Utilizing the Electronic Health Record as a Tool for Reducing LGBT Health Disparities: An Institutional Approach

Efforts to eliminate health disparities among lesbian, gay, bisexual, transgender, queer and intersex (LGBTQI) populations face historic challenges. Historic extensive mistreatment in medicine helped create a culture in which many deny or hide their sexual orientation and gender identity (SO/GI) when seeking care. In turn, many care providers are not aware which of their patients are LGBTQI. Until recently, there was virtually no education on LGBTQI health provided in medical schools. Without that education, many providers never consider SO/GI in the care of their patients. To improve quality of care for LGBTQI patients, providers must be able to discuss SO/GI with their patients and understand that person’s health risks. The electronic health record (EHR) is a tool which can be used to identify LGBTQI patients and to prompt providers about potentially valuable prevention and treatment efforts. At the University of California, Davis we have begun to gather patient SO/GI data in the EHR, incorporating information communicated from patient to provider directly or through a questionnaire on the patient portal into the EHR. A 4 year competency based curriculum around sexual orientation and gender identity has been developed along with grand rounds and workshops teaching how to discuss SO/GI. Improving atmosphere and educating providers and staff about LGBTQI health disparities has become core to our commitment to improve the experience of LGBT learners, faculty and staff and the quality of care for LGBT patients.