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How health IT can advance health equity for trans and nonbinary patients

The Biden administration recently issued an executive order promoting LGBTQ+ health equity.

Technology can advance health equity for the transgender patient population, which has traditionally been marginalized by the healthcare industry, according to health IT experts. In fact, there is evidence that transgender people have much higher rates of chronic health conditions than the general population—discrimination and stigma can affect their physical and mental health.

To this end, athenahealth, a provider of cloud-based enterprise software, including EHRs, for medical groups and health systems, as well as for more than 1 million doctors, nurses, pharmacists and AthenaHealth epocrates, a company that provides essential clinical content for other healthcare professionals, is taking steps to empower clinicians

For example, athenahealth recently introduced a new feature for its EHR that allows Providers record and display important information in patient charts, including pronouns, name use (plus legal name), and gender identity (plus sex assigned at birth). In addition, epocrates recently launched a new clinical guideline that makes the latest transgender care guidelines available to clinicians at the point of care.

Allyson Livingstone is the Executive Director of Diversity and Inclusion at athenahealth. Dr. Acey Albert is Head of Clinical Content at epocrates.

Healthcare IT News interviewed them about how Livingstone EHR technology can help health systems create a more welcoming environment for transgender patients A welcome space, and how this can ultimately improve health outcomes, and Albert’s insight into the challenges clinicians face due to current gaps in transgender care guidance and the growing need for technology to help clinicians find accurate information as care guidance grows develop.

Q. Why are athenahealth and epocrates taking steps to document transgender information in the EHR and provide transgender care guidance?

Livingstone : Transgender and non-binary communities are Vulnerable patient groups, traditionally marginalized by the healthcare system. As a result, they are at a much higher risk of negative health outcomes – evidence suggests that transgender and nonbinary patients have higher rates of chronic health conditions, mental illness, and sexual and physical violence than the general population much more.

This is our reality as the LGBTQ+ community often feels unwelcome and discriminated against in the healthcare system. Research from the Center for American Progress found that 15 percent of LGBTQ Americans said they avoided healthcare because of discrimination, and one-third of transgender patients had to educate doctors about transgender health.

In response to these inequities, we’ve found a way to address many of them and help patients feel like they’re seen and heard with new EHR capabilities. The technology records information about transgender patients (e.g., gender assigned at birth, pronouns, preferred names, etc.) and displays this information to providers in an accurate and comprehensive manner throughout important steps in the healthcare journey.

While this may seem like a minor adjustment, the positive effects of the enhancement are profound. By bringing these aspects of patient identity and experience into the therapeutic space, we can ultimately create a more welcoming healthcare environment that eliminates fear or isolation and leads to better health outcomes for all.

Albert: At epocrates, we provide qualified medical associations and associations from trusted global and national medical associations Expert guidance so clinicians can provide high-quality and personalized care to their patients. All patients, including those from non-binary and transgender communities.

“Many times, trans patients have to educate their doctors about trans health, which shouldn’t be the case.”

PhD. Acey Albert, epocrates

This year we put a lot of emphasis on adding gender-affirming nursing to clinical guidelines in our app, as unfortunately there are still significant gaps in the industry when it comes to accessing and utilizing transgender nursing guidelines.

Especially as misinformation spreads and transgender health care rights come under fire and new legislation is proposed across the country, as stewards of clinical information we need to do our part power to ensure clinicians receive the most accurate and up-to-date care guidance when treating transgender patients.

With athenahealth’s EHR capabilities and our updated clinical guidelines, I truly believe we can help build a more welcoming and supportive care for trans and non-binary patients health care system.

ask. What does the transgender update do in the athenahealth EHR and what must doctors and nurses do?

Livingstone : This specific product enhancement is a Patient registration solution, in our athenaOne platform. In addition to the legal name and gender assigned at birth, it can accurately label patients’ names, gender identity, and pronouns.

As with any doctor visit, the patient will go through an intake process. However, our technology allows patients to share their gender information with their provider prior to the appointment if they wish .

The technology then records and presents this data to clinicians and administrators throughout every step of the patient’s medical journey – including enrollment, scheduling, enrollment, checkout, patient communication, All the way to billing, follow-up, etc.

This technique does not add any additional workload to clinicians or administrators. It will only bring this vital data to the forefront, enabling healthcare providers to leverage the right data points over time so that their patients receive the most personalized, gender-affirming and appropriate care.

Goal This specific improvement aims to enable a more inclusive healthcare experience by increasing the availability and visibility of patient preferred names, gender identities, and pronouns. More broadly, this is just one aspect of our ongoing goal of improving health equity.

This initiative was born out of our first company-wide hackathon in 2021, Hack for Health Equity, in which groups of employees from across the country came up with a range of solutions, whether code-based Still creative to bridge equity gaps across the healthcare ecosystem.

Given the positive impact we have seen from this innovation, we will continue to pay more attention to how we can innovate to advance health equity and build a thriving and supportive healthcare ecosystem .

ask. What is the nature of the epocrates Transgender Care Guide and how do doctors and nurses access and use it?

Albert: Doctors and nurses can use the epocrates mobile app Program provides free access to an interactive care coaching tool, an app designed to be accessed at the point of care to support clinical decision-making.

Our nursing guidelines source and incorporate the latest guidelines from four major organizations: World Professional Association for Transgender Health (WPATH), Endocrine Society, American Academy of Pediatrics (AAP), and the United States College of Obstetrics and Gynecology (ACOG).

With so much misinformation spreading about the topic of transgender healthcare, we feel a responsibility to ensure that clinicians have access to the most accurate care guidance quickly and easily, especially since There is still a lot to learn about this topic from a clinical perspective.

In addition, the tool includes guidance to help clinicians interact with transgender patients and care with a more inclusive mindset. An example includes cancer screening guidelines.

We included gender-neutral terminology and transgender-specific recommendations for cervical, breast, and prostate cancer screening guidelines. We also included guidance on how clinicians can normalize gender expression and encourage a multidisciplinary care setting when treating patients.

Q. How does health IT create more welcoming spaces for transgender patients? And how does this ultimately improve health outcomes?

Livingstone: Health IT for Healthcare Healthcare providers create opportunities to help all patients feel cared for. Transgender people in particular are more likely to trust their providers when they can truly reflect themselves in their interactions with the healthcare system.

In addition, with the ability to understand the overall identity of transgender patients in the care process, clinicians can think more holistically when treating. Although subtle, these changes are major steps in building trust, which promotes health equity and positive health outcomes among transgender and nonbinary populations.

As more healthcare practices focus on respectfully affirming the gender of their patients throughout the care process, we will continue to understand the nuances of transgender healthcare , and explore how technology can play a bigger role in this journey.

Albert: Many times trans patients have to educate their doctors about trans health , but it shouldn’t be. The HIT industry, especially companies creating clinical decision support technology, can play an important role by providing education about caring for transgender and nonbinary patients that most medical schools do not currently offer.

By equipping clinicians with the most modern tools, resources and insights, they will be better able to support and deliver the most personalized care to these marginalized patient populations, leading to greater Good patient experience and outcomes.

Twitter: @SiwickiHealthIT
Email the author: [email protected]
Healthcare IT News is a HIMSS media publication.



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