Hospital Reporting of Patient Demographic Data

During its 2021 session, the Washington State Legislature passed new hospital data reporting requirements (HB 1272) for inpatient and observation records used to populate the CHARS database. RCW 43.70.052(6) and WAC 246-455-025 require all hospitals to collect and submit detailed patient self-identified demographics, including race, ethnicity, language, disabilities, sexual orientation and gender identity. A detailed overview of the new law and its requirements for hospitals is available to members and the public in WSHA’s Bulletin and the DOH ESSHB 1272 CHARS Implementation webpage.

Washington is the first state in the country to require all hospitals to report this level of detailed information for patients. Early implementation focused heavily on modifying EHR systems, mapping new codes to other reporting systems and developing workflows. While much has been accomplished, we seek to continuously improve data collection, patient experience and utility of demographic data reported. Tools and resources will be added to this webpage as they become available.

Patient Education Materials

To promote patient participation, hospitals are encouraged to explain the purpose of collecting detailed demographic information, including the option to decline to respond. Guidance may be needed for parents and guardians responding on behalf of their dependents.

Example data collection forms:

Definitions of Demographic Terms

The required categories for sexual orientation and gender identity (SOGI) may be unfamiliar to some patients and staff. To avoid confusion, hospitals are encouraged to make available brief definitions of all SOGI terms. In addition to collecting gender identity, it is best practice to also note a patient’s pronouns and preferred name to avoid misgendering.

Staff Training

Asking patients about their identities can be uncomfortable for staff. To build confidence, hospitals are encouraged to provide training, including opportunities for roleplay, supported by scripting and video. Staff appreciate guidance for de-escalating situations where patients react with anger or disrespect. It is important to remind staff that patients have the option to decline to report their demographic information and may prefer to respond to the questions privately.

Patient Feedback

Understanding how to make sharing identity information comfortable, private and convenient for patients is critical to improving the quality and completeness of demographic data collected. Some hospitals have employed feedback surveys to better understand patient preferences and experiences. In addition, collaborating with patient and family advisory councils or community groups is a helpful way to co-design processes that are well accepted.

Frequently Asked Questions

At what age should demographic information be collected? How is this age determined? 

Which demographics should be collected at registration, and which (if any) should be incorporated into the clinical encounter?

  • A WSHA implementation survey of hospitals (prior to June 8, 2023) found all hospitals are collecting at least some demographic information at registration, more than half also collect it pre-visit or during the e-check in process, and some are collecting demographics during the clinical encounter. A few are collecting demographics at discharge.
  • Sexual orientation and disability data is more likely to be collected by clinical staff in the privacy of a clinic room than by registration staff, but there is no consensus among the hospitals (some hospitals collect all demographic data at registration and through the patient portal).

How did you address mapping of new CHARS (72) race codes to pre-existing standard reporting, such as the federal Office of Management and Budget (OMB)?

  • DOH created a table showing how detailed CHARS race categories can be aggregated/collapsed into the 1997 OMB minimum standard for purposes of federal reporting. The document is titled: Aggregation Guidelines for Federal Hospitalization Reporting in WA. Hospitals note the limitations of the DOH table, as many “races” are aggregated into “other” (including: Central American, Chicano/a or Chicanx, Cuban, Dominican, Indigenous-Latino/a or Indigenous Latinx, Mestizo, Mexican/Mexican American, Puerto Rican, South African, South American).


Contact Us

Washington State Hospital Association
999 Third Avenue
Suite 1400
Seattle, WA 98104

Map / Directions

206.281.7211 phone
206.283.6122 fax

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