LGBTQ Patients Are Focus of AHIMA Support

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Original story posted on: October 1, 2018

The lesbian, gay, bisexual, transgender, and queer (or questioning) (LGBTQ) population faces barriers to appropriate healthcare access.

EDITOR’S NOTE: The American Health Information Management Association (AHIMA) has developed a practice brief on this issue, and ICD10monitor will continue to report on how recognition of this vulnerable population is being demonstrated by providers.

The American Health Information Management Association (AHIMA) recognized the growing need to provide best practices and resources for our membership to provide proper communication and an inclusive environment for the LGBTQ patient population. 

A volunteer workgroup is very active; publishing blogs, articles, practice briefs and presenting to component state associations on the topic.  Last week in Miami, Florida at our 90th Annual Convention and Exhibit, the workgroup presented “Data Collection for Sexual Orientation and Gender Identity in the EHR” to a packed house of engaged attendees.      

The LGBTQ community face a variety of health disparities.  There are challenges with receiving adequate health care including concerns for social stigma and discrimination that have been associated with mental health issues, substance abuse and unfortunately, even suicide. 

The government has recognized the need for additional documentation capture to foster better care for this patient population.   

For the first time, the U.S. Department of Health and Human Services (HHS), through their Healthy People 2020 initiative, addressed LGBTQ health directly.  HHS included sexual orientation/gender identity (SO/GI) data elements in the 2015 Edition of Certified Technology (CEHRT) and provided guidance on how to capture the data elements.

While the government’s steps are certainly a huge step forward, healthcare organizations have a long way to go to ensure they are addressing, communicating, documenting and caring for the LGBTQ population to the best of their abilities. 

All caregivers who encounter patients should receive adequate sensitivity training to enable proper communication and foster trust with the LGBTQ patient population.  For instance, if a transgender individual presents who may be undergoing transition (affirmation), the registration staff need to be trained properly to address and communicate with the patient.  As discussed in AHIMA’s Journal articles and practice briefs on the topic, creating a diversity task force within each healthcare organization is a highly recommended first step. 

HIM professionals must work diligently with their IT professionals to ensure proper data can be captured to adequately support operations and the revenue cycle.  This collaborative and iterative approach should be inclusive of EHR and registration system vendors. 

Fields such as preferred name and associated pronoun, legal name and sex, sex assigned at birth, and self-identified sexual orientation / gender identity status should all be considered.  For now, workarounds for capturing and maintaining data needed to support orders, coding and billing for this patient population is necessary.

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Julie A. Dooling, MSHI, RHIA, CHDA, FAHIMA

Julie A. Dooling, MSHI, RHIA, CHDA, FAHIMA, is a director of HIM Practice Excellent for AHIMA.

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