EHR rollout could be problematic for LGBT patients

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Electronic health records could create additional complexities for providers when treating lesbian, gay, bisexual and transgender (LGBT) patients, according to a recent report by nonprofit independent news organization Truthout.

For instance, according to the article, some of the fields in EHRs are not designed with LGBT patients in mind, referring to "marital status" but not "relationship status." There also are logistic concerns regarding whether and how to include such information in an EHR, and whether physicians should affirmatively raise such questions with their patients.

A benefit of including LGBT information in EHRs would be that providers could automatically factor such information into treatments, the article points out. However, a downside of including the information in an EHR would be that it is more readily shared among providers, even if a patient doesn't want it shared. That, in turn, could subject patients to discrimination, according to Barbara Warren, director of LGBT health services at Beth Israel Medical Center in New York.

"If you're outed in your health record, and you're not necessarily in a state where you have equal protection, there are possible problems as a result that you could be exposed to," Warren told Truthout. "Equal protection under law is also related to access to insurance. We don't have that guarantee in every state; we don't have marriage equality in every state."

Some recommendations to improve EHR use when treating LGBT patients, according to the article, are to discourage use of labels such as "transgender," and instead inputting more exact medical histories into a system to improve patient care. 

The Institute of Medicine was one of the first stakeholders to weigh in on issues surrounding EHRs and the LGBT community, recommending in 2011 that EHRs be used to gather data to address their unique healthcare needs.   

To learn more:
- read the article

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