Vanderbilt has now developed a three-stage implementation plan for modifying the 210 unique clinical intake forms used by its 95 physician practices. The recommended text for use on the intake forms includes two parts. The gender identification section asks for patients’ legal name; their preferred name, if different; their sex at birth; and their gender identity—male, female, transgender, and prefer not to answer. The sexual orientation section asks if the patient is heterosexual, straight, lesbian, gay, bisexual, queer, something else, or prefer not to answer. In developing these questions, the Vanderbilt team considered the same issues that the previous speakers had identified: Who is asking the questions? Where is the information recorded in the EHR? How often is the patient asked for this information? What to ask in terms of identity versus behavior?
In summary, Ehrenfeld made the following three recommendations:
Given the importance of training providers and health care system staff prior to introducing questions about sexual orientation and gender identity, it is critical to begin thinking about how to accomplish that training early in the process, said Robin Weinick. For most health care systems,