Temporal and Geographic Patterns of Documentation of Sexual Orientation and Gender Identity Keywords in Clinical Notes

Bibliographic Data

ID9104321
AuthorsT Elizabeth Workman (0000-0002-2273-078X, Biomedical Informatics Center, corresponding author), Joseph L Goulet (0000-0002-0842-804X, Department of Emergency Medicine), Cynthia A Brandt (Department of Emergency Medicine), Cynthia Brandt (0000-0001-8179-1796, VA Connecticut Healthcare System), Louise Lindemann (0000-0003-2675-5244, Yale University), Luke Lindemann (Yale University), Melissa Skanderson (0000-0002-5539-8680, VA Connecticut Healthcare System), Allison R Warren (0000-0003-3621-3617, VA Connecticut Healthcare System PRIME Center, West Haven, CT), Jacob R Eleazer (Department of Psychiatry), Jacob Eleazer (0000-0002-2228-7933, VA Connecticut Healthcare System), Clair Kronk (0000-0001-8397-8810, Yale School of Medicine, corresponding author), Kirsha S Gordon (0000-0002-4925-1914, Yale School of Medicine, corresponding author), Mandi L Pratt-Chapman (0000-0002-9303-7659, George Washington University), Mandi Pratt-Chapman (GW Cancer Center, The George Washington University), Qing Zeng-Treitler (Biomedical Informatics Center), Qing Zeng‐Treitler (0000-0002-8353-7473, Translational Research Informatics Center (Japan), corresponding author)
Year2023
Volume61
Issue3
Pages130-136
Publication date2023-03-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000001803
PMID36511399
OpenAlexW4311288745
LanguageEN
Citations received1
References cited22

OBJECTIVE: Disclosure of sexual orientation and gender identity correlates with better outcomes, yet data may not be available in structured fields in electronic health record data. To gain greater insight into the care of sexual and gender-diverse patients in the Veterans Health Administration (VHA), we examined the documentation patterns of sexual orientation and gender identity through extraction and analyses of data contained in unstructured electronic health record clinical notes. METHODS: Salient terms were identified through authoritative vocabularies, the research team's expertise, and frequencies, and the use of consistency in VHA clinical notes. Term frequencies were extracted from VHA clinical notes recorded from 2000 to 2018. Temporal analyses assessed usage changes in normalized frequencies as compared with nonclinical use, relative growth rates, and geographic variations. RESULTS: Over time most terms increased in use, similar to Google ngram data, especially after the repeal of the "Don't Ask Don't Tell" military policy in 2010. For most terms, the usage adoption consistency also increased by the study's end. Aggregated use of all terms increased throughout the United States. CONCLUSION: Term usage trends may provide a view of evolving care in a temporal continuum of changing policy. These findings may be useful for policies and interventions geared toward sexual and gender-diverse individuals. Despite the lack of structured data, the documentation of sexual orientation and gender identity terms is increasing in clinical notes

Consistency (knowledge bases) · Documentation · Gender identity · Health care · Political science · Psychiatry · Psychological intervention · Repeal · Reproductive health · Sexual orientation · Sociology · Computer Science · Demography · Health Literacy and Information Accessibility · LGBTQ Health, Identity, and Policy · Medicine · Psychology · Sex and Gender in Healthcare · Social Psychology