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Gender harmony: improved standards to support affirmative care of gender-marginalized people through inclusive gender and sex representation
OBJECTIVE: Accurate representation of clinical sex and gender identity in interoperable clinical systems is a major challenge for organizations intent on improving outcomes for sex- and gender-marginalized people. Improved data collection has been hindered by the historical approach that presumed a...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8757317/ https://www.ncbi.nlm.nih.gov/pubmed/34613410 http://dx.doi.org/10.1093/jamia/ocab196 |
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author | McClure, Robert C Macumber, Caroline L Kronk, Clair Grasso, Chris Horn, Robert J Queen, Roz Posnack, Steven Davison, Kelly |
author_facet | McClure, Robert C Macumber, Caroline L Kronk, Clair Grasso, Chris Horn, Robert J Queen, Roz Posnack, Steven Davison, Kelly |
author_sort | McClure, Robert C |
collection | PubMed |
description | OBJECTIVE: Accurate representation of clinical sex and gender identity in interoperable clinical systems is a major challenge for organizations intent on improving outcomes for sex- and gender-marginalized people. Improved data collection has been hindered by the historical approach that presumed a single, often binary, datum was sufficient. We describe the Health Level Seven International (HL7) Gender Harmony logical model that proposes an improved approach. MATERIALS AND METHODS: The proposed solution was developed via an American National Standards Institute (ANSI)-certified collaborative balloted process. As an HL7 Informative Document, it is an HL7 International-balloted consensus on the subject of representing sex and representing gender in clinical systems based on work of the gender harmony project led by the HL7 Vocabulary Work Group. RESULTS: The Gender Harmony Model is a logical model that provides a standardized approach that is both backwards-compatible and an improvement to the meaningful capture of gender identity, recorded sex or recorded gender, a sex for clinical use, the name to use, and pronouns that are affirmative and inclusive of gender-marginalized people. CONCLUSION: Most clinical systems and current standards in health care do not meaningfully address, nor do they consistently represent, sex and gender diversity, which has impeded interoperability and led to suboptimal health care. The Gender Harmony Project was formed to create more inclusive health information exchange standards to enable a safer, higher-quality, and embracing healthcare experience. The Gender Harmony Model provides the informative guidance for standards developers to implement a more thorough technical design that improves the narrow binary design used in many legacy clinical systems. |
format | Online Article Text |
id | pubmed-8757317 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-87573172022-01-13 Gender harmony: improved standards to support affirmative care of gender-marginalized people through inclusive gender and sex representation McClure, Robert C Macumber, Caroline L Kronk, Clair Grasso, Chris Horn, Robert J Queen, Roz Posnack, Steven Davison, Kelly J Am Med Inform Assoc Brief Communications OBJECTIVE: Accurate representation of clinical sex and gender identity in interoperable clinical systems is a major challenge for organizations intent on improving outcomes for sex- and gender-marginalized people. Improved data collection has been hindered by the historical approach that presumed a single, often binary, datum was sufficient. We describe the Health Level Seven International (HL7) Gender Harmony logical model that proposes an improved approach. MATERIALS AND METHODS: The proposed solution was developed via an American National Standards Institute (ANSI)-certified collaborative balloted process. As an HL7 Informative Document, it is an HL7 International-balloted consensus on the subject of representing sex and representing gender in clinical systems based on work of the gender harmony project led by the HL7 Vocabulary Work Group. RESULTS: The Gender Harmony Model is a logical model that provides a standardized approach that is both backwards-compatible and an improvement to the meaningful capture of gender identity, recorded sex or recorded gender, a sex for clinical use, the name to use, and pronouns that are affirmative and inclusive of gender-marginalized people. CONCLUSION: Most clinical systems and current standards in health care do not meaningfully address, nor do they consistently represent, sex and gender diversity, which has impeded interoperability and led to suboptimal health care. The Gender Harmony Project was formed to create more inclusive health information exchange standards to enable a safer, higher-quality, and embracing healthcare experience. The Gender Harmony Model provides the informative guidance for standards developers to implement a more thorough technical design that improves the narrow binary design used in many legacy clinical systems. Oxford University Press 2021-10-06 /pmc/articles/PMC8757317/ /pubmed/34613410 http://dx.doi.org/10.1093/jamia/ocab196 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the American Medical Informatics Association. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Brief Communications McClure, Robert C Macumber, Caroline L Kronk, Clair Grasso, Chris Horn, Robert J Queen, Roz Posnack, Steven Davison, Kelly Gender harmony: improved standards to support affirmative care of gender-marginalized people through inclusive gender and sex representation |
title | Gender harmony: improved standards to support affirmative care of
gender-marginalized people through inclusive gender and sex representation |
title_full | Gender harmony: improved standards to support affirmative care of
gender-marginalized people through inclusive gender and sex representation |
title_fullStr | Gender harmony: improved standards to support affirmative care of
gender-marginalized people through inclusive gender and sex representation |
title_full_unstemmed | Gender harmony: improved standards to support affirmative care of
gender-marginalized people through inclusive gender and sex representation |
title_short | Gender harmony: improved standards to support affirmative care of
gender-marginalized people through inclusive gender and sex representation |
title_sort | gender harmony: improved standards to support affirmative care of
gender-marginalized people through inclusive gender and sex representation |
topic | Brief Communications |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8757317/ https://www.ncbi.nlm.nih.gov/pubmed/34613410 http://dx.doi.org/10.1093/jamia/ocab196 |
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