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  • Short discussion on environmental scan draft paper done by Dr. Lau's group
  • Review and discussion of any proposal for the minimum set of values for Gender Identity
    • Two files are attached. Base-
    • line-coding from Rob Horn, and Possible gender value sets from Francis Lau

Discussion items

  • Current affairs, anyone new?
    • Mark Duteau - working closely with Rob on a few projects
  • HL7 NIB deadline for Sept July 5
 20mSex/Gender Environmental scan  Francis Lau, Kelly others

Enivironment scan found for sex:

  • Five (5) different data element names
  • Seven (7) code system sources that have codified sex values
  • 21 different value sets

Similarly, for administrative gender, there were similar numebrs, and approximately 22 different value sets.

Base definitoins were provided from various sources, including this project. 

Rapid review for what has been reported in the literature regarding sex and gender in EHRs. Focused around 5 areas including polic,y, practice, community, implementation etc...
Consultation session with 40 organizations from the community to gather feedback to create a proposed action plan.

Related presentations locate here

20mReview initial proposal for GI minimum setLau/Horn et al

Detals in attachments above:

One approach in what we record for gender identity is a core set of concepts that would represent M, F and X Additional codes can be sent in jurisdictions in which they are allowed. X would act
as a collection point for gender identities other than M and F. This approach aligns with Austrilian and California regulations. This apporach does not force further specifcation of "X" if they choose not
to do so. 

CT: Define a way to express GI in the most comprehensive way independent of regulation, or are we targeting the lowest denominator from different jurisdicitons? If juristdictions have different means, then we run the risk of misuse. 
RH: I hope to accomodate both.

RM: X is intended to mean all GIs other than M or F. Technically, in FHIR, if we set the values to MFX, and used an extensible binding, users would need to choose X then send one of the other gender codes as a translation. Alternatively we put all of the codes into a superset that we have identified, not including X/other - then everyone would need to map their non-MF codes to one of the codes included in our super set.

RH: There is a third option - consider Leg and Knee - thus we can choose the level of specificity.

CT/CM: hierarchies in theory would work, but most systems will just have a list.

RM: we would have to create that hierarhcy. however, we could publish a mapping table. MIN is M,F,X then provide a mapping table that maps the collection of additional codes to the core.

RH: that would work

CT: I'd hope to separete the jurisidiction, where the meaning of "X" may vary greatly, from the definition of gender identity being a self-assigned sense of gender. 

RM: So X comes out of this list and goes to documented gender? 

CM: In the same way we respect the option of privacy, we shouldn't remove the option to purposely declare a GI other than M or F

CT: Ability to support the most discrete quality data is important, so if you can't handle the more discrete information, you have a mapping table where they can "down map"

RM: Mininum M, F, X then a mapping table from additional values to X

Action items

  • Rob McClure Formalize proposal for gender identity value set, send via email to project members if possible. Add to agenda for next call so we can start out with that motion.