Over 60% of adult electronic health records (EHR) lack sexual orientation and gender identity (SOGI) data, hindering health equity research for sexual and gender minority (SGM) individuals, according to a study in JAMIA. The absence of standardized coding schemes and training, along with concerns about patient offense, contribute to incomplete data. The researchers recommend improving SOGI data collection practices, emphasizing clinical benefits, enhancing training efforts, and tying payment reimbursement to data completeness to incentivize accurate documentation and high-quality care for SGM populations.
According to a study published in JAMIA, the absence of sexual orientation and gender identity (SOGI) data collection within electronic health record (EHR) systems is impeding health equity research for sexual and gender minority (SGM) individuals.
Researchers examined EHR data from a large academic health system, focusing on older adults aged 50 and above from 2018 to 2022.
Out of the 153,827 older adults discharged from the hospital, 67.6% of records lacked sexual orientation data, while 63.0% lacked gender identity information.
The study authors emphasized the significance of complete SOGI data for healthcare systems to comprehend the unique requirements of SGM individuals and develop targeted interventions and programs that address health disparities in these populations.
To improve and standardize SOGI data collection practices, the researchers put forth several recommendations. First, they highlighted the need for training and infrastructure to support the collection of SOGI data.
The absence of consensus regarding who should be responsible for collecting SOGI data and the lack of comprehensive SOGI categories in EHR systems contribute to the missing data, as noted by the researchers.
Although healthcare professionals have expressed concerns about potentially offending patients by asking about their SOGI, multiple studies have shown that patients are generally supportive of such questions and willing to answer them. However, providers do not consistently document SOGI data.
While healthcare systems offer training on SOGI data collection, further research is required to determine the optimal content and delivery methods of this training. The authors suggested that emphasizing the clinical benefits and importance of SOGI data collection to healthcare workers could enhance the data collection process.
Another challenge highlighted by the researchers is the absence of standardized coding schemes for SOGI data collection, which hampers information exchange across different EHR systems. This lack of continuity poses difficulties in ensuring seamless care for patients transitioning between healthcare settings. Initiatives like the Trusted Exchange Framework and Common Agreement have been developed to address this issue by standardizing secure information sharing among different EHR systems.
Lastly, the researchers proposed tying payment reimbursement to the completeness of SOGI data as a means to improve documentation. They argued that incentivizing health systems through payment reimbursement and implementing disparities-sensitive measures could encourage accurate and complete SOGI data collection, thus ensuring high-quality care for SGM populations.
