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LB11 Transforming Primary Care for LGBT People

Thursday, September 22, 2016
Galleria Exhibit Hall
Bruce W. Furness, MD, MPH1, Dan Lentine, MPH2, Kathy McNamara, BSN, MA3, Ashley Barrington, MBA4, Rodney VanDerwarker, MPH5, Lauren Bifulco, MPH6, Kelly Gagnon, MPH7 and Wanda Montalvo, PhD, RN7, 1DC DOH - HIV/AIDS, Hepatitis, STD and TB Administration, Division of STD/TB Control, Centers for Disease Control and Prevention, DSTDP, Washington, DC, 2Centers for Disease Control & Prevention, 3National Association of Community Health Centers, Washington, DC, 4National Association of Communith Health Centers, 5The Fenway Institute, Fenway Health, Boston, MA, 6Communith Health Center Inc., 7Community Health Center Inc.

Background: “Transforming Primary Care for LGBT People” is a year-long multi-institution collaboration to increase community health center capacity to provide culturally responsible comprehensive primary care for Lesbian, Gay, Bisexual, and Transgender (LGBT) populations.  The objective of this study was to assess the implementation of the Practice Improvement Collaborative (PIC) - which uses quality improvement methods to drive practice transformation, system improvement, and implementation of best practices.

Methods: Ten health centers were carefully chosen to implement the Collaborative and report on five Phase 1 measures monthly from March 2016 - March 2017.

Results: As of June 23, 2016, eight out of ten centers reported data for March, April and May on patients seen within the past 12 months – two from their electronic health record, three from chart reviews of a subset of patients, and three with unknown methods.  The percentage of patients with documented Sexual Orientation and Gender Identity was 1.8% (1089/60589) in March, 3.5% (2315/65377) in April, and 5.9% (4168/70597) in May.  The percentage of LGBT patients with documented sexual histories was 32.8% (41/125) in March, 36.2% (59/163) in April, and 32.0% (64/200) in May.  The percentage of LGBT patients screened for syphilis was 12.8% (16/125) in March, 14.1% (23/163) in April, and 12.5% (25/200) in May.  The percentage of LGBT patients screened for chlamydia/gonorrhea was 16.8% (21/125) in March, 22.7% (37/163) in April, and 25.0% (50/200) in May.  The number of HIV-negative LGBT patients screened for HIV was 20.2% (23/114) in March, 26.5% (40/151) in April, and 28.5% (53/186) in May.

Conclusions: Data collection and extraction have been problematic.  As centers update their processes and electronic health records, and normalize monitoring and evaluating these data, we hope to see a gradual increase in the number and percentage of patients meeting Phase 1 measure definitions and the gradual reporting of Phase 2 measures.

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