Documentation of Sexual Partner Gender is Low in Electronic Health Records

BACKGROUND: The 2011 IOM report on the health of LGBT populations recommended that data on sexual orientation and gender identity (SO/GI) be collected in electronic health records (EHRs). Most EHRs cannot document SO/GI, but some can record gender of sexual partners. Little is known about the rate at which sexual partner data are recorded in EHRs or factors associated with documentation.

AIMS: To determine the proportion of patients with gender of sexual partners recorded in the EHR and to identify factors associated documentation.

METHODS: Retrospective analysis of 170,570 adult patients seen at 40 internal medicine (IM) and family medicine (FM) practices. The primary outcome was documentation of sexual partner gender, captured in the EHR. We examined the proportion of patients with this documentation and used multivariate logistic regression to assess factors affecting documentation.

RESULTS: 76,767 patients (45%) had the gender of sexual partners recorded. Among those, 4.3% had same-gender partners. Sexual partner gender documentation was independently higher for women; blacks; patients with a preventive visits; those with a physician assistant, nurse practitioner, or resident provider (vs. attending); those seen at urban practices; those at smaller practices; and those at a residency-affiliated FM practice, residency-affiliated IM practice, or non-residency IM practice (vs. non-residency FM practice). Older age and Medicare insurance were independently associated with lower documentation.

DISCUSSION: Documentation of sexual partner gender in the EHR is low. Primary care practices should make efforts to routinely record this information, and more work is needed to identify best practices for collecting SO/GI data.