After a push from regulators and advocacy groups to integrate gender identity information into medical records, coders and providers are still working through functional and practical challenges.
Data on gender identity and sexual orientation are requirements under the Office of National Coordinator for Health IT’s (ONC) 2015 Edition EHR Certification. Currently, hospitals are required to upgrade to EHRs that meet those standards by January 2018, although health IT and provider groups have pushed to delay that deadline.
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Last week, the Center for Medicare and Medicaid Services (CMS) relaxed EHR certification requirements for physicians participating in the Merit-based Incentive Payment System (MIPS), but as of now, hospitals are still on the hook.
Integrating gender identity data hasn’t been easy. Julie Campbell, Epic’s vice president of patient experience, first began raising the issue of gender identity in medical records in 2003 as a software developer for the EHR vendor, according to Wired. Last year, Epic released a two-question gender identity addition to its EHR platform which customers have been slowly activating.
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But building in the code has only been the initial hurdle. Now providers are grappling with how to respectfully approach the topic with patients and who should be the one responsible for collecting information. Adrian Dual, an emergency physician at Emory Healthcare in Atlanta, Georgia, told Wired the system has been split about whether it should be doctors or registration personnel that broach the topic.
"Everyone has to be on board at the hospital in order to be collecting this stuff and then using it in a sensitive way,” he told the magazine.
Integrating data on gender identity and sexual orientation is particularly important given large healthcare disparities among the LGBT population. Earlier this year, the American Health Informatics Management Association (AHIMA) released guidance for health information professionals to incorporate new LGBT patient data and highlighted patient portals as a key tool in engaging an overlooked patient population.