Over 1.4 million Americans identify as part of the transgender community and, moreover, are faced with increased mortality rates and lower life expectancies. This is due to many factors such as acts of violence, suicide, acquired immunodeficiency syndrome, cardiovascular disease, drug abuse, and various cancers.
Some may not feel like there’s much that can be done to change these factors, but in the sphere of health care, that’s changing. Improving the patient experience from beginning to end is a starting point. Making simple changes such as ensuring that the patient’s correct name and pronouns are being used during registration, throughout the patient’s stay, and through any follow-up appointments, can actually make a huge difference in patient outcome. In doing so, health care teams can provide validating experiences and build trust with the patient.
Inclusive software has been proven to improve the patient experience and promote patient safety. Members of the transgender community have historically low rates of cancer screenings. In one study published by the American Cancer Society, eligible transgender patients were approximately 70 percent less likely than cisgender patients to be screened for breast cancer, 60 percent less likely to be screened for cervical cancer, and 50 percent less likely to be screened for colorectal cancers. According to one physician in this study, these patients “remain susceptible to cancers of reproductive organs that are no longer in alignment with their gender.” Some contributing factors to these historically low rates of cancer screening include the individual’s fear of discrimination, lack of provider education, and electronic systems failing to send out appointment reminders based on patients’ documented identifiers. Health care systems and the software platforms they use can implement guardrails so that no patient is missed.
The transgender population is also at increased risk of cardiovascular disease, specifically transgender men. The Journal of the American Heart Association published a study that revealed transgender men had greater than a two-fold and greater than a four-fold increase in the rate of myocardial infarction compared to cisgender men and cisgender women, respectively. How can health systems clearly indicate and identify these risk factors and display them to providers?
Lab results pose another potential risk factor for this population. Lab reference ranges are often split out by male and female, and what’s considered an elevated level for one sex may not be for the other. If we had a trans man, for example, their legal identification might be male, and their health care provider compares their lab to the standard range for males. This lab may not appear to be elevated. But when comparing it to the biologically female population, perhaps that same lab result would potentially be flagged as abnormal. Health systems need to help ensure that providers are using proper reference ranges based on their patients’ anatomy to prevent patient harm.
What can we do in the sphere of intervention and mental health? Transgender teenagers and adults face increased substance abuse and suicide rates. The largest survey of transgender people in the U.S. to date found that 81.7 percent of respondents reported ever seriously thinking about suicide in their lifetimes, while 48.3 percent had done so in the past year. What are practices doing to increase outreach to these populations? How can electronic health systems help automate that process?
At pMD, we can create customized workflows designed to streamline patient engagement for various scenarios. We can all help move the needle forward to improve patient care, whether it’s embracing new education and new workflows, or continuing to develop inclusive software with the patient in mind. pMD is ever-evolving to serve the needs of patients and practices. Contact us to learn more about how pMD can best assist you and your practice!
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