Earlier this fall, the U.S. Department of Health and Human Services announced that electronic health records must now include the option to designate patients’ sexual orientation and gender identity (SO/GI). Though care providers will not be required to ask patients about SO/GI, this important addition to electronic medical records has the ability to improve patient care, facilitate better research and reduce the health inequities faced by LGBT patients.
At BWHC, Harry Reyes Nieva and Kerstin Palm, MA, OTR/L, CHT, co-chairs of the LGBT & Allies Employee Resource Group, have been working to make this change a reality since May 2014, when BWHC and Partners leadership made a significant commitment to support the work necessary for the ability to document SO/GI demographics in Epic for Partners eCare implementation.
The multidisciplinary SO/GI eCare Working Group was then formed—comprised of clinical content experts, admitting and registration personnel, social workers and many others—to develop a framework for collection of SO/GI demographics in Partners eCare across all Partners institutions. The group created the Epic fields, developed the specific language that would be used in the system, held training sessions for clinicians and shared best practices to improve clinicians’ knowledge about how to accurately and compassionately gather SO/GI information.
Through the Employee Resource Group’s efforts, leaders at BWHC, Partners and MGH also co-signed a letter with several non-Partners institutions to advocate for inclusion of SO/GI demographics in Meaningful Use 3, further demonstrating the system’s commitment to LGBT health equity on a national scale. Meaningful Use is a Medicare and Medicaid program that awards incentives for using certified electronic health records to improve patient care.
“Collecting this information allows us to better understand LGBT health, including inequities in insurance coverage, access to care, diagnosis and treatment,” said Reyes Nieva, a research manager in General Medicine and Primary Care. “From a clinical perspective, understanding our patients as individuals is imperative to tailoring their health care to ensure a positive experience and the best possible outcome. By capturing SO/GI information, clinicians can be sure appropriate preventive care and screenings are conducted.”
Some of the health inequities experienced by LGBT patients include high rates of behavioral health issues, such as thoughts of suicide and suicide attempts, a higher prevalence of sexually transmitted infections and HIV, and a greater likelihood of being overweight or obese, lipid abnormalities, glucose intolerance, inactivity and cardiovascular disease.
Reyes Nieva, Palm and Tanya Zucconi, MBA, formerly of BWH, recently presented a workshop at this year’s Gay and Lesbian Medical Association (GLMA) annual meeting about the work they and colleagues across BWHC and Partners did to ensure the collection of SO/GI data from BWHC patients. The inclusion of SO/GI demographics in Partners eCare has positioned BWHC and Partners as leaders in the field of LGBT health care equality.
“Providers who may not have asked these questions in the past are now more aware of its importance and the support that exists for them institutionally,” said Palm, Outpatient Rehab Services manager at BWFH. “This is a systematized way that providers will be cued to get to know their patients in the areas of sexual orientation and gender—a way for patients to be known by their providers and have their health care tailored to them as individuals. This is best practice for patient care and continues our long tradition of high-quality health care centered on patients. I’m glad we’re doing it here.”
The BWHC LGBT & Allies Employee Resource Group meets the fourth Tuesday of every month. To learn more, email firstname.lastname@example.org.