Will Clinical Standards Not Be Part of the Choir? Harmonization Between the HL7 Gender Harmony Project Model and the NASEM Measuring Sex, Gender Identity, and Sexual Orientation Report in the United States

Details

• Personal Author:
  Baker, Kellan E. ; Compton, D'Lane ; Fechter-Leggett, Ethan D. ; Grasso, Chris ; Kronk, Clair A.
• Description:
  Objectives: To propose an approach for semantic and functional data harmonization related to sex and gender constructs in electronic health records (EHRs) and other clinical systems for implementors, as outlined in the National Academies of Sciences, Engineering, and Medicine (NASEM) report Measuring Sex, Gender Identity, and Sexual Orientation and the Health Level 7 (HL7) Gender Harmony Project (GHP) product brief "Gender Harmony-Modeling Sex and Gender Representation, Release 1." Materials and Methods: Authors from both publications contributed to a plan for data harmonization based upon fundamental principles in informatics, including privacy, openness, access, legitimate infringement, least intrusive alternatives, and accountability. Results: We propose construct entities and value sets that best align with both publications to allow the implementation of EHR data elements on gender identity, recorded sex or gender, and sex for clinical use in the United States. We include usability- and interoperability-focused reasoning for each of these decisions, as well as suggestions for cross-tabulation for populations. Discussion and Conclusion: Both publications agree on core approaches to conceptualization and measurement of sex- and gender-related constructs. However, some clarifications could improve our ability to assess gender modality, alignment (or lack thereof) between gender identity and assigned gender at birth, and address both individual-level and population-level health inequities. By bridging the GHP and NASEM recommendations, we provide a path forward for implementation of sex- and gender-related EHR elements. Suggestions for implementation of gender identity, recorded sex or gender, and sex for clinical use are provided, along with semantic and functional justifications. [Description provided by NIOSH]
• Subjects:
  Occupational Health Safety Sex Characteristics
• Keywords:
  Author Keywords: Gender Identity Data Processing Electronic Health Records Gender Factors Health Information Interoperability Health Level Seven Information Processing National Academies Of Science, Engineering, And Medicine Sex Sex Factors Statistical Quality Control

  More +
• ISSN:
  1067-5027
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Connecticut ; District of Columbia ; Illinois ; Louisiana ; Maryland ; Massachusetts ; OSHA Region 1 ; OSHA Region 3 ; OSHA Region 5 ; OSHA Region 6 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  RHD - Respiratory Health Division
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  11 pdf pages
• Volume:
  30
• Issue:
  1
• NIOSHTIC Number:
  nn:20066620
• Citation:
  J Am Med Inform Assoc 2022 Dec; 30(1):83-93
• Contact Point Address:
  Clair A. Kronk, PhD, Center for Medical Informatics, Yale University School of Medicine, 300 George Street, Suite 501, New Haven, CT 06511, USA
• Email:
  clair.kronk@yale.edu
• Federal Fiscal Year:
  2023
• Peer Reviewed:
  True
• Source Full Name:
  Journal of the American Medical Informatics Association
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:009c4a2dea6db4ba04a90fddfc7681cb4bdbd7e59e7e1211222fef6346c4adb9daa4ab0489116c271e06c231f5f01170fd9bc98a00c4097a7b3f63e3ad590f5f
• Download URL:
  https://stacks.cdc.gov/view/cdc/230625/cdc_230625_DS1.pdf
• File Type:
  [PDF - 337.45 KB ]