scholarly journals Correction: An Environmental Scan of Sex and Gender in Electronic Health Records: Analysis of Public Information Sources

10.2196/30764 ◽  
2021 ◽  
Vol 23 (6) ◽  
pp. e30764
Author(s):  
Francis Lau ◽  
Marcy Antonio ◽  
Kelly Davison ◽  
Roz Queen ◽  
Katie Bryski
Keyword(s):  
Electronic Health Records ◽  
Information Sources ◽  
Public Information ◽  
Sex And Gender ◽  
Health Records ◽  
Environmental Scan ◽  
Electronic Health ◽  
And Gender

scholarly journals An Environmental Scan of Sex and Gender in Electronic Health Records: Analysis of Public Information Sources

10.2196/20050 ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. e20050
Author(s):  
Francis Lau ◽  
Marcy Antonio ◽  
Kelly Davison ◽  
Roz Queen ◽  
Katie Bryski
Keyword(s):  
Health Information ◽  
Information Sources ◽  
Public Information ◽  
International Health ◽  
International Standards ◽  
Data Element ◽  
Sex And Gender ◽  
Health Records ◽  
Value Sets ◽  
And Gender

Background Historically, the terms sex and gender have been used interchangeably as a binary attribute to describe a person as male or female, even though there is growing recognition that sex and gender are distinct concepts. The lack of sex and gender delineation in electronic health records (EHRs) may be perpetuating the inequities experienced by the transgender and gender nonbinary (TGNB) populations. Objective This study aims to conduct an environmental scan to understand how sex and gender are defined and implemented in existing Canadian EHRs and current international health information standards. Methods We examined public information sources on sex and gender definitions in existing Canadian EHRs and international standards communities. Definitions refer to data element names, code systems, and value sets in the descriptions of EHRs and standards. The study was built on an earlier environment scan by Canada Health Infoway, supplemented with sex and gender definitions from international standards communities. For the analysis, we examined the definitions for clarity, consistency, and accuracy. We also received feedback from a virtual community interested in sex-gender EHR issues. Results The information sources consisted of public website descriptions of 52 databases and 55 data standards from 12 Canadian entities and 10 standards communities. There are variations in the definition and implementation of sex and gender in Canadian EHRs and international health information standards. There is a lack of clarity in some sex and gender concepts. There is inconsistency in the data element names, code systems, and value sets used to represent sex and gender concepts across EHRs. The appropriateness and adequacy of some value options are questioned as our societal understanding of sexual health evolves. Outdated value options raise concerns about current EHRs supporting the provision of culturally competent, safe, and affirmative health care. The limited options also perpetuate the inequities faced by the TGNB populations. The expanded sex and gender definitions from leading Canadian organizations and international standards communities have brought challenges in how to migrate these definitions into existing EHRs. We proposed 6 high-level actions, which are to articulate the need for this work, reach consensus on sex and gender concepts, reach consensus on expanded sex and gender definitions in EHRs, develop a coordinated action plan, embrace EHR change from socio-organizational and technical aspects to ensure success, and demonstrate the benefits in tangible terms. Conclusions There are variations in sex and gender concepts across Canadian EHRs and the health information standards that support them. Although there are efforts to modernize sex and gender concept definitions, we need decisive and coordinated actions to ensure clarity, consistency, and competency in the definition and implementation of sex and gender concepts in EHRs. This work has implications for addressing the inequities of TGNB populations in Canada.

scholarly journals An Environmental Scan of Sex and Gender in Electronic Health Records: Analysis of Public Information Sources (Preprint)

2020 ◽  
Author(s):  
Francis Lau ◽  
Marcy Antonio ◽  
Kelly Davison ◽  
Roz Queen ◽  
Katie Bryski
Keyword(s):  
Health Information ◽  
Information Sources ◽  
Public Information ◽  
International Health ◽  
International Standards ◽  
Data Element ◽  
Sex And Gender ◽  
Health Records ◽  
Value Sets ◽  
And Gender

BACKGROUND Historically, the terms sex and gender have been used interchangeably as a binary attribute to describe a person as male or female, even though there is growing recognition that sex and gender are distinct concepts. The lack of sex and gender delineation in electronic health records (EHRs) may be perpetuating the inequities experienced by the transgender and gender nonbinary (TGNB) populations. OBJECTIVE This study aims to conduct an environmental scan to understand how sex and gender are defined and implemented in existing Canadian EHRs and current international health information standards. METHODS We examined public information sources on sex and gender definitions in existing Canadian EHRs and international standards communities. Definitions refer to data element names, code systems, and value sets in the descriptions of EHRs and standards. The study was built on an earlier environment scan by Canada Health Infoway, supplemented with sex and gender definitions from international standards communities. For the analysis, we examined the definitions for clarity, consistency, and accuracy. We also received feedback from a virtual community interested in sex-gender EHR issues. RESULTS The information sources consisted of public website descriptions of 52 databases and 55 data standards from 12 Canadian entities and 10 standards communities. There are variations in the definition and implementation of sex and gender in Canadian EHRs and international health information standards. There is a lack of clarity in some sex and gender concepts. There is inconsistency in the data element names, code systems, and value sets used to represent sex and gender concepts across EHRs. The appropriateness and adequacy of some value options are questioned as our societal understanding of sexual health evolves. Outdated value options raise concerns about current EHRs supporting the provision of culturally competent, safe, and affirmative health care. The limited options also perpetuate the inequities faced by the TGNB populations. The expanded sex and gender definitions from leading Canadian organizations and international standards communities have brought challenges in how to migrate these definitions into existing EHRs. We proposed 6 high-level actions, which are to articulate the need for this work, reach consensus on sex and gender concepts, reach consensus on expanded sex and gender definitions in EHRs, develop a coordinated action plan, embrace EHR change from socio-organizational and technical aspects to ensure success, and demonstrate the benefits in tangible terms. CONCLUSIONS There are variations in sex and gender concepts across Canadian EHRs and the health information standards that support them. Although there are efforts to modernize sex and gender concept definitions, we need decisive and coordinated actions to ensure clarity, consistency, and competency in the definition and implementation of sex and gender concepts in EHRs. This work has implications for addressing the inequities of TGNB populations in Canada.

scholarly journals An Environmental Scan of Sex and Gender in Electronic Health Records: Analysis of Public Information Sources (Preprint)

2021 ◽  
Author(s):  
Francis Lau ◽  
Marcy Antonio ◽  
Kelly Davison ◽  
Roz Queen ◽  
Katie Bryski
Keyword(s):  
Health Information ◽  
Information Sources ◽  
Public Information ◽  
International Health ◽  
International Standards ◽  
Data Element ◽  
Sex And Gender ◽  
Health Records ◽  
Value Sets ◽  
And Gender

BACKGROUND Historically, the terms sex and gender have been used interchangeably as a binary attribute to describe a person as male or female, even though there is growing recognition that sex and gender are distinct concepts. The lack of sex and gender delineation in electronic health records (EHRs) may be perpetuating the inequities experienced by the transgender and gender nonbinary (TGNB) populations. OBJECTIVE This study aims to conduct an environmental scan to understand how sex and gender are defined and implemented in existing Canadian EHRs and current international health information standards. METHODS We examined public information sources on sex and gender definitions in existing Canadian EHRs and international standards communities. Definitions refer to data element names, code systems, and value sets in the descriptions of EHRs and standards. The study was built on an earlier environment scan by Canada Health Infoway, supplemented with sex and gender definitions from international standards communities. For the analysis, we examined the definitions for clarity, consistency, and accuracy. We also received feedback from a virtual community interested in sex-gender EHR issues. RESULTS The information sources consisted of public website descriptions of 52 databases and 55 data standards from 12 Canadian entities and 10 standards communities. There are variations in the definition and implementation of sex and gender in Canadian EHRs and international health information standards. There is a lack of clarity in some sex and gender concepts. There is inconsistency in the data element names, code systems, and value sets used to represent sex and gender concepts across EHRs. The appropriateness and adequacy of some value options are questioned as our societal understanding of sexual health evolves. Outdated value options raise concerns about current EHRs supporting the provision of culturally competent, safe, and affirmative health care. The limited options also perpetuate the inequities faced by the TGNB populations. The expanded sex and gender definitions from leading Canadian organizations and international standards communities have brought challenges in how to migrate these definitions into existing EHRs. We proposed 6 high-level actions, which are to articulate the need for this work, reach consensus on sex and gender concepts, reach consensus on expanded sex and gender definitions in EHRs, develop a coordinated action plan, embrace EHR change from socio-organizational and technical aspects to ensure success, and demonstrate the benefits in tangible terms. CONCLUSIONS There are variations in sex and gender concepts across Canadian EHRs and the health information standards that support them. Although there are efforts to modernize sex and gender concept definitions, we need decisive and coordinated actions to ensure clarity, consistency, and competency in the definition and implementation of sex and gender concepts in EHRs. This work has implications for addressing the inequities of TGNB populations in Canada.

scholarly journals A rapid review of gender, sex, and sexual orientation documentation in electronic health records

2020 ◽  
Vol 27 (11) ◽  
pp. 1774-1783 ◽  
Author(s):  
Francis Lau ◽  
Marcy Antonio ◽  
Kelly Davison ◽  
Roz Queen ◽  
Aaron Devor
Keyword(s):  
Sexual Orientation ◽  
Electronic Health Records ◽  
Rapid Review ◽  
Culturally Competent ◽  
Care Needs ◽  
Health Records ◽  
Gender Minorities ◽  
Literature Reviews ◽  
Electronic Health ◽  
And Gender

Abstract Objective The lack of precise and inclusive gender, sex, and sexual orientation (GSSO) data in electronic health records (EHRs) is perpetuating inequities of sexual and gender minorities (SGM). We conducted a rapid review on how GSSO documentation in EHRs should be modernized to improve the health of SGM. Materials and Methods We searched MEDLINE from 2015 to 2020 with terms for gender, sex, sexual orientation, and electronic health/medical records. Only literature reviews, primary studies, and commentaries from peer-reviewed journals in English were included. Two researchers screened citations and reviewed articles with help from a third to reach consensus. Covidence, Excel, and Atlas-TI were used to track articles, extract data, and synthesize findings, respectively. Results Thirty-five articles were included. The 5 themes to modernize GSSO documentation in EHRs were (1) creating an inclusive, culturally competent environment with precise terminology and standardized data collection; (2) refining guidelines for identifying and matching SGM patients with their care needs; (3) improving patient-provider relationships by addressing patient rights and provider competencies; (4) recognizing techno-socio-organizational aspects when implementing GSSO in EHRs; and (5) addressing invisibility of SGM by expanding GSSO research. Conclusions The literature on GSSO documentation in EHRs is expanding. While this trend is encouraging, there are still knowledge gaps and practical challenges to enabling meaningful changes, such as organizational commitments to ensure affirming environments, and coordinated efforts to address technical, organizational, and social aspects of modernizing GSSO documentation. The adoption of an inclusive EHR to meet SGM needs is a journey that will evolve over time.

Asthma/COPD Data Set And Definitions: Environmental Scan Of Electronic Health Records

2012 ◽  
Author(s):  
Janice P. Minard ◽  
Mary Ann Juurlink ◽  
Carole Madeley ◽  
Anne Van Dam ◽  
M. D. Lougheed
Keyword(s):  
Electronic Health Records ◽  
Data Set ◽  
Health Records ◽  
Environmental Scan ◽  
Electronic Health

scholarly journals Planning and implementing sexual orientation and gender identity data collection in electronic health records

2018 ◽  
Vol 26 (1) ◽  
pp. 66-70 ◽  
Author(s):  
Chris Grasso ◽  
Michal J McDowell ◽  
Hilary Goldhammer ◽  
Alex S Keuroghlian
Keyword(s):  
Health Care ◽  
Sexual Orientation ◽  
Data Collection ◽  
Gender Identity ◽  
Electronic Health Records ◽  
Current Evidence ◽  
Institute Of Medicine ◽  
Health Records ◽  
Electronic Health ◽  
And Gender

AbstractLesbian, gay, bisexual, transgender, and queer (LGBTQ) people experience significant health disparities across the life course and require health care that addresses their unique needs. Collecting information on the sexual orientation and gender identity (SO/GI) of patients and entering SO/GI data in electronic health records has been recommended by the Institute of Medicine, the Joint Commission, and the Health Resources and Services Administration as fundamental to improving access to and quality of care for LGBTQ people. Most healthcare organizations, however, have yet to implement a system to collect SO/GI data due to multiple barriers. This report addresses those concerns by presenting recommendations for planning and implementing high-quality SO/GI data collection in primary care and other health care practices based on current evidence and best practices developed by a federally qualified health center and leader in LGBTQ health care.

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