Submitted by rmcclure on 2023-04-17
Continued support for inclusion of Gender Identity
Per the Gender Harmony Project as discussed and voted on 2023-04-17:
We strongly support the existing Gender Identity element and have no changes to propose.
Data used to categorize individuals for identification, records matching, and other purposes.
Data Element |
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Gender Identity
Description
A person’s internal sense of being a man, woman, both, or neither. Applicable Vocabulary Standard(s) Applicable Standards
Gender Identify must be coded in accordance with SNOMED CT® and HL7 Version 3 Standard, Value Sets for AdministrativeGender and NullFlavor, attributed as follows:
Adopted at 45 CFR 170.207(o)(2) |
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Submitted by rmcclure on 2023-04-17
Per the Gender Harmony Project as discussed and voted on 2023-04-17:
We strongly support the existing Gender Identity element and have no changes to propose.
Submitted by yale-coredQMRoadmap on 2023-04-17
CMS supports the ISWG and HITAC recommendation for expanding the Gender Identity data element definition to include the Gender Harmony Project’s minimum value set, with ISWG refinements.
The additional values in the defined terminology work collectively with the sex data element to represent sex and gender diversity that supports improved care for vulnerable or underserved populations. The values for this data element are self-reported and not clinically determined, which allows for better representation of diversity.
Maturity: These elements are classified as Level 2 by ONC.
Submitted by Svellanky on 2022-09-29
CMS supports the ISWG and HITAC recommendation for expanding the Gender Identity data element definition to include the Gender Harmony Project’s minimum value set, with ISWG refinements. The additional values in the defined terminology work collectively with the sex data element to represent gender diversity that supports improved care for vulnerable and/or underserved populations. The values for this data element are self-reported and not clinically determined, which allows for better representation of diversity. The ISWG supported the expansion of the Gender Identity data element with the Gender Harmony Project’s minimum value set in addition to the two fields from USCDI that add critical data, for which CMS supports.
Maturity: These elements are classified as Level 2 by ONC.
Current uses, exchange, and use cases: Elements related to gender are captured in nearly all clinical and administrative records. The information is routinely exchanged as part of healthcare information exchange. As more appropriate and diverse terminology are standardized, the capture and exchange of the data must also keep pace to ensure appropriate and high quality of care. CMS also uses gender information for quality measurement and continues to support Gender Harmony project efforts, reflected in this recommendation.
Submitted by nedragarrett_CDC on 2022-09-29
Submitted by cmayo@med.umich.edu on 2022-09-28
The AAPM Operational Ontology for Radiation Oncology ( https://aapmbdsc.azurewebsites.net) noted several systems for identifying gender. HL7 Reference system was recommended as the primary system.
http://hl7.org/fhir/2018May/codesystem-gender-identity.html
Values are
Other systems evaluated were
CDC https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.113883.1.11.1
DICOM http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_7455.html#table_CID_7455
Health IT https://www.healthit.gov/isa/representing-patient-gender-identity
LOINC https://loinc.org/76691-5/
Submitted by nedragarrett_CDC on 2022-04-29
Please see the attached
Submitted by RUy on 2022-04-29
Collecting SO/GI data is essential to providing high-quality, patient-centered care for transgender people. ONC has provided good leadership on the standardization of this content in USCDIv2. FQHCs are required to collect these data for all their patients and report them to HRSA so these data are well established and are imperative to the patient-centered provision of care.
NACHC believes gender identity is a foundational component of patient identity. However, it is also associated with serious health inequity and health disparities. Furthermore, it is clinically relevant to several domains of sexual health, cancer risk, trauma and interpersonal violence, substance abuse and mental health risk factors.
We strongly support the requirement for gender identity data to be captured in a standardized way in EHRs to support patients’ identities, reduce health disparities and facilitate effective clinical risk that may be modified by sexual orientation. However, NACHC proposes the modification to the gender identity value set based on work from the Gender Identity Working Group at HL7.
Submitted by nedragarrett_CDC on 2022-04-29
Gender identity defined in USCDI v2 does not represent all different gender identities expressed by the community as a whole. There are additional gender identities that could not be categorized in any of the values existing in the current version. For example – there are community members identifying themselves as ‘Transgender’ rather than either ‘Male Transgender’ or ‘Female Transgender’. Similarly, there are additional categories that are presently represented by ‘other’ which accurately represents additional gender identities, as follows:
*New values being proposed
Submitted by nedragarrett_CDC on 2022-04-27
Gender Identity
CSTE Comment:
Submitted by yale-coredQMRoadmap on 2023-09-19
CMS-CCSQ Support for Gender Identity def. expansion for USCDI v5
CMS-CCSQ supports the ISWG and HITAC recommendation included in the ISWG and HITAC Recommendations on Draft USCDI v3 (April 13, 2022) and Draft USCDI v4 (April 12, 2023) for expanding the Gender Identity data element definition to include the Gender Harmony Project’s minimum value set, with ISWG refinements.