title: Introducing sexual orientation and gender identity into the electronic health record: one academic health center's experience.
abstract: Many U.S. populations experience significant health disparities. Increasing health care providers' awareness of and education about sexual orientation (SO) and gender identity (GI) diversity could help reduce health disparities among lesbian, gay, bisexual, and transgender (LGBT) patients. The authors share the University of California, Davis, Health System's (UCDHS's) experience as it became the first U.S. academic health center to formally introduce patient SO/GI demographic data into its electronic health record (EHR) as a step toward reducing LGBT health disparities. Adding these data to the EHR initially met with resistance. The authors, members of the UCDHS Task Force for Inclusion of SO/GI in the EHR, viewed this resistance as an invitation to educate leaders, providers, and staff about LGBT health disparities and to expose providers to techniques for discussing SO/GI with patients. They describe the strategies they employed to effect institutional culture change, including involvement of senior leadership, key informant interviews, educational outreach via grand rounds and resident workshops, and creation of a patient safety net through inviting providers to self-identify as welcoming LGBT patients. The ongoing cultural change process has inspired spin-off projects contributing to an improved climate for LGBT individuals at UCDHS, including an employee organization supporting SO/GI diversity, support for and among LGBT medical learners through events and listservs, development and implementation of an LGBT health curriculum, and creation of peer navigator programs for LGBT patients with cancer. The authors reflect on lessons learned and on institutional pride in and commitment to providing quality care for LGBT patients.
authors.affiliation: Dr. Callahan is associate dean for academic personnel and professor of family and community medicine, University of California, Davis, School of Medicine, Sacramento, California. Ms. Sitkin is a first-year student, Yale School of Medicine, New Haven, Connecticut. Dr. Ton is director of cultural competency and professionalism and associate professor of psychiatry, University of California, Davis, School of Medicine, Sacramento, California. Dr. Eidson-Ton is associate professor of family and community medicine, University of California, Davis, School of Medicine, Sacramento, California. Ms. Weckstein is a social worker, Department of Social Services, University of California, Davis, Health System, Sacramento, California. Dr. Latimore is associate dean for student diversity and professor of internal medicine, University of California, Davis, School of Medicine, Sacramento, California.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Callahan
authors.forename: Nicole
authors.initials: N
authors.lastname: Sitkin
authors.forename: Hendry
authors.initials: H
authors.lastname: Ton
authors.forename: W Suzanne
authors.initials: WS
authors.lastname: Eidson-Ton
authors.forename: Julie
authors.initials: J
authors.lastname: Weckstein
authors.forename: Darin
authors.initials: D
authors.lastname: Latimore
mesh_terms: D000046:Academic Medical Centers; D057286:Electronic Health Records / Q000458:organization & administration*; D005260:Female; D005783:Gender Identity; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D019529:Sexuality