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Implementation of Gender Identity and Assigned Sex at Birth Data Collection in Electronic Health Records: Where Are We Now?
journal contributionposted on 2022-11-15, 22:05 authored by Hale M Thompson, Clair A Kronk, Ketzel Feasley, Paul Pachwicewicz, Niranjan S Karnik
In 2015, the United States Department of Health and Human Services instantiated rules mandating the inclusion of sexual orientation and gender identity (SO/GI) data fields for systems certified under Stage 3 of the Meaningful Use of Electronic Health Records (EHR) program. To date, no published assessments have benchmarked implementation penetration and data quality. To establish a benchmark for a U.S. health system collection of gender identity and sex assigned at birth, we analyzed one urban academic health center's EHR data; specifically, the records of patients with unplanned hospital admissions during 2020 (N = 49,314). Approximately one-quarter of patient records included gender identity data, and one percent of them indicated a transgender or nonbinary (TGNB) status. Data quality checks suggested limited provider literacy around gender identity as well as limited provider and patient comfort levels with gender identity disclosures. Improvements are needed in both provider and patient literacy and comfort around gender identity in clinical settings. To include TGNB populations in informatics-based research, additional novel approaches, such as natural language processing, may be needed for more comprehensive and representative TGNB cohort discovery. Community and stakeholder engagement around gender identity data collection and health research will likely improve these implementation efforts.
CitationThompson, H. M., Kronk, C. A., Feasley, K., Pachwicewicz, P.Karnik, N. S. (2021). Implementation of Gender Identity and Assigned Sex at Birth Data Collection in Electronic Health Records: Where Are We Now? International Journal of Environmental Research and Public Health, 18(12), 6599-. https://doi.org/10.3390/ijerph18126599
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Behavioral and Social ScienceClinical ResearchHealth ServicesPatient SafetyNetworking and Information Technology R&DSOGI datanonbinarypopulation healthclinical informaticstransgender health disparitiesSO/GI dataData CollectionElectronic Health RecordsFemaleGender IdentityHumansInfant, NewbornMaleSexual BehaviorTransgender PersonsToxicology