire way to avoid this issue. Likewise, if you're calling patients to confirm appointments or seek payment on overdue bills, calling an outdated phone number will prove fruitless. Most medical software offers patient engagement tools, such as automated patient reminders and a patient portal. Making use of these can reduce no-shows and cancellations while also helping to educate your patients and get them more involved in their health and wellness.

  • Improve patient care. Notice that a patient's demographics answer many of the questions you might ask to determine their risk factors. For example, since 1 in every 5 women at least 50 years old has osteoporosis, you'll know to check for osteoporosis in patients with corresponding demographics. This preventive approach supports emerging value-based care models that can improve patient outcomes.

  • Increase cultural competency. A patient's demographics may correspond with certain lived experiences and views that practitioners should keep in mind during patient encounters. For example, medical mistrust is common among Black Americans. A culturally competent practitioner should care for Black patients while keeping this trend and its origins in mind. Patient demographics are the starting point for doing so.

How to collect and track patient demographics

As with all patient intake and registration processes, demographic collection and tracking processes should be standardized. The thing is, many practice management experts have observed unreliable patient demographic collection and tracking processes time and again. The following tips and tricks can help your practice avoid this issue.

1. Ask the right questions.

It's one thing to ask, "Is your information up to date?" This question results in one of two outcomes: The patient has to spend time finding your information on them, or they just assume their information is correct. Neither outcome is ideal, as you want the patient intake process to be as efficient as possible, and patients who assume your information is correct can be wrong. 

To solve this problem, make sure your question immediately presents your patient with the data you're asking about. Instead of "Is your information up to date?" ask, "Is 123-456-7890 still the best phone number for you?" or "Can you please provide your current phone number?" You should ask similar questions about the patient's address, insurance number and emergency contact. 

2. Know how to ask the right questions.

Developing a list of highly specific questions for demographic collection is different than knowing how to best obtain that information. In fact, it's not uncommon to hear stories of patients feeling disrespected when asked for their demographics. Additionally, some patients might decline to share certain types of information. To avoid this obstacle, figure out how you'll ask the questions you've come up with.

One factor to reckon with here is your method of communication. Having a nurse collect demographics by phone when the patient calls to make an appointment can create privacy concerns for the patient. Switching to an online registration portal may feel more private since patients can walk through the process alone at home. 

Think about it like this: Do you think your patients would feel comfortable sharing stigmatized conditions or demographic data to people with no hands-on role in their healthcare? Probably not. Knowing who should ask demographic collection questions and when to use online portals instead creates a much-needed privacy barrier. 

TipTip: After determining which questions are best for your data collection goals, figure out how to ask those questions.

3. Learn which collection tools authorities recommend or require.

No two medical practices will collect and track patient data in exactly the same way, but all practices must do so in accordance with certain guidelines and regulations. One such regulation is the Quality Improvement Strategy (QIS) program, which the Centers for Medicare & Medicaid Services (CMS) oversees. QIS is designed to encourage better patient outcomes with fewer hospitalizations, and the CMS website details QIS patient data collection best practices.

Your practice may also be subject to state-level patient demographic regulations. For example, in Massachusetts, hospitals are required to collect race and ethnicity data for inpatient, observation unit and ER stays. The exact language of the Massachusetts law includes this important stretch of text: "[A] recommended data collection tool has been developed … to standardize efforts across hospitals."

This language states that all practices to which the law applies should use the same technology to collect patient demographics. Although this language doesn't require using the tool in question, a government recommendation is strong enough to all but count as a mandate for many organizations. So if language like this governs data collection in your state, you should follow it.

As in Massachusetts, many states have their own rules that apply to certain types of medical facilities or practitioners. Consult other practitioners in your field or medical law experts in your area to determine your requirements.

4. Set up your EMR for easy data intake.

After collecting your data, you'll need a place to store it. Increasingly, that place is within an electronic medical record (EMR) platform. These platforms make patient data available with just a few clicks and protect it with digital security measures more robust than physical storage. They also allow for efficient, streamlined access across your practice and easy sharing with practitioners at other facilities. 

That said, not every practice currently uses EMR systems. As of March 2020, Centers for Disease Control and Prevention (CDC) data shows that 14.1% of office-based physicians don't yet have an EMR system. The good news is that finding the right EMR system for your practice can be easy.

Whether you're new to EMR systems or you already have one but are looking for a change, visit our EMR software best picks page to begin your journey. From highly user-friendly options like the one featured in our Kareo review to consulting-heavy platforms like the one in our athenahealth review, EMR systems come in whichever shapes and sizes you might need. Once you've implemented your EMR platform, the patient demographic collection process becomes that much easier.

Image Credit: PrathanChorruangsak / Getty Images
Max Freedman
Max Freedman
Business News Daily Contributing Writer
Max Freedman is a content writer who has written hundreds of articles about small business strategy and operations, with a focus on finance and HR topics. He's also published articles on payroll, small business funding, and content marketing. In addition to covering these business fundamentals, Max also writes about improving company culture, optimizing business social media pages, and choosing appropriate organizational structures for small businesses.