On Thursday, the University of California Davis Health System announced that it will begin recording sexual orientation and gender identity information along with other demographic data in its electronic health records system. As is currently the case with demographic information such as race and ethnicity, patients will now be invited to voluntarily share their sexual orientation and gender identity with providers, either in person or through a questionnaire in UC Davis’s secure online system.
This is part of UC Davis’s larger initiative to address the needs of lesbian, gay, bisexual, and transgender, or LGBT, patients. In an interview with the Center for American Progress last year, UC Davis medical professor Dr. Edward Callahan described the electronic health record as “an instrument to change the conversation between the provider and the patient.” Because LGBT people face particular health challenges, knowing a patient’s sexual orientation and gender identity enables a provider to deliver better and more tailored care. To facilitate these conversations, UC Davis has also developed training modules for providers on LGBT cultural competency and is creating a list of providers who identify themselves as LGBT-welcoming.
The move to collect sexual orientation and gender identity information in electronic health records is in line with emerging expert consensus on recommendations for improving LGBT health. In 2010, the U.S. Department of Health and Human Services included data collection on LGBT populations as a key objective in Healthy People 2020, the federal government’s blueprint for building a healthier nation between 2010 and 2020. The Institute of Medicine’s 2011 report on LGBT health recommended that sexual orientation and gender identity become a standard part of the demographic information collected in confidential electronic medical records, and a 2012 Institute of Medicine workshop on LGBT data collection convened experts to discuss practical strategies for achieving this goal.
The Office of the National Coordinator for Health Information Technology, or ONC, is currently considering including sexual orientation and gender identity data collection in its Stage 3 criteria for “meaningful use” of electronic health records. These criteria set the national standard for what constitutes appropriate use of an electronic health records system, and they also determine which systems can qualify for certification and financial incentives under the Medicare and Medicaid Electronic Health Records Incentive Programs. The Center for American Progress and over 140 other LGBT and health advocacy organizations have strongly endorsed this policy change.
UC Davis’s LGBT health initiatives will serve as a valuable example to all medical institutions, and ONC should follow their lead to continue to help make LGBT health a national priority.