Documentation Of Identity Research Articles

Risks, Benefits, and Importance of Collecting Sexual Orientation and Gender Identity Data in Healthcare Settings: A Multi-Method Analysis of Patient and Provider Perspectives.

Research suggests that LGBT populations experience barriers to healthcare. Organizations such as the Institute of Medicine recommend routine documentation of sexual orientation (SO) and gender identity (GI) in healthcare, to reduce LGBT disparities. We explore patient views regarding the importance of SO/GI collection, and patient and provider views on risks and benefits of routine SO/GI collection in various settings. We surveyed LGBT/non-LGBT patients and providers on their views on SO/GI collection. Weighted data were analyzed with descriptive statistics; content analysis was conducted with open-ended responses. One-half of the 1516 patients and 60% of 429 providers were female; 64% of patients and 71% of providers were White. Eighty percent of providers felt that collecting SO data would offend patients, whereas only 11% of patients reported that they would be offended. Patients rated it as more important for primary care providers to know the SO of all patients compared with emergency department (ED) providers knowing the SO of all patients (41.3% vs. 31.6%; P < 0.001). Patients commonly perceived individualized care as an SO/GI disclosure benefit, whereas providers perceived patient-provider interaction improvement as the main benefit. Patient comments cited bias/discrimination risk most frequently (49.7%; N = 781), whereas provider comments cited patient discomfort/offense most frequently (54.5%; N = 433). Patients see the importance of SO/GI more in primary care than ED settings. However, many LGBT patients seek ED care due to factors including uninsurance; therefore, the ED may represent an initial point of contact for SO/GI collection. Therefore, patient-centered approaches to collecting SO/GI are needed. Patients and providers differed in perceived risks and benefits to routine SO/GI collection. Provider training in LGBT health may address patients' bias/discrimination concerns, and ultimately reduce LGBT health disparities.

Documentation of Gender Identity in an Adolescent and Young Adult Clinic

PurposeTo determine if changing electronic health record (EHR) note templates can increase documentation of gender identity in an adolescent and young adult clinic. MethodsA two-step gender question was added to EHR note templates for physicals in February 2016. A retrospective chart review was performed 3 months before and after this addition. The primary measure was whether answers to the two-step question were documented. Gender identity/birth-assigned sex discordance, age, and use of the appropriate note template post-template change were also measured. ResultsOne hundred twenty-five pretemplate change and 106 post-template change physicals were reviewed with an inter-rater reliability of 97%. Documentation of answers to the two-step gender identity question increased from 11% to 84% (p < .001). ConclusionsThis study suggests that incorporating a standardized question into EHR note templates is effective at improving the documentation of gender identity in youth presenting for annual physicals.

G441(P) Please sir, which is the best school allergy care plan?

Introduction Multidisciplinary allergy school care plans are important to manage children with allergies safely in school. They focus on allergen avoidance and treatment of reactions. The Cardiff children’s allergy service have developed and used their own plan for 20 years. A new national allergy care plan has been published by BSACI (British Society of Allergy and Clinical Immunology). Aim To compare Cardiff plan with the BSACI anaphylaxis plan. Methods Based on the NICE guideline for Anaphylaxis (2011) recommendation on information provision, a questionnaire was devised auditing 9 different components of the care plans for clarity and effectiveness. We surveyed teachers, parents, and school nurses in person; respondents completed the questionnaire comparing the two plans. Parents and teachers data (non-healthcare professionals) was compared to school nurses. Data was analysed with Chi Squared analysis with P Results There were 111 participants (31 teachers, 40 parents and 40 school nurses). The table shows respondents’ preferences. For brevity “not answered” and “no preference” responses are not shown. Conclusion Overall parents and teachers preferred the BSACI plan’s succinct format and Epipen usage explanation. In contrast school nurses preferred the Cardiff plan for the same reason! The Cardiff action plan was preferred by most respondents for its clearer documentation of identity, contact details, and parental consent. Teachers/ parents also preferred it for post Epipen advice. A revised national version with clearer contact details, better information on what to do after Epipen is administered and parental consent is required.

A canary in the coal mine: Documenting citizenship and identity in the State of Massachusetts

The U.S. federal government requires original documentation of citizenship and identity for applicants to qualify for coverage under Medicaid. The purpose of this investigation is to identify what challenges one state Medicaid agency has faced when implementing this requirement; and to identify what strategies this agency and other interested parties (e.g., providers, community advocates) adopted to help overcome them. The setting for this study is MassHealth, the Medicaid agency for the State of Massachusetts. Data derive from archival documents, direct observation, and in-depth interviews with key stakeholders, including state officials, provider agencies, community health centers, and beneficiary advocates. While MassHealth has met several of the implementation benchmarks put forth in federal regulations and guidance letters, the agency has fallen short in several respects. This includes assisting applicants seeking to enroll in MassHealth and maintaining a seamless documentation submission process. The result has been an increase in application processing time and misinterpretations in the MassHealth community; for example, that legal immigrants should not apply for coverage even though the new requirement does not affect them. Assuming a prominent role in informing and assisting MassHealth applicants has been providers and community-based organizations. Consumer advocacy groups have also worked to streamline the process for demonstrating citizenship and identity. Synergies have been formed between MassHealth and these other organizations as well. Findings suggest a number of lessons for state Medicaid agencies wishing to address the challenges posed by federal requirements to demonstrate citizenship and identity. These include working to ensure the readability, comprehension and non-English translation of materials provided to program applicants. It also includes strengthening the document handling process and forming partnerships with providers, beneficiary advocates, and other community organizations.

Four Documents, a Non‐Citizen, and a Diplomatic Controversy: The Documentation of Identity in the Mid‐Nineteenth Century

AbstractA forgotten diplomatic controversy centered on the claim to U.S. protection by a yet‐to‐be‐naturalized citizen is analyzed to offer insights into the mid‐nineteenth century understanding of the status and function of the documentation of individual identity. It makes clear the documentation of identity had a contested and gradual development. Documentation was contested in that people (both officials and members of the public) struggled to understand how it was that a document identified a person. This uncertainty centered not only on who had the authority to document identity, but how that authority was represented on a document. Beyond its mid‐nineteenth century and U.S. focus this essay is intended to provide the context for an understanding of the administrative, bureaucratic, and social developments that had to occur before identification documents could play a pivotal role in the development of the twentieth century state. In this way it suggests that official identification is an important object of analysis for debates about the articulation of information and governing in state formation.

Bio-Power: CBC Television's Life & Times and A&E Network's Biography on A&E

In a section of Imagined Communities Benedict Anderson presents biography as part of the documentation of identity that is based on a forgetting and then repetition of origins that cannot be remembered. The nation itself is a narrative made of the collection of individual stories. Anderson's image of biography as the site of a forgetting and as the means of national suturing is an excellent way to examine how the genre of biography works as a social practice within national discourse in two popular biography shows on television: the American cable network A'E's flagship series Biography on A'E and the Canadian television network CBC's long-running biography programme Life & Times. In this paper, I look at selected programmes by each network about artists, political figures and sports stars as one of the latest attempts to make “biographies of the nation” on television in Canada and the United States. In my analysis, genre is understood as a set of social practices that constructs and limits many types of cultural meaning for audiences and cultural producers. “Biography” as a genre has been translated into the medium of television without losing sight of its origins in popular collective biography of the Victorian era.