Planning and implementing sexual orientation and gender identity data collection in electronic health records

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) people experience significant health disparities across the life course and require health care that addresses their unique needs. Collecting information on the sexual orientation and gender identity (SO/GI) of patients and entering SO/GI data in electronic health records has been recommended by the Institute of Medicine, the Joint Commission, and the Health Resources and Services Administration as fundamental to improving access to and quality of care for LGBTQ people. Most healthcare organizations, however, have yet to implement a system to collect SO/GI data due to multiple barriers. This report addresses those concerns by presenting recommendations for planning and implementing high-quality SO/GI data collection in primary care and other health care practices based on current evidence and best practices developed by a federally qualified health center and leader in LGBTQ health care.

[1]  S. Reisner,et al.  Alcohol research with transgender populations: A systematic review and recommendations to strengthen future studies. , 2018, Drug and alcohol dependence.

[2]  David E. Buchholz,et al.  Electronic Health Records and Transgender Patients—Practical Recommendations for the Collection of Gender Identity Data , 2015, Journal of General Internal Medicine.

[3]  K. Mayer,et al.  Do Ask, Do Tell: High Levels of Acceptability by Patients of Routine Collection of Sexual Orientation and Gender Identity Data in Four Diverse American Community Health Centers , 2014, PloS one.

[4]  A. Darzi,et al.  Systematic review of the application of the plan–do–study–act method to improve quality in healthcare , 2013, BMJ quality & safety.

[5]  K. Conron,et al.  A population-based study of sexual orientation identity and gender differences in adult health. , 2010, American journal of public health.

[6]  E. Callahan,et al.  Introducing sexual orientation and gender identity into the electronic health record: one academic health center's experience. , 2015, Academic medicine : journal of the Association of American Medical Colleges.

[7]  Jesse M. Ehrenfeld,et al.  The Opportunity for Medical Systems to Reduce Health Disparities Among Lesbian, Gay, Bisexual, Transgender and Intersex Patients , 2015, Journal of Medical Systems.

[8]  M. van Ryn,et al.  Patient Acceptance of Sexual Orientation and Gender Identity Questions on Intake Forms in Outpatient Clinics: A Pragmatic Randomized Multisite Trial , 2018, Health services research.

[9]  C. Tate,et al.  A Two-Question Method for Assessing Gender Categories in the Social and Medical Sciences , 2013, Journal of sex research.

[10]  E. Erosheva,et al.  The physical and mental health of lesbian, gay male, and bisexual (LGB) older adults: the role of key health indicators and risk and protective factors. , 2012, The Gerontologist.

[11]  D. Ketley,et al.  Influencing sceptical staff to become supporters of service improvement: a qualitative study of doctors’ and managers’ views , 2004, Quality and Safety in Health Care.

[12]  E. Lombardi,et al.  The Utility of the Two-Step Gender Measure Within Trans and Cis Populations , 2016 .

[13]  Gilbert Gonzales,et al.  Comparison of Health and Health Risk Factors Between Lesbian, Gay, and Bisexual Adults and Heterosexual Adults in the United States: Results From the National Health Interview Survey. , 2016, JAMA internal medicine.

[14]  Madeline B. Deutsch,et al.  Electronic medical records and the transgender patient: recommendations from the World Professional Association for Transgender Health EMR Working Group , 2013, J. Am. Medical Informatics Assoc..

[15]  H. Makadon,et al.  Sexual Orientation and Gender Identity Data Collection in Clinical Settings and in Electronic Health Records: A Key to Ending LGBT Health Disparities. , 2014, LGBT health.

[16]  Lisa M. Kodadek,et al.  Risks, Benefits, and Importance of Collecting Sexual Orientation and Gender Identity Data in Healthcare Settings: A Multi-Method Analysis of Patient and Provider Perspectives. , 2017, LGBT health.

[17]  Mollie A. Ruben,et al.  Will Veterans Answer Sexual Orientation and Gender Identity Questions? , 2017, Medical care.

[18]  Blake W. Hawkins,et al.  Prevalence of Depression and Anxiety Among Bisexual People Compared to Gay, Lesbian, and Heterosexual Individuals:A Systematic Review and Meta-Analysis , 2018, Journal of sex research.

[19]  Robert Graham,et al.  The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding , 2011 .

[20]  Claire Snyder,et al.  Emergency Department Query for Patient-Centered Approaches to Sexual Orientation and Gender Identity: The EQUALITY Study , 2017, JAMA internal medicine.

[21]  R. Bjarnadottir,et al.  Patient perspectives on answering questions about sexual orientation and gender identity: an integrative review , 2017, Journal of clinical nursing.

[22]  S. Reisner,et al.  Monitoring the health of transgender and other gender minority populations: Validity of natal sex and gender identity survey items in a U.S. national cohort of young adults , 2014, BMC Public Health.

[23]  S. Valentine,et al.  A systematic review of social stress and mental health among transgender and gender non-conforming people in the United States. , 2018, Clinical psychology review.

[24]  Lisa M. Kodadek,et al.  Is It Okay To Ask: Transgender Patient Perspectives on Sexual Orientation and Gender Identity Collection in Healthcare , 2017, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[25]  Hale M. Thompson Patient Perspectives on Gender Identity Data Collection in Electronic Health Records: An Analysis of Disclosure, Privacy, and Access to Care , 2016, Transgender health.

[26]  S. Cahill,et al.  Inclusion of Sexual Orientation and Gender Identity in Stage 3 Meaningful Use Guidelines: A Huge Step Forward for LGBT Health. , 2016, LGBT health.

[27]  L. J. Peacock,et al.  Acute alcohol intoxication and female orgasmic response , 1982 .

[28]  D. Nease,et al.  The Role of the Champion in Primary Care Change Efforts: From the State Networks of Colorado Ambulatory Practices and Partners (SNOCAP) , 2012, The Journal of the American Board of Family Medicine.