UC Davis Health asks LGBT patients to share info for tailored care

06/14/2013 12:00 AM

06/18/2013 8:21 AM

There's a groundswell of concern in the medical community that lack of sexual orientation and gender identity information might be impacting care of lesbian, gay, bisexual and transgender patients.

The UC Davis Health System responded to those concerns Thursday, saying it will become the first academic health system in the nation to incorporate that information as standard demographic elements within the electronic health records of its patients.

Patients have the option of providing information about their sexual orientation and gender identity when logging onto the health system’s “MyChart” online communications system.

Officials said about 76,000 patients who use the online communications system to access their medical information, schedule appointments and interact with physicians will receive the email.

For years, records have included basic information such as age, race and family history.

Officials said the move was prompted in part by a 2011 Institute of Medicine report noting a meager amount of research data about the health of lesbian, gay, bisexual and transgender patients.

Also, officials believe LGBT patients have long avoided medical clinics out of fear of being humiliated or rejected.

"Patients and physicians, even in the clinical setting, are not very good at talking about sex," said Edward Callahan, professor of family and community medicine and a coordinator of the UC Davis initiative. "Unfortunately, the problem is more than just one of embarrassment.

"LGBT individuals face significant health challenges that can be better addressed when a doctor's office is seen as a truly welcoming and understanding environment. We're inviting patients to voluntarily share their gender identity and sexual orientation information to help us create an atmosphere in which we're able to provide the most knowledgeable and informed care possible."

According to the 2011 Institute of Medicine report, that knowledge might make a significant difference in treating LGBT patients. Research shows that a disproportionate number of LGBT individuals suffer from alcoholism, drug abuse, depression, suicide risk and chronic diseases.

Researchers noted that decades-old studies of health issues affecting women and racial/ethnic minorities produced vital information for care and treatment of multiple diseases.

"We know that the routine collection of information on race and ethnicity has greatly expanded our understanding of the conditions that arise among certain groups and how they are affected differently," Callahan said. "That same approach is crucial for sexual minority populations, too.

"Stigma, prejudice and fear have long kept LGBT patients away from exam rooms and from speaking more comfortably about their health. This is about breaking down barriers and reducing health disparities."

Shara Perkins Murphy, executive director of the Sacramento Gay and Lesbian Center, said, "We are incredibly happy that UC Davis has taken this step," adding that center officials have talked with UCD about such action for more than a year.

"We are so very proud to have a major health system in our area taking on this work," she said. "There is a need to understand that, in the transgender community for example, there are medical issues that cannot be addressed if (doctors) don't know."

Callahan said a relatively small portion of the overall U.S. medical community obtains sexual orientation and gender identity information, including Fenway Health Institute in Boston and some LGBT-specific health clinics nationwide.

He said some major players are getting close to implementing LGBT demographics in medical records.

The UC Davis Health System's LGBT questionnaire is voluntary. If provided, sexual/gender information will be added to each individual's confidential health record. Patients also have the option of providing information in person, during a clinic appointment, for example.

UC Davis also is developing a physicians list of health care providers who self-identify as "LGBT-welcoming." Officials say the new database is scheduled to go online this summer.

Call The Bee's Mark Glover, (916) 321-1184.

Editor's note: This story was changed June 14 to correctly state how patients may provide the health system with gender identity and sexual orientation information. Patients have the option of providing that information when logging onto the health system’s “MyChart” online communications system.

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