2023 MIPS Improvement Activity IA_AHE_11: Create and Implement a Plan to Improve Care for Lesbian, Gay, Bisexual, Transgender, and Queer Patients

<h1>Activity Description</h1>
Create and implement a plan to improve care for lesbian, gay, bisexual, transgender, and queer (LGBTQ+) patients by understanding and addressing health disparities for this population. The plan may include an analysis of sexual orientation and gender identity (SO/GI) data to identify disparities in care for LGBTQ+ patients. Actions to implement this activity may also include identifying focused goals for addressing disparities in care, collecting and using patients’ pronouns and chosen names, training clinicians and staff on SO/GI terminology (including as supported by certified health IT and the Office of the National Coordinator for Health Information Technology US Core Data for Interoperability [USCDI]), identifying risk factors or behaviors specific to LGBTQ+ individuals, communicating SO/GI data security and privacy practices with patients, and/or utilizing anatomical inventories when documenting patient health histories.
<th>Activity ID</th>
<th>Activity Weighting</th>
<th>Sub-Category Name</th>
<td>Achieving Health Equity</td>
<h1>Objective & Validation Documentation</h1>
Objective: Begin to address disparities in health care and health outcomes for LGBTQ+ people by creating and implementing a plan to improve care for lesbian, gay, bisexual, transgender, and queer patients.

Validation documentation: Evidence of a practice-wide review and implementation of a plan to improve care for LGBTQ+ patients.
1) Review – Documentation of a practice-wide review of existing tools and policies; AND
2) Assessment memo – Completion of an assessment memo summarizing the results of the above review; AND
3) Plan to Improve Care for LGBTQ+ patients – A new or updated plan, which includes actions, intended outcomes, and timeline for completion for the eligible clinician’s practice; this plan must identify ways in which issues and gaps identified in the review can be addressed and should include target goals and milestones, and the eligible clinician or practice should also consider including training on sexual orientation and gender identity; AND
4) Plan Implementation – Report with results from implementing the new or updated plan for improving care for LGBTQ+ patients.

Example(s): A practice-wide review indicated that existing website and human-resources documents do not mention a commitment to inclusion of LGBTQ+ people, and that electronic medical records data on sexual orientation and gender identity are frequently incomplete. The practice updated its website and human-resources materials to reflect its commitment to caring for LGBTQ+ patients, and trained clinicians on best practices for gathering and documenting sexual orientation and gender identity data in health records.

• This Institute of Medicine report assesses the state of science on the health status of LGBT populations in three life stages – childhood and adolescence, early/middle adulthood, and later adulthood: The Health of Lesbian, Gay, Bisexual and Transgender People: Building a Foundation for Better Understanding. (https://nap.nationalacademies.org/catalog/13128/the-health-of-lesbian-gay-bisexual-and-transgender-people-building)
• CMS offers a one-hour web-based training course for health care providers and staff who are responsible for collecting Medicare patient data from LFBTQ people: Improving Health Care Quality for LGBTQ People. (https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN3390633-OMH-LGBTQ/OMHLGBTQ/sogi/index.html)
• This 2019 article by Chris Grasso et. al. presents recommendations for planning and implementing high-quality sexual orientation and gender identity data collection in health care practices: Planning and implementing sexual orientation and gender identity data collection electronic health records. Journal of the American of Medical Informatics Association 2019 Jan 1:26(1)66-70. (https://pubmed.ncbi.nlm.nih.gov/30445621/)
• This training manual from the National LGBT Health Education Center provides information for clinicians and other staff working in health care to help them understand transgender and gender-diverse people and their health needs, and offers tips and strategies for communication with and about transgender and gender-diverse individuals: Affirmative Services for Transgender and Gender-Diverse People. (https://www.lgbtqiahealtheducation.org/wp-content/uploads/2020/03/TFIE-40_Best-Practices-for-Frontline-Health-Care-Staff-Publication_web_final.pdf)