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This page is no longer being updated! Please see:

This page which is maintained by the V2MG who is working on the V2 GH solution: SOGI Data Exchange


To be determined:

  • What mechanisms can be used to carry each of the following. Need to determine if new element in existing segment, new segment, or how to use existing elements.
    • Gender Identity (GI)
    • Sex For Clinical Use (SFCU)
    • Recorded Sex or Gender (RSG)
    • Name to use 
    • Pronouns 

For consideration:

  • Create new fields for Patient level data in existing segments (PID, PD1, others?)
    • GI
    • SFCU - Patient level context. For all procedure-specific SFCU it should go in OBX
    • pronouns
    • RSG
  • Create a new segment for the above named elements (and support the explicit context they need to be used in)
  • PID-8 - should no longer be used
  • Can use XPN data type in PID-5 aligned with FHIR Patient name (human name ) type Usual. for Name to use
  • Use OBX
    • For all elements (except Name to Use) 
    • Only for context-specific SFCU

...


Prior discussion linked to LIVID, ask at order entry

Summary

Concept nameLocation in V2Location in C-CDALocation in FHIRCode for the elementanswer valuesCode systems suggested for answersISA reference
Gender IdentityOBX

76691-5 Gender Identity

Male

Female

Female-to-Male (FTM)
Male-to-Female (MTF)
Identifies as non-conforming gender

Something else, please describe (Other)

Choose not to disclose 

SNOMED CT (US Edition)

NULLFL (HL7V3)

https://www.healthit.gov/isa/representing-patient-gender-identity
Sexual OrientationOBX

76690-7 Sexual orientation

Lesbian, gay or homosexual
Straight or heterosexual
Bisexual
Something else, please describe (Other)
Don’t know
Choose not to disclose

Sexually attracted to neither male nor female sex

SNOMED CT (US Edition)

NULLFL (HL7V3)

https://www.healthit.gov/isa/representing-patient-identified-sexual-orientation
Sex at Birth / Birth SexOBX

76689-9 Sex assigned at birth 

Male

Female

Undifferentiated

Unknown

Other

Asked, but Unknown

Not asked

??? Rob McClure to fill in

NULLFL (HL7V3)

https://www.healthit.gov/isa/representing-patient-sex-birth

Other concepts may be important to consider by implementers, but are not included in the ISA and have not been explicitly discussed in detail by this group. These concepts will likely be amenable to the same OBX based solution as Sexual Orientation, Gender Identity and Birth Sex, but implementers should thoroughly investigate these concepts before implementing them.

Core OBX Segment Content

See Chapter 7 of the base standard for more details on the OBX segment.

FieldContent
OBX-2 (Value Type)Typically CE or CWE when the concept is codeable
OBX-3 (Observation Identifier)Typically the LOINC code for the concept being conveyed (e.g. 76691-5 for Gender Identity)
OBX-5 (Observation Value)

The "answer", often as a coded value (formatted per the data type in OBX-2). Note that when the concept is codeable, the codes used may vary locally depending on what data needs to be captured and how the questions are asked (e.g. what is the list of options on form). There is no clear consensus on a complete, singular value set for any of these concepts but there are values that are common to many jurisdictions including:

Gender Identity:

Female, Male, Nonbinary, Other and Choose not to Answer

Jurisdictions will need to define the complete set of local values for these concepts including adding additional codes not listed above.

OBX-11  (Observation Result Status)Typically "F" for Final
OBX-14 (Date/Time of the Observation)

Typically the date the question was answered

OBX-29 (Observation Type)Available only in later versions of the base standard. Typically QST for a "question" (often at the time of order entry) or SCI for "supporting clinical information"

Example:

OBX|1|CWE|76691-5^Gender Identity^LN||446141000124107^Identifies as Female Gender^SCT||||||F|||202103011100|||||||||<performing Org name>|<performing org address usind XAD datatype|||||QST|

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