The IT department and staff are key in implementing an effective framework for collecting and using structured data on sexual orientation, gender identity, and other related aspects of patient identity within a hospital or health system. IT staff can identify infrastructure capacity and needs and are best able to integrate the necessary elements of the framework (codes, fields, etc.) into existing systems or, if needed, to modify the systems that exist.
Various questions that arise in the IT context around collecting sexual orientation and gender identity data include:
- Is it possible to incorporate the actual script for asking the questions on the registration screen so front-line staff can explain or provide the rationale for why they are asking patients to provide information related to their sexual orientation and gender identity?
- Can a “declined” response category be added for those patients who do not want to answer this question and decline to do so (this is different than “unavailable”)?
- Is it possible to flag these responses in different colors to make it easier for staff (e.g., “declined” indicates do not ask again, and “unavailable” indicates ask again)?
- Who will have access to the data, and can access permissions be easily modified?
- Can modifications be made to the fields as terminology and concepts evolve over time?
- Will all registration staff (in the hospital and those off-site) see the same registration screens once modifications are made?
- How should decision support protocols build on the sexual orientation and gender identity data in these fields to assist clinicians in providing appropriate care for the clinical health care needs of LGBT people?