Eric,
What a great question to pose! To be honest, I hadn't thought of this, but it makes so much sense! I don't think patients are aware of things like CareEverywhere or other PHI-sharing software, so it's likely not top of mind when they disclose sensitive information. I wonder what this looks like for HIV-status, which often requires more safeguards. Unfortunately, I don't have a lot of answers, but would be happy to collaborate. This would be a great op-ed to get people thinking...
Katie
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Katie Fasullo DNP, RN, GERO-BC
Corporate Director of Population Health and Health Equity
Evanston IL
United States
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Original Message:
Sent: Sun August 07,2022 11:26 PM
From: Erik McIntosh
Subject: Unintentional Outing of Patients in the EMR
I just posed this question to the Nursing Informatics Community and wanted to post it here too. Does anyone know if there is guidance regarding protecting patients' SOGI information in the EHR when patients move across state lines?
My concern is that patients who reside in states with LGBTQ protections, like Illinois or NY, are encouraged and want to share their SOGI information. However, if they then move to states like Texas or Florida, their SOGI information can easily be shared via EMR capabilities like Epic Care Everywhere, putting them at risk of being denied healthcare access and discrimination. I'm not confident that a majority of patients are aware of this or think about this risk.
With states actively pursuing anti-LGBTQ legislation and policy, especially in healthcare, I think healthcare providers need guidance on how to educate their patients about this potential unintentional outing in the EMR. I'm also curious if EMR companies, like Epic, have any safeguards in place to protect SOGI information if a hospital system in a non-affirming LGBTQ state requests records---ie) SOGI information needs to be re-entered in the EMR for states like Texas or Florida in order to allow patients to reassess the safety of sharing their SOGI information in another state.
I would like to write an article on best practices for providers and anyone with interest or ideas on this topic, I would love to collaborate!
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Erik McIntosh, DNP, RN
Acute Care Nurse Practitioner
Chicago, IL
U.S.A
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