Implementing MyChart-Driven Sexual Orientation and Gender Identity Data Collection at Three Comprehensive Cancer Center Clinics

Background: Although systematic collection of sexual orientation and gender identity (SOGI) data is essential for identifying and addressing disparities—and has been associated with improved survivorship outcomes—its implementation in oncology care remains limited. Recognizing clinic time and staff barriers, we piloted a multicomponent implementation strategy centered on collecting SOGI data through an online patient portal and evaluated its feasibility, acceptability, and effectiveness. Patients and Methods: This SOGI strategy, previously developed with input from national stakeholders, included (1) assignment of SOGI questions to all patients via MyChart, with follow-up in clinic as needed; (2) staff training for SOGI understanding, patient respect, and safety; (3) a script for asking patients about their SOGI; and (4) a clinic champion. We piloted the strategy at 3 outpatient adult cancer clinics for a total of 6 months. We conducted an evaluation that included preimplementation clinic staff surveys, patient surveys and interviews (after patients were asked about their SOGI), and postimplementation staff surveys and interviews. We evaluated SOGI collection rates for the study period using EPIC Clarity data. Results: SOGI data were collected from 71% (n=1,410) of patients, and 94% of responses were collected on MyChart before clinic. The training helped 40% of surveyed staff (n=4) feel more comfortable asking about SOGI; however, staff interviewed (n=6) reported not attending the entire training. This likely contributed to their reported fear of patient reactions and lack of understanding that they were expected to ensure SOGI was documented for all patients. Of the 98 patient survey respondents (33% response rate), 69% reported that it was important for their provider to know their SOGI. In interviews (n=17), patients described MyChart as an acceptable and private method for collecting SOGI information. Conclusions: The MyChart-driven strategy for SOGI data collection was efficient, effective, feasible, and acceptable for collecting this information from most patients. Future work will focus on refining and reformatting staff training to ensure respectful SPGI data collection and on capturing information from patients who did not previously respond.