The 2015 Health IT certification criteria include the capture of sexual orientation and gender identity in the demographics certification criteria, according to the National Association of Healthcare Access Management (NAHAM).
“As part of an important patient matching initiative by the Office the National Coordinator for Health IT (ONC), patient sex is one of five key attributes that are now part of the certification criteria,” NAHAM said in a released statement. NAHAM is developing Recommended Best Practices on the Collection of Key Patient Attributes.
Patient sex was proposed to be captured by using the following values: male (M), female (F), and unknown (UNK), as part of the development of the 2015 criteria. The decision to use the coding for “sex” to present birth sex was of significance in the final rule for health IT certification, NAHAM said.
“The ONC did not adopt recommendations made by commenters from the general public to capture a patient’s sexual orientation or gender identity as part of this criterion,” NAHAM said. “Instead, the ONC proposed the capture of sexual orientation and gender identity (SO/GI) data as part of the proposed ‘social, psychological, and behavioral data’ certification criterion.” ONC’s narrative is in the final rule, Sexual Orientation and Gender Identity (SO/GI).
NAHAM reports on the following comment and response from ONC:
Comment. One commenter recommended we consider including structured and coded questions for soliciting SO/GI information as part of certification.
Response. While we [the ONC] thank the commenter for providing this recommendation, we do not believe that the suggested questions have yet been scientifically validated for use in health care settings and, thus, have not adopted them. We do, however, believe that these questions are being used today in health care settings as ‘‘best practices,’’ and would suggest that health care providers and institutions decide whether to include these questions in the collection of SO/GI information. These ‘‘best practice’’ questions and the answers we have adopted are:
- Do you think of yourself as:
- Straight or heterosexual;
- Lesbian, gay, or homosexual;
- Something else, please describe.
- Don’t know.
- What is your current gender identity? (Check all that apply.)
- Transgender male/Trans man/Female-to-male;
- Transgender female/Trans woman/Male-to-female;
- Genderqueer, neither exclusively male nor female;
- Additional gender category (or other), please specify.
- Decline to answer.
NAHAM advises that patient access departments ask the following questions:
- Does your access department have protocols in place to capture birth sex only, or gender as noted on an official government-issued identification, or do you record only what the patient reports?
- Does your information technology have fields, or do you attempt to capture sexual orientation or gender identity if different from what is reported on a government-issued identification?
- Is patient access ready to capture these attributes?