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Case Reports
. 2022 Jan 12;29(2):372-378.
doi: 10.1093/jamia/ocab227.

Overcoming technical and cultural challenges to delivering equitable care for LGBTQ+ individuals in a rural, underserved area

Heather L Marney  1 , David K Vawdrey  1   2 , Leyla Warsame  1 , Spencer Tavares  1 , Andrea Shapiro  1 , Arthur Breese  3 , Amy Brayford  3 , Aliasgar Z Chittalia  4
Affiliations
Case Reports

Overcoming technical and cultural challenges to delivering equitable care for LGBTQ+ individuals in a rural, underserved area

Heather L Marney et al. J Am Med Inform Assoc. .

Abstract

The lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ+) community is vulnerable to health-care disparities. Many health-care organizations are working to collect sexual orientation and gender identity in their electronic health records (EHRs), with the goal of providing more inclusive care to their LGBTQ+ patients. There are significant human and technical barriers to making these efforts successful. Based on our 5-year experience at Geisinger (an integrated health system located in a rural, generally conservative area), this case report provides insights to overcome challenges in 4 critical areas: (1) enabling the EHR to collect and use information to support the health-care needs of LGBTQ+ patients, (2) building a culture of awareness and caring, empowering members of the health-care team to break down barriers of misunderstanding and mistrust, (3) developing services to support the needs of LGBTQ+ patients, and (4) partnering with local communities to become a trusted health-care provider.

Keywords: cultural competency; electronic health records; gender identity; health-care disparities; sexual and gender minorities.

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Figures

Figure 1.
Figure 1.
Examples of patient identifiers in the EHR in the patient record, reports and arm bands. EHR: electronic health record.
Figure 2.
Figure 2.
Data collection workflow implemented at Geisinger for sexual orientation and gender identity-related information.
Figure 3.
Figure 3.
Geisinger services available for clinicians and the LGBTQ+ community. LGBTQ+: lesbian, gay, bisexual, transgender, queer, or questioning.
See this image and copyright information in PMC

References

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