How To Talk About SOGI With Our Patients

We use Sexual Orientation and Gender Identity (SOGI) information to communicate respectfully with our patients, support their health care needs and build trust. Complete SOGI data is essential to providing safe, effective care—health maintenance, preventative care, medication dosing, lab reference ranges and other clinical decisions are frequently impacted by a patient’s SOGI.

SOGI data includes:

• Preferred name
• Legal sex
• Sex assigned at birth
• Gender identity
• Preferred pronouns

Asking About SOGI

Discussing SOGI information can feel uncomfortable at first. Approach it the same way you ask about any other patient data—in a pleasant, respectful and open manner. Here are some sample phrasing suggestions and notes:

Preferred Name

• "What name would you like us to use when we communicate with you?"
• "What name do you use?"
• "Would you like me to document a preferred name? Our providers and staff will use this name when communicating with you."

Legal Sex

• "For legal reasons, the legal sex in our system must match your government ID. But I can document your gender identity so our staff will know how to address you." Note: Many states, including Virginia, acknowledge a third legal sex, abbreviated on government IDs with an X or NB. In Epic, this is reflected by the term non-binary.

Sex Assigned at Birth

• "What sex were you assigned on your original birth certificate? This information helps us provide you with the best possible care."

Gender Identity

• "How would you like me to document your gender identity?"
• "What is your gender identity?" Note: Document gender identity using whatever language the patient uses. If the patient uses language that doesn’t correspond to one of the available choices, select Other.
• Many transgender individuals identify as male or female—only select Transgender Male or Transgender Female if this is how the patient describes themselves.

Pronouns

• "What pronouns would you like us to use when communicating with or about you?"

Epic Data Collection Process

When a patient discloses any SOGI information, collect and update each of the Epic fields listed at the top of this article. SOGI data is disclosed when a patient:

• Presents a legal ID with an updated first name or legal sex
• Presents a legal ID with a non-binary sex marker (represented in Virginia with X)
• Asks for their name or sex to be updated in the medical record (without legal documentation)
• Verbally discloses SOGI information to you Note: Clinical staff cannot update the Legal Sex field. If a patient’s legal sex needs updating, refer the patient to a registration staff member. 

With the recent Epic upgrade, SOGI information became more accessible for documentation in Epic. The SOGI SmartForm was added to Family and Internal Medicine Rooming Navigators as well as the Inpatient Admission navigator. As before, the SmartForm is always accessible by clicking the patient’s gender marker in Storyboard. This information should be recorded any time a patient shares it with clinical or non-clinical staff members. Since May, there have been nearly 1,000 SOGI SmartForm inquiries and we continue to see higher trends of documentation of patient preferred pronouns. Thank you for working to improve communication with our patients to deliver exceptional care!

Improved Clinical Decision Support

Providers and pharmacists now receive notifications in Epic when a patient has relevant SOGI data that impacts clinical decision-making. More detailed information is available in the SOGI SmartForm.

If you have questions, please reach out to Todd Null and Dawn Murray, Education and Organizational Development, at SOGI_Help@carilionclinic.org.