the national lgbt health education center · the fenway institute clinical professor of medicine...
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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
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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
Who We Are
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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.
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
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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
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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
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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.”
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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
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Core Content Who: LGBT Demographics
Why: LGBT Heath Disparities
Optimizing LGBT Care Throughout the Life Cycle (Youth, Mid-life, Older Adults)
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Transgender Identity and Health
HIV/STD Screening and Prevention
Creating an Environment of Inclusion
The ACA, PCMH’s and LGBT Health
Where We’re Working
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Affordable Care Act: Innovation to
Enhance Clinical and Cost Effectiveness
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Health Center Patient Centered
Medical Home
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
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Creating Systems for Change!
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
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LGBT data can be gathered at patient
contact points during the process of
care and integrated into the EHR
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Provider
Visit
Input From
History
Self Report of Information on Sexual
Orientation (S.O.) and Gender
Identity (G.I.)
Data
Input At
Home
Arrival Register
Onsite
SO
/GI
data
rep
ort
ed
SO
/GI
data
no
t
rep
ort
ed
Information
Entered
into EHR
Information
Entered Into
EHR
NO
YES
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
www.lgbthealtheducation.org
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“Like” us on Facebook…
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Questions?