The National LGBT Health Education Center Harvey J. Makadon, MD Director, National LGBT Health Education Center, The Fenway Institute, Clinical Professor of Medicine, Harvard Medical School Annual Community Health Institute May 9-11, 2012 Resort & Conference Center of Hyannis Hyannis, MA
Massachusetts League of Community Health Centers Community Health Institute May 11, 2012 Harvey J. Makadon, MD Director, National LGBT Health Education Center The Fenway Institute Clinical Professor of Medicine Harvard Medical School 2
Who We Are The National LGBT Health Education Center provides training, educational resources, and technical assistance to health care organizations in order to help them optimize their ability to provide accessible, high quality, and cost effective care to LGBT people. We are a division within The Fenway Institute. 3
National Cooperative Agreement(NCA) 2011 award from HRSA s Bureau of Primary Health Care The first and only NCA for LGBT health Supports free trainings and technical assistance for all health centers (FQHCs & look-alikes) Collaborations with other NCAs, Primary Care Associations, Departments of Health 4
Needs Assessment: Preliminary Results 147 health centers, 9 PCAs, 21 state public health departments 60% urban, 40% rural health centers Percentage responding that at least 20% of their patients were: African American, 40% Latino/Hispanic, 60% Asian/Pacific Islander, 4% American Indian, 4% Very high level of interest; 90% of respondents are interested in LGBT health education trainings on the topics we offer 5
6 Needs Assessment: Respondents Perceptions and Practices 29% rarely/never see LGBT patients in their health centers 78% probably have a lot more LGBT patients than they know 34% include sexual orientation on their intake forms 84% feel their governing board would support them in pursuing training in LGBT health care
Needs Assessment: Typical Narrative Comments [Need training on] respectful and appropriate language, especially for transgender individuals. How to best serve non [LGBT]-identified men and women in our primarily Latino population. Stigma associated [with LGBT individuals] in this small rural community is a barrier to offering training. [Our patients are] spread out over [thousands of] square miles. [A]ny LGBT adults here would be extremely reluctant to self identify. 7
What We Offer-Now Webinars and workshops Grand Rounds Publications The Fenway Guide-A New Second Edition Learning about Sexual Health and Behavior: Implications for Patient Centered Medical Home Innovation (NACHC) Website: www.lgbthealtheducation.org Blog / LGBT health news Archived webinars, CME Links to Suggested Resources 8
Core Content Who: LGBT Demographics Why: LGBT Heath Disparities Optimizing LGBT Care Throughout the Life Cycle (Youth, Mid-life, Older Adults) Transgender Identity and Health HIV/STD Screening and Prevention Creating an Environment of Inclusion The ACA, PCMH s and LGBT Health 9
Where We re Working 10
Affordable Care Act: Innovation to Enhance Clinical and Cost Effectiveness Health Center Patient Centered Medical Home 11
Our Work: Facilitating Change Readiness Assessment Creating an Inclusive Environment Managing the Health of LGBT People Developing Action Steps to Optimize Systems and Care Facilitating the Process Education Technical Assistance In collaboration with health centers 12
Creating Systems for Change! 13
How well do you know the patient s seen in your health center? How do you find out? New Patients New Lesbian/Gay or Transgender Patients How do people feel and what do they do when learning this?
Why gather data on sexual orientation and gender identity? Increases ability to screen, detect, and prevent conditions more common in LGBT people Helps develop a better understanding of patients lives Allows comparison of patient outcomes with national survey samples of LGBT people Patients may feel safer discussing their health and risk behaviors once they ve disclosed 15
SO/GI data reported SO/GI data not reported LGBT data can be gathered at patient contact points during the process of care and integrated into the EHR Information Entered Into EHR Data Input At Home Arrival Register Onsite Provider Visit Input From History YES NO Self Report of Information on Sexual Orientation (S.O.) and Gender Identity (G.I.) Information Entered into EHR 16
PCMH 2011 Core Standards PCMH 1: Enhance Access and Continuity PCMH 2: Identify and Manage Patient Populations PCMH 3: Plan and Manage Care PCMH 4: Provide Self-Care and Community Support PCMH 5: Track and Coordinate Care PCMH 6: Measure and Improve Performance
Implementing Change Elements of Population Health Define and Identify Populations Understand Unique Health Issues Develop Best Practices Quality Cost LGBT Health-Creating Clinical Practice Guidelines Transgender Health Care Behavioral Heath HIV Prevention and Care 18
19 www.lgbthealtheducation.org
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