Capturing sexual orientation and gender identity information in electronic medical records to inform the person-centred care of sexual and gender minority people.

BACKGROUND

The healthcare disparities of sexual and gender minority (SGM) people are globally recognised. Research from the United States has advocated for sexual orientation and gender identity (SOGI) information capture via the electronic medical record (EMR) to support the generation of knowledge regarding SGM people's healthcare needs and the appropriate care for this population. In November 2022, The Royal Melbourne Hospital (RMH) enabled the SOGI capture EMR functionality. The purpose of this study is to understand how SOGI capture can inform the person-centred care of SGM people by way of interviews with SGM patients and RMH staff. It quantitatively describes RMH SOGI capture throughout the study period to provide additional insights.

METHODS

This study uses an embedded mixed-methods design: qualitative data are primary and quantitative data are supplementary. SOGI capture uptake at RMH informed the recruitment of SGM patients (n = 11) and RMH staff (n = 13). Participants were engaged in in-depth semi-structured interviews that were then reflexively thematically analysed. SOGI capture throughout the study period (8th November 2022 to 23rd September 2024) was quantitatively described via frequency and percentage and then analysed in relation to the qualitative results to provide additional insights.

RESULTS

Interviewed participants considered SOGI capture a significant step toward providing person-centred care for SGM people. However, participants shared problems in SGM healthcare and expressed that for SOGI capture to benefit SGM patients, staff must be aware of not only SOGI capture but also SGM healthcare issues. Other recommendations for SOGI capture included patient informed consent; patient preferences accurately captured; and mandatory SOGI questions to normalise this process. During the study period 272,672 patients were admitted to RMH, of which there were 2,174 (0.8%) SGM SOGI captures; 2,000 (0.7%) captured a gender identity that was not 'male' or 'female' and 1,113 captured a sexual orientation that was not 'straight' or 'not reported' (0.4%). These numbers demonstrate SGM patients' minority status and signal the need for more staff and patient awareness of SOGI capture and mandatory SOGI questions to increase the representation and knowledge of this population and ultimately improve its care provision. A diversity of identifiers for this population was captured (10 sexual orientation identifiers and 14 gender identity identifiers) which demonstrate the significance of recognising SGM patient preferences.

CONCLUSION

This study presented an in-depth exploration of how SOGI capture can inform the person-centred care of SGM people if staff are aware of SGM healthcare issues, and if SOGI capture is done according to patient preference and consent and is normalised through mandatory questions. Insights and recommendations generated from this study can inform local and international policies and processes in the implementation of SOGI capture such that it can inform person-centred care for SGM people.