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Implementation of Gender Identity and Assigned Sex at Birth Data Collection in Electronic Health Records: Where Are We Now?

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 asse...

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Autores principales: Thompson, Hale M., Kronk, Clair A., Feasley, Ketzel, Pachwicewicz, Paul, Karnik, Niranjan S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8296460/
https://www.ncbi.nlm.nih.gov/pubmed/34205275
http://dx.doi.org/10.3390/ijerph18126599
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author Thompson, Hale M.
Kronk, Clair A.
Feasley, Ketzel
Pachwicewicz, Paul
Karnik, Niranjan S.
author_facet Thompson, Hale M.
Kronk, Clair A.
Feasley, Ketzel
Pachwicewicz, Paul
Karnik, Niranjan S.
author_sort Thompson, Hale M.
collection PubMed
description 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.
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spelling pubmed-82964602021-07-23 Implementation of Gender Identity and Assigned Sex at Birth Data Collection in Electronic Health Records: Where Are We Now? Thompson, Hale M. Kronk, Clair A. Feasley, Ketzel Pachwicewicz, Paul Karnik, Niranjan S. Int J Environ Res Public Health Article 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. MDPI 2021-06-19 /pmc/articles/PMC8296460/ /pubmed/34205275 http://dx.doi.org/10.3390/ijerph18126599 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Thompson, Hale M.
Kronk, Clair A.
Feasley, Ketzel
Pachwicewicz, Paul
Karnik, Niranjan S.
Implementation of Gender Identity and Assigned Sex at Birth Data Collection in Electronic Health Records: Where Are We Now?
title Implementation of Gender Identity and Assigned Sex at Birth Data Collection in Electronic Health Records: Where Are We Now?
title_full Implementation of Gender Identity and Assigned Sex at Birth Data Collection in Electronic Health Records: Where Are We Now?
title_fullStr Implementation of Gender Identity and Assigned Sex at Birth Data Collection in Electronic Health Records: Where Are We Now?
title_full_unstemmed Implementation of Gender Identity and Assigned Sex at Birth Data Collection in Electronic Health Records: Where Are We Now?
title_short Implementation of Gender Identity and Assigned Sex at Birth Data Collection in Electronic Health Records: Where Are We Now?
title_sort implementation of gender identity and assigned sex at birth data collection in electronic health records: where are we now?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8296460/
https://www.ncbi.nlm.nih.gov/pubmed/34205275
http://dx.doi.org/10.3390/ijerph18126599
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