Collecting Sexual Orientation and Gender Identity Data in Electronic Health Records Workshop Summary (2013) / Chapter Skim
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3 Federal Perspective on the Use of Electronic Health Records to Collect Sexual Orientation and Gender Identity Data
3 Federal Perspective on the Use of Electronic Health Records to Collect Sexual Orientation and Gender Identity Data
Pages 15-24
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From page 15... ...
• Stage 2 meaningful use regulations for EHR adoption do not include the col lection of LGBT data, as there was concern over the lack of consensus on definitions, and on the standards for structured data entry for gender identity and sexual orientation. • EHR adoption by federally funded community health centers, which provide services to many LGBT people, exceeds the national average and can serve as a model for wider adoption by other health care systems.
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From page 16... ...
Six speakers at the workshop discussed the steps that the federal government is taking to promote the collection of sexual orientation and gender identity data as an integral part of efforts to reduce health disparities among LGBT people. EFFORTS AT THE DEPARTMENT OF HEALTH AND HUMAN SERVICES In 2011, HHS released a data progression plan intended to begin the integration of sexual orientation and gender identity variables into HHS national health surveys, explained Donald Moulds.
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From page 17... ...
THE VIEW FROM THE CENTERS FOR MEDICARE & MEDICAID SERVICES The "meaningful use" of electronic health records provision of HITECH is a powerful tool for getting pertinent data, including LGBT data, to better the health and well-being of all Americans, said Robert Tagalicod. CMS, he explained, oversees more than just Medicare and Medicaid; it also runs the Child Health Insurance Program, the new health insurance exchanges c reated by the Affordable Care Act, and the Innovation Center.
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From page 18... ...
HEALTH RESOURCES AND SERVICES ADMINISTRATION PERSPECTIVE The mission of the Health Resources and Services Administration (HRSA) , said Sylvia Fisher, is "to improve health and achieve health equity through access to quality services, a skilled health workforce, and innovative programs." She noted that HRSA is committed to addressing the health care needs of LGBT communities.
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From page 19... ...
In a survey conducted earlier by George Washington University's Geiger Gibson Community Health Research Foundation, Harris noted that 70 percent of community health centers were using electronic records, but only 45 percent were completely electronic, using no paper in their collection of patient data. The discrepancy with the numbers reported to HRSA in December 2011 may indicate increased levels of adoption of electronic records.
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From page 20... ...
A survey conducted in the summer of 2011 found that more than 78 percent of Ryan White clinics use an EHR. Some 97 percent are electronically capturing patient history and demographic data, 94 percent are capturing clinical notes electronically, and 84 percent view lab results electronically.
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From page 21... ...
"Until we make it a seamless process whereby you enter your data electronically and you can have real time data to track how you are doing in quality and where you can interact and improve, we really are not helping providers," she said. "The goal is to make it seamless for providers to report to CMS, to report to HRSA, to report to other federal agencies, and also to develop the datasets they need in real time to track and identify areas of disparity so that they can improve the quality of care they provide." CONFIDENTIALITY, PRIVACY, AND THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT The Office for Civil Rights in HHS administers the privacy and security rules embedded in the Health Insurance Portability and Accountability Act (HIPAA)
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From page 22... ...
Individuals can also ask their providers to provide additional protection for specific data, but providers are not required to agree to that request. The HIPAA privacy rule does give entities regulatory permission to use protected health information for core purposes of providing health care to their patients.
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From page 23... ...
You might feel behind, but since we don't really know how to segment the information yet and we're working on it, coming in on this phase in those discussions may actually turn out to be a little fortuitous." DISCUSSION In response to a question from Alex Gonzalez, medical director at Fenway Health, about how to treat mental health records that are part of a shared EHR, McAndrew said that anything incorporated into the general medical record is not shielded under the special mental health provisions. Only in cases where the records are maintained separately are they subject
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From page 24... ...
Ignatius Bau asked McAndrew about the kind of outreach or education planned around the letter that came from the Office for Civil Rights clarifying that section 1557 under the Affordable Care Act would protect against discrimination on the basis of gender identity. He also asked how that fits into broader nondiscrimination protections.
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