Process integrates data on sexual orientation, gender identity into electronic health record
A case report on this systemwide effort was published this month in the Journal of the American Medical Informatics Association.
According to the National Center for Transgender Equality, more than 50% of LGBTQ+ people surveyed reported experiencing healthcare discrimination, and 28% said they have postponed medical care as a result. Compared to non-LGBTQ+ people, LGBTQ+ individuals experience lower rates of mammography and Pap smear screenings, and higher rates of substance abuse, smoking, unhealthy weight control or perception, HIV, and other sexually transmitted infections.
In 2017, Geisinger established a physician-led, multi-disciplinary team to develop a process for collecting and using SOGI information to improve healthcare delivery. Geisinger modified its EHR to enable collection and use of data including gender identity, birth sex, affirmation history and organ inventory and ensure inclusive documentation for existing data such as legal sex, preferred pronouns, correct name, marital status and emergency contacts. The data was collected through face-to-face discussions with healthcare providers as well as self-reporting questionnaires.
Geisinger recently developed a questionnaire that allows patients to self-report their race, ethnicity, language, veteran status and SOGI information. Since August 2021, more than 65,000 patients have self-identified, and Geisinger is using the information to identify disparities and create quality programs to meet patient’s needs.
“It is imperative that patients understand the questions, feel respected, know why the information is being collected and how it will be used, and understand how their privacy is being protected,” said Heather Marney, director of provider informatics at Geisinger and lead author of the case report.
To complement and support these changes, Geisinger worked to establish a culture of diversity and inclusion across the organization, implementing comprehensive, interactive education and training for all staff. Geisinger also engaged with LGBTQ+ communities across its service area to share information about its diversity and inclusion efforts and collaborate with and support existing community groups.
“Creating a technical solution to collect SOGI information is just one part of a larger program for promoting health equity,” said Aliasgar Chittalia, M.D., a Geisinger primary care physician and co-author of the case report. “Providing respectful, high-quality care to the LGBTQ+ community is not a ‘one-and-done’ initiative. Organizations must create a culture in which staff and patients understand the importance of the topic, assess how to sensitively ask questions, and determine how to meaningfully use the information across the continuum of care.”
Geisinger recently hired Kim Drumgo as the health system’s first chief diversity, equity and inclusion officer. In this new role, Drumgo will champion and guide the organization to better understand the importance and value of a diverse, equitable and inclusive environment, providing systemwide thought leadership, strategic direction and implementation of diversity, equity and inclusion-related programs and initiatives.
Geisinger is committed to making better health easier for the more than 1 million people it serves. Founded more than 100 years ago by Abigail Geisinger, the system now includes nine hospital campuses, a health plan with more than half a million members, two research centers and the Geisinger Commonwealth School of Medicine. With nearly 24,000 employees and more than 1,600 employed physicians, Geisinger boosts its hometown economies in Pennsylvania by billions of dollars annually. Learn more at www.geisinger.org, or connect with us on Facebook, Instagram, LinkedIn and Twitter.
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