Recommended
Recommended
More Related Content
Similar to Inclusion & Equity: Understanding SOGI Data Collection
Similar to Inclusion & Equity: Understanding SOGI Data Collection (20)
More from Accelerate Utah
More from Accelerate Utah (7)
Recently uploaded
Recently uploaded (20)
Inclusion & Equity: Understanding SOGI Data Collection
- 2. C O N F I D E N T I A L OBJECTIVE INTRODUCTION TO CONCEPTS & TERMINOLOGY UNDERSTANDING OF WHY WE NEED TO ASK THIS INFORMATION WHAT IS YOUR ROLE
- 3. C O N F I D E N T I A L Quick Facts about the State of Utah WHY | EVERY PATIENT COUNTS Source • Based on these assumptions, we estimate we are seeing more than 270 LGBTQ+ a day at U of U Health. • Consistently asking our patients for their SOGI data will allow us to better understand our patient population at U Health
- 4. C O N F I D E N T I A L Asking for SOGI may feel unfamiliar. Asking SOGI information of patients is not about changing anyone’s personal, religious or political beliefs. You are not expected to understand the complexity of gender and sexuality. COMPASSION OVER COMPREHENSION
- 5. C O N F I D E N T I A L WHY Empowers our healthcare system to get to know our patients better. Provides our patients with culturally responsive, patient-centered services they deserve. LGBTQ+ people experience significant health disparities that are necessary to capture in our local communities so we can target initiatives to improve access to care.
- 6. C O N F I D E N T I A L WHY | TARGET HEALTH DISPARITIES Less likely to seek preventative care More likely to delay necessary care Higher cancer rates, suicide rates, smoking, drug/alcohol use Higher uninsured rates LGBTQIA+ HEALTH DISPARITIES
- 7. C O N F I D E N T I A L Clinical Decisions ∙ Knowing a patient's SOGI details can help us provide the most appropriate care - Preventive care and safety measures based on anatomy, not sex WHY | APPROPRIATE PATIENT CARE Prostate exam for a trans-feminine patient Pap for a trans- masculine patient Appropriate Radiology precautions for patients based on anatomy Sexual behaviors to watch for certain health concerns i.e. PrEP for HIV prevention
- 8. C O N F I D E N T I A L PROJECT LEADERSHIP Kimberly Killam She/Her Operations Project Manager II Kim Pacheco She/Her Director, Revenue Cycle Support Systems Patient Access CLINICAL EXECUTIVE SPONSOR Cori Agarwal, MD She/Her Associate Professor, Division of Plastic Surgery Director, Transgender Health Program PHYSICIAN SPONSOR PROJECT LEAD PROJECT SPONSOR PROJECT MANAGER Ariel Malan, MHA She/They Outreach Network and Development Specialist University of Utah Health Transgender Health Program John Inadomi, MD He/Him/His Chair of the Department of Internal Medicine ADMINISTRATIVE EXECUTIVE SPONSOR Gina Hawley, DrPH, MHA She/Her Chief Operating Officer
- 9. C O N F I D E N T I A L MULTIDISCIPLINARY PROJECT TEAM PATIENT EXPERIENCE CLINICAL SUPPORT OPERATIONS PROJECT SUPPORT EDUCATION Full Project Team ∙ Transgender Health ∙ Health Equity, Diversity, & Inclusion ∙ Patient Experience ∙ Transgender Health Patient & Family Advisory Board ∙ Community Engagement ∙ Physicians ∙ Nursing ∙ Nursing Informatics ∙ Laboratory ∙ HR EDI Consultants ∙ IT Training ∙ Clinical Staff Education ∙ IT ∙ OEO ∙ General Counsel ∙ Research ∙ Project Management ∙ Revenue Cycle/Front End ∙ Care Navigation ∙ Huntsman Mental Health Institute ∙ Huntsman Cancer Institute
- 10. C O N F I D E N T I A L TERMINOLOGY / FIELD DEFINITION Chosen Name The name a person chooses to be addressed by. This name may differ from a person's legal name. Also known as preferred name or name used. Pronouns Words we use to refer to someone when not using their name. Examples: he/him/his, she/her/hers, they/them/theirs and others Legal Sex This represents the sex used for legal | administrative purposes. Sex Assigned at Birth The sex (male or female) assigned to an infant, most often based on the infant’s anatomical and other biological characteristics. Gender Identity A person’s inner sense of being a girl/woman/female, boy/man/male, something else, both, or having no gender. Sexual Orientation How a person characterizes their emotional and sexual attraction to others. TERMINOLOGY 101
- 11. C O N F I D E N T I A L 2% 98% WHY | KNOWING OUR PATIENTS BETTER 1.7% 98.3% 30.4% 69.6% 24.5% 75.5% 43.1% 56.9% Documented Not Documented Outpatient visits | Location: All | Department: All | Appt Provider: All | NPV vs. RPV: All | 2/1/22-2/16/23 PATIENT SOGI DATA Chosen Name Pronouns Sex Assigned at Birth Sexual Orientation Gender Identity
- 12. C O N F I D E N T I A L ∙ Workflow proposal ∙ Data collection reporting ∙ SOGI pulse & public patient webpage ∙ SOGI pilot plan proposed ∙ SOGI super user expectations drafted ∙ Staff resources bank, including confidential email ∙ Education feedback and updates initiated ∙ MyChart updates ∙ Expanding/correcting SOGI values in Epic ∙ Pronoun display in Epic ∙ Update to visit and chart labels ∙ Loop screens posted ACHIEVEMENTS
- 13. C O N F I D E N T I A L Legal name Name used or chosen name Legal sex Pronouns (coming soon) STAFF AND CLINICIAN SOGI DATA ENTRY SCHEDULING & REGISTRATION CLINICAL STAFF & PHYSICIANS/APCs WHO & WHAT WHERE ALL CLINICAL LOCATIONS Especially important: Primary Care Emergency Department Radiology Surgery Pronouns Sexual Orientation Gender Identity Sex Assigned at Birth Organ Inventory (Physicians/APCs only) Patients 18 and older to be asked for their SOGI data Clinical Staff may include Techs, MAs, RNs, or other roles.
- 14. C O N F I D E N T I A L ∙ Livestreams ∙ Direct Leadership PRESENTATIONS SUPPORT EDUCATION ∙ Tip sheets ∙ Accelerate Articles ∙ Pulse ∙ Super Users PATIENT EDUCATION ∙ SOGI Webpage ∙ Loop Screens Virtual Learning ∙ Fundamental SOGI Learning ∙ Epic How to HOW | EDUCATION PLAN
- 15. C O N F I D E N T I A L CURRENT STAFF RESOURCES SOGI PULSE PAGE • Additional Resources • LMS E-Learnings • (Search Best Practice for Gender Affirming Care) • Best Practices • Tip Sheets SOGI WEBPAGE • Information for our patients • What, Why, How TRANSGENDER HEALTH PULSE • Staff and Provider Resources • Patient and Family Resources • Request Trainings ASK ADMIN EMAIL • Confidential inbox for SOGI related questions
- 16. C O N F I D E N T I A L Pilot the SOGI workflow, Epic features, and education PILOT BECOME FAMILIAR WITH SOGI Utilize current resources to learn more about SOGI • Pulse Page • Public SOGI Website • E-Learning Finalize SOGI education and create a deployment plan EDUCATION Finalize the SOGI data collection workflow WORKFLOW STAFF PROJECT NEXT STEPS
- 17. C O N F I D E N T I A L THE ASK PROJECT SUPPORT HELP TO BREAK DOWN BARRIERS PROMOTE CULTURAL READINESS
- 18. C O N F I D E N T I A L THANK YOU QUESTIONS?
Editor's Notes
- Acknowledging some of these emotions that come with diversity, equity and inclusion projects is essential to creating a shared understanding of our goals. SOGI – sexual orientation and gender identity is an important part of our EDI mission.
- Our objective for today, is for you to become familiar with the SOGI project. We’ve put together a list of resources that will be linked and available to you after the presentation that you can start engaging with today.
- Recent research is telling us that at least 20 million adults in the US identify as LGBTQ+, in Utah we have older data showing us that 3.7% of our population is LGBTQ. This ends up being approximately 270 patients a day at U Health, even if our overall volumes are low for an average of 7300 outpatient visits a day. Asking about SOGI not only supports our patients, but it also supports our staff. When we give our patients and employees the option to self-identify we are saying we see you and you are valued here. But we can also look at that data and make informed decisions that improve the experiences our employees and patients are having in our system.
- We do understand that asking for SOGI may feel unfamiliar and recognize this can bring up many feelings from discomfort, apprehension, uncertainty or perhaps excitement and passion. SOGI is part of our mission/vision/values (here on right) We want to be clear, asking SOGI information of patients is not about changing anyone’s personal, religious or political beliefs but this is a necessity for all patients as we are a human-first organization. We provide compassionate care without compromise. This means you are not expected to understand the complexity of gender and sexuality, but it is necessary to respect all patients. Asking for SOGI Data also supports out LGBTQ+ Staff
- We provide compassionate care without compromise. Asking for SOGI Data also supports out LGBTQ+ Staff
- So why ask all of our patients about their SOGI? Because information is power, and accurate SOGI data is necessary to identify health disparities, provide inclusive and welcoming care, and improve health outcomes. During COVID, we were able to correlate COVID infection with race and found that our communities of color were being hit the hardest by this virus. We weren’t able to do that with SOGI because we did not have the data. The data we do have is that LGBTQ+ people have worse health outcomes compared heterosexual people: they’re less likely to seek preventative care, more likely to delay necessary care and are more likely to be uninsured. We also know that transgender and bisexual communities have higher rates of poor health outcomes compared to lesbian and gay communities, so even that granularity tells us a story about the experiences our patients are having.
- SOGI also plays an important role in the clinical care we deliver from recommending a pap smear for a transmasculine patient who still has a uterus, to informing patients about preventative health measures they can take based on sexual behaviors. Too often our staff and clinicians will look at someone’s legal sex and have that lead their assumptions about a person’s organs and their health needs, instead of asking questions about SOGI to get them more accurate information. There is a common misconception about asking SOGI, which is “what if patients get angry with us for asking them about this?” Research conducted on asking SOGI in health centers shows us even heterosexual/straight patients don’t mind being asked about SOGI if they know why they’re being asked and how that information is being used to support their health. SOGI, is also optional to disclose, so if they don’t want to answer for any reason, they have the option to not disclose. There is a QR code on your handout and at the end of the presentation that leads to a public facing webpage about SOGI that patients can visit.
- Because this project impacts all of our patients across the system we created a committee that has broad representation from several areas. We utilize our executive sponsors and project leadership to steer the bigger group, and have engaged folks for smaller subgroups based on project needs.
- So let’s briefly touch on a few terms to make sure we have the same foundation of understanding. Throughout the presentation we will be using the term SOGI, this refers to sexual orientation and gender identity, however we’ll be talking about other terms listed here as part of overall SOGI data collection. Chosen name, this used to be called preferred name, this is the name that someone chooses to use that may be different than their legal name. Pronouns are the words we use to refer to people when not using their name so examples you are already familiar with include she/he/they. Legal sex is the sex listed on legal forms of ID such as driver’s licenses, birth certificates, insurance cards etc. Sex assigned at birth is documented by a clinician when an infant is born, this is usually only based on the presence of anatomical features and doesn’t consider chromosomes or hormones. Gender identity is our internal sense of gender, it’s who we feel like we are. These concepts of gender including man/woman, or non-binary are what we call social constructs and they’re defined by the society we live in. Up to this point in time, at least in European and American society, we have based medicine around these binary assignments of gender and sex. Sexual orientation is our physical, emotional, and romantic attachments to others. All of these concepts are independent of each other and one doesn’t predict the other for example someone’s gender identity does not necessarily predict what their sexual orientation will be and vice versa. The most important thing to highlight about these terms is that everyone has these. This is why we want to collect this information from all of our patients which we’ll discuss.
- We don’t have to start from zero, we do have some data collection already Patients have been able to updated Chosen name, Sexual orientation, and Gender Identity in MyChart. Chosen name education was rolled out 2017, this has supported higher data collection for chosen name. Pronouns (From Patient Chosen Name Dashboard ) 9,589 (1.72%) with + without 549,015 (98.3) = 558,604 Chosen Name (From Patient Chosen Name Dashboard ) 257,585 (46%) with + without 339,569 (60.79)= 597,154 Sexual Orientation (from Outpatient Dashboard): 136,598 (24.46) with + 421,937 (75.54) without = 558,535 Gender Identity (from Outpatient Dashboard): 169,596 (30.36) with + 388,939 (69.64%) without = 558,535 Sex assigned at birth (from Outpatient Dashboard1 14,183 (2.54%) with + 544, 352 (97.46%) without = 558,535
- So what has the project workgroup completed so far? We have created workflows and education to support staff and clinicians. We’ve incorporated patient feedback through the Patient Design Studio and the Transgender Health Program patient and family advisory board. We have made updates in both Epic and MyChart to include more SOGI options and to allow for better self-reporting by the patient. We’ve also gotten buy in from NCOC, LOC, and created dashboards to help us measure our capture rates and provide outreach and coaching to those departments who may be struggling. These dashboards could be utilized by the system in the future to measure health disparities.
- MyChart is preferred by patients and best practice. Due to Epic limitations and risk of outing minors, the SOGI committee and with the direction of the Adolescent Medicine Clinic at Primary’s, we will not be collecting SOGI of minors. When Epic enhances their privacy for minor patients, we will re-address SOGI for this population. Providers are able to update SOGI for minor patients but patients should be educated about who has access to their medical record.
- You will be supported in asking SOGI of patients, our goal is to help you feel confident asking these questions of patients. Visit our SOGI pulse page for the full list, but note that you can ask confidential questions through the Ask Admin email. You all are key players in helping us create a welcoming environment for all of our patients and collecting SOGI helps us do that.
- Next step is for you to become more familiar with SOGI. We’ll touch on where you can find those next. Our committee is working on the workflow to obtain SOGI data We are recommending our Educational materials be required for all new hires and annually for all staff. This will promote the cultural readiness we need and promote the Promise Standards. We will identify a clinical site to test pilot test our program.
- SOGI is an integral part of our vision to create an inclusive environment in which everyone feels they belong and can thrive in our UofU community.