March 30, 2017

Enhancing Patient Engagement for LGBT Populations

READ TIME: 3 MIN.

Healthcare professional and health information management professionals (HIM) can help create a healthcare environment that is non-judgmental and welcoming to patients of all backgrounds.

The American Health Information Management Association's newest practice brief, "Improved Patient Engagement for LGBT Populations," provides guidelines and a range of suggestions for enhanced HIM practices for the LGBT community, as well as individuals on a spectrum of sexual orientations and gender identities.

"When a healthcare environment is accessible, sensitive and respectful, patients are more likely to share details of their personal health information that are needed to provide the best patient care and safety," said AHIMA CEO Lynne Thomas Gordon, MBA, RHIA, CAE, FACHE, FAHIMA. "As healthcare populations become more diverse, a focus on inclusiveness for all patient populations will promote patient engagement and help to reduce health disparities. In turn, this will help ensure health information can be found where and when it is needed."

LGBT patients often identify partner/spouse rights as a primary concern. In addition to making sure both partners sign their provider's HIPAA-approved form, it is recommended that they exchange access information on their respective patient portals. The traditional birth certificate can also pose a problem. California has revised its birth certificate legislation to be more inclusive of LGBT parents; parents can now be listed as two mothers or two fathers and the gender-neutral term parent is available along with the option to check mother or father.

The patient portal is a powerful tool for all patients to become more engaged in their own healthcare, but there are specific aspects which can be established to support LGBT patients:

  • Allow patients to submit data securely though the web or a mobile app to alleviate potential concerns a patient may have about identifying personal and private information at registration.

  • Make sure content is inclusive. The patient should be able to list preferred name and gender, along with legal name and gender. This also impacts how procedures and medications are listed in the portal. For example, a listing of the hormones a patient undergoing gender reassignment surgery is taking should be available for the patient to view in the portal.

  • Offer reference ranges for lab results that can be adapted and modified according to a person's gender. For example, a person undergoing female-to-male reassignment may have a different "normal" range than someone born male.

  • Display a clear notice about nondiscrimination and consider complementing pictures of traditional families with nontraditional families.

    The practice brief noted that the electronic health record (EHR) can include new fields to capture specific information such as "Gender Identity," "Sexual Orientation," "Sex Assigned at Birth," and "Organ Inventory." According to the practice brief, "gathering this data will enable healthcare providers to treat transgender patients with appropriate care across the continuum, from being addressed properly on a phone call to getting the appropriate wellness reminders assessed on their organ inventory, not just their gender." These EHR additions can help limit the creation of duplicate or misleading health records.

    The practice brief recommends that all staff members who interact with patients should receive diversity education that includes LGBT health and the multifaceted concepts related to sexual orientation and gender identity.

    "The more healthcare professionals understand diverse populations, the better patient-centered support we can provide," Thomas Gordon said.

    The American Health Information Management Association (AHIMA) represents more than 103,000 health information professionals in the United States and around the world. AHIMA is committed to promoting and advocating for high quality research, best practices and effective standards in health information and to actively contributing to the development and advancement of health information professionals worldwide. AHIMA's enduring goal is quality healthcare through quality information.

    For more information, visit www.ahima.org

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