Expanding Electronic Health Records (EHRs) data collection to include sexual orientation and gender identity (SOGI) information is critical to eliminate the invisibility of LGBT (lesbian, gay, bisexual and transgender) people in the healthcare system. The Institute of Medicine (IOM) has also recommended that it is the only way to end this disparity. Efforts to implement this solution are in progress. Entering SOGI related information into EHR fields that support documentation of such details will ensure that clinicians have the necessary medical data at the right time to address and screen for health conditions disproportionately affecting LGBT people and have frank discussions with their patients. Many physicians still prefer dictating patient details and in such cases, a medical transcription company can be of assistance in that their transcriptionists will take care of the transcription process and entering the required details into the EHR.
According to an article published in LGBT Health Journal in 2013 by a group of scientists, recording SOGI information of patients in EHRs can help clinicians to identify the unique health needs of LGBT people. For instance, transgender women need regular prostate exams. Many transgender men retain their natal anatomy and therefore require pap smears. If the doctor is handling the case of a transgender person, EHR that has SOGI fields can help the doctor to quickly determine whether there is a need to assess current anatomy. In an EHR without such fields, sexual orientation and gender identity information are often included in a non-standardized way that prevents correlation with preventive procedures, medical or behavioral symptoms or illness.
The researchers also explain that recording SOGI information on EHRs can facilitate better conversation between doctors and patients regarding the specific risk factors LGBT individuals may have for certain conditions. According to the U.S. Centers for Disease Control and Prevention, there is an increased risk for gay and bisexual men to contract HIV and other sexually transmitted diseases than other individuals. With SOGI information and a clear record of all the medications patients may be on and any tests they have received, physicians can determine whether their patients are at risk and provide appropriate advice as early as possible.
The scientists also emphasize that if SOGI data were available to the physicians at the right time, care disparities could be reduced significantly. For example, both lesbian and bisexual women experience cervical cancer at the same rate as that of heterosexual women, but they are much less likely to get routine pap tests to screen for cervical cancer. EHRs with decision support system related to SOGI data can prompt the doctor conducting an annual exam for a woman to take a pap smear to check for cervical cancer and conduct a breast exam.
Implementing EHRs with decision support system related to sexual orientation and gender identity requires clinicians to become better informed and aware of the needs of LGBT people. This will require time, continued education, advocacy and collaboration across the continuum of care. The U.S. government is already contemplating on whether to include SOGI data collection in the Stage 3 guidelines for the incentive program that promotes meaningful use of EHR. However, it is up to the providers to ensure the accuracy of SOGI information within their EHR, once such a system is established. They can utilize the latest technologies and obtain the help of a professional medical transcription company.
