ONC: EHRs need better sex and gender inclusion standards

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Clinical data collection is being hindered by EHRs' failure to represent sex and gender diversity, according to Steven Posnack, the deputy national coordinator at the Office of the National Coordinator for Health Information Technology.

In an Oct. 27 blog post he wrote for the ONC, Mr. Posnack said relying on a single, oftentimes binary sex and gender categorization can hamper interoperability and lead to suboptimal care outcomes. He called on the healthcare industry to eliminate ambiguities surrounding the meaning, context and expected use of sex and gender data.

"This ranges from missing preventative screening notifications to inaccurate reference ranges on lab tests all the way to denied claims because the patient’s 'administrative sex' on the clinical side didn’t match their 'gender' on the health insurance side," Mr. Posnack wrote.

He discussed the idea of "sex for clinical use," which is a sex classification based on one or more clinical observations, such as a patient's organs, chromosomes or hormone levels. He also suggested EHRs establish better ways to represent patients' gender identities, preferred names and pronouns.

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