Benefits of Implementing and Improving Collection of Sexual Orientation and Gender Identity Data in Electronic Health Records

Abstract

Individuals in lesbian, gay, bisexual, and transgender communities experience several disparities in physical and mental health (eg, cardiovascular disease and depression), as well as difficulty accessing care that is compassionate and relevant to their unique needs. Access to care is compromised in part due to inadequate information systems that fail to capture identity data. Beginning in January 2018, meaningful use criteria dictate that electronic health records have the capability to collect data related to sexual orientation and gender identity of patients. Nurse informaticists play a vital role in the process of developing new electronic health records that are sensitive to the needs and identities of the lesbian, gay, bisexual, and transgender communities. Improved collection of sexual orientation and gender identity data will advance the identification of health disparities experienced by lesbian, gay, bisexual, and transgender populations. More inclusive electronic health records will allow providers to monitor risk behavior, assess progress toward the reduction of disparities, and provide healthcare that is patient and family centered. Concrete suggestions for the modification of electronic health record systems are presented, as well as how nurse informaticists may be able to bridge gaps in provider knowledge and discomfort through interprofessional collaboration when implementing changes in electronic health records.

Routine collection of sexual orientation and gender identity data: a mixed-methods study

“…41 Further research is required in a variety of Canadian and international settings in consultation with LGBTQ2S communities. 43 Such work could result in a standard approach to implementation, data extraction and analysis. Research is also required on how data collection can affect awareness and acceptance of diverse sexual and gender identities.…”

Differences in Multimorbidity among Cisgender Sexual Minority and Heterosexual Adults: Investigating Differences across Age-Groups

“…Clinicians should additionally educate sexual minority adults on their risk factors for development of multimorbidity while assessing their access to important supports (e.g., mental and emotional). Assessment of sexual orientation in clinical settings has been identified as a challenge to providing culturally competent care for sexual minority adults (Bosse et al, 2018). Routine assessment of sexual orientation among clinicians is critical to providing culturally appropriate care to patients who identify as a sexual minority and determining which sexual minority individuals are at greatest risk for multimorbidity.…”

Stakeholder Experiences With Gender Identity Data Capture in Electronic Health Records: Implementation Effectiveness and a Visibility Paradox

“…Bauer and colleagues (Bauer et al, 2009; Bauer et al, 2017) invoke Namaste’s (2000) focus on community-generated visibility with the development of more extensive GI measures than the two-step method for a range of Canadian informational contexts; clinically, more extensive categories may allow a patient to feel more clearly understood by a provider. Bosse et al (2018) more recently claimed that standardized, two-step GI data capture in EHRs will improve access to care and reduce health disparities. Similarly, the Institute of Medicine, the Fenway Institute, the Center for American Progress, the Williams Institute, and the San Francisco Department of Public Health have issued recommendations, white papers, and original research with the goal of advancing EHR GI data collection (Bradford et al, 2012; Cahill & Makadon, 2014; Cahill et al, 2014; City and County of San Francisco Department of Public Health, 2013; Conron, Landers, et al, 2014; Conron, Lombardi,& Reisner, 2014).…”