Improving Patient Engagement for the LGBT Population

Now more than ever, it’s critically important that medical and health information management (HIM) professionals work to create a healthcare environment that is non-judgmental and welcoming to patients of all backgrounds, according to a recent practice brief published by the American Health Information Association (AHIMA), the subject of which will be explored in today’s edition of Talk Ten Tuesdays.

“We applaud the decision of AHIMA to publish this practice brief and have Lesley Kadlec, AHIMA’s practice excellence director for health information management (HIM), as today’s program’s special guest,” said Chuck Buck, publisher of ICD10monitor and executive producer and program host for the Internet radio program.

Buck said the inspiration to feature this topic came as a result of a news release published by AHIMA that quoted Association CEO Lynne Thomas Gordon, who offered 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 – in her recent brief, “Improving Patient Engagement for LGBT Populations.”

“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,” Gordon said. “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 or spouse rights as a primary concern associated with their healthcare, AHIMA reported. In addition to making sure that both partners sign their provider’s HIPAA-approved form, the Association also recommended that they exchange access information on their respective patient portals.

The traditional birth certificate can also pose a problem, AHIMA warned. The state of California recently revised its birth certificate legislation to be more inclusive of LGBT parents, officials noted, and parents can now be listed as two mothers or two fathers. Additionally, the gender-neutral term “parent” is available along with the option to cite a mother or father.

AHIMA labeled patient portals a “powerful tool” that could allow all patients to become more engaged in their own healthcare, but also pointed out specific features that can be established to support LGBT patients. Specifically, the Association said, an ideal portal should:

•  Allow patients to submit data securely though the web or a mobile app to alleviate potential concerns about identifying personal and private information at registration;
•  Make sure content is inclusive. Ideally, the patient should be able to list a 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; and
•  Display a clear notice about nondiscrimination and consider complementing pictures of traditional families with nontraditional families.

The practice brief also 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.”

The EHR additions can help limit the creation of duplicate or misleading health records, AHIMA noted.

The practice brief further recommends that all staff members who interact with patients should receive diversity education that includes LGBT health topics 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.

Lesley Kadlec, MA, RHIA, CHDA
AHIMA Practice Excellence Director of Health Information Management (HIM)