Alameda Health System Addressing Population Health Management

Alameda Health System is collecting race, ethnicity, and language (REAL) data, as well as sexual orientation and gender identity (SOGI) data, to develop population management strategies that reduce healthcare disparities across the board.

For years, Alameda Health System has collected demographic data about its patients’ race, ethnicity, and language (REAL) demographics. In 2018, it added sexual orientation and gender identity (SOGI) data to its collection process. Below, learn how Alameda Health System is using population health management and a well-designed data collection system to improve its outcomes and the patient experience.

Alameda Health System Is Committed to Health Equity

Not everyone has equal access to healthcare. Data suggests that race, ethnicity, language, sexual orientation, and gender identity can negatively impact your healthcare experience and lead to negative health outcomes. For example, more than 25% Latino and Black adults avoid or delay health care because of cost or other reasons.

Alameda Health System is a leader in health equity in the Bay Area. As an integrated, community-based health care system, its mission is to care, heal, teach, and serve all of Alameda County. Many of its hospitals, including Highland HospitalAlameda Hospital, and San Leandro Hospital, are a vital safety net for the community.

The system is also recognized as a Bay Area leader in health equity. It has a series of programs and initiatives that encourage a more diverse healthcare workforce, a more welcoming patient experience, and community engagement. For example, its HealthPATH Simulation Center aims to diversify the health care workforce, and its hospitals offer interpretation and translation services for their patients in 26 languages. Recently, Alameda Health System began using population health management to improve their patient experience, decrease costs, and provide customized care.

Population Health Management Can Help Identify and Combat Health Disparities

Population health management systems analyze data and identify trends and health risks within a community. Healthcare organizations then analyze the data and build programs and systems that improve health and wellness in at-risk communities while delivering culturally-sensitive healthcare.

Hospitals Must Collect Demographic Data From Their Patients

Under a series of federal and state laws, healthcare organizations must collect demographic data about their patients’ race, ethnicity, and primary language. This information is used to help identify a community’s needs and build systems that improve healthcare equity. However, all sensitive data must remain confidential, and healthcare organizations cannot disclose an individual’s race, ethnicity, sexual orientation, or gender identity without their permission.

Alameda Health System is also participating in the State of California’s Public Hospital Redesign and Incentives in Medi-Cal (PRIME) program. PRIME is a five-year initiative that helps safety net hospitals build a data-driven, patient-centered experience through population health management. To create the robust data necessary for this project, clinicians are collecting detailed demographic data about the hospitals’ patients.

Unfortunately, many patients are uncomfortable providing this information. They might even be afraid that providers are trying to assess their immigration status or discriminate against them. As a community and industry, healthcare organizations need to do a better job explaining why they collect (and how they protect) demographic data.

We Ask Because We Care: How to Improve Your REAL and SOGI Data Collection

As a healthcare provider, you might feel uncomfortable asking patients about their demographic data. These questions can cause discomfort and illicit awkward responses, especially if the patient is nervous or from a vulnerable social group.

While brochures and other materials can explain why you’re asking for REAL and SOGI data, they might not alleviate these fears. According to a 2005 survey, more than 50% of people voiced concerns that their demographic data would be used for discriminatory purposes. To get the best possible data, healthcare providers need to implement well-designed collection policies.

Research suggests patients are most comfortable giving their REAL and SOGI data when:

  • The health care system consults with community leaders to create plans that are culturally appropriate
  • A nurse or doctor asks the questions, rather than an administrator
  • The provider emphasizes that the data is used to monitor the hospital’s quality of care and ensure that all patients receive the same level of care
  • There are community outreach programs that educate minority populations about demographic data collection before they enter the hospital
  • The health care system publishes reports that summarize its REAL and SOGI data and discusses health equity measures that it will implement based on its findings

Staff training about proper data collection techniques is also vital. Before Alameda Health System began asking about REAL and SOGI data, its staff and physicians participated in a detailed training program. It also initiated its “We Ask Because We Care” campaign, which educates patients and community members about the reasons the hospitals collect demographic data.


Artiga, S., Foutz, J., Cornachione, E., & Garfield, R. (2016, June 7). Key facts on health and health care by race and ethnicity. Kaiser Family Foundation.

Baker, D. (2006, January 1). Patients attitudes toward health care providers collecting information about their race and ethnicity. The Commonwealth Fund. Retrieved from