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Coalition to End Racism in Clinical Algorithms (CERCA)

Toolkit: Removing Harmful Race-Based Clinical Algorithms

Based on the work of CERCA and in partnership with the Digital Medicine Society and the SCAN Foundation, the NYC Health Department is proud to share an open access toolkit to help health systems across the country begin and advance the process of de-implementing harmful race-based clinical algorithms. The toolkit is based on real-world experiences of CERCA members and others. It includes:

Five clear steps to navigate the de-implementation process
Guidance for engaging health system leadership and clinician
Resources for educating providers and supporting patients

View the toolkit at the Digital Medicine Society's website: Removing Harmful Race-based Clinical Algorithms: A Toolkit.

Right to Vaginal Birth After Cesarean Campaign

For educational and advocacy information on vaginal birth after cesarean for women and birthing people, families, and health care providers, visit Vaginal Birth After Cesarean.

The NYC Coalition to End Racism in Clinical Algorithms (CERCA) was formed to end the inclusion of race adjustment in clinical algorithms. Clinicians use clinical algorithms to guide their decision-making in the medical care of patients. Clinical algorithms using race adjustment often negatively impact treatment and care for people of color.

CERCA is expanding our scope of work to include:

A new focus area, race-based prescription in hypertension
An emphasis on downstream consequences of ending race adjustment in clinical algorithms.
Increased patient engagement in CERCA subcommittees

Previous work has focused on eliminating the use of race in the algorithms for Estimated Glomerular Filtration Rate, Vaginal Birth After Cesarean and Pulmonary Function Tests.

Since CERCA’s inception, most health system members have described significant institutional and team support for the work. Seven out of nine health systems have de-implemented or addressed the use of a race-based adjustment in one of the three priority clinical algorithms.

CERCA members successfully advocated for updated recommendations by the American Thoracic Society around de-implemented race-based reference equations in spirometry.

Over $3 million was received to evaluate processes and provide robust support to safety-net hospitals in their CERCA activities. An evaluation of the first iteration of CERCA activities will be published in 2024.

For more on CERCA’s work so far, see: