Gender code issue conflict with US requirements - 2016-09 core #56

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    • Type: Change Request
    • Resolution: Not Persuasive
    • Priority: Medium
    • FHIR Core (FHIR)
    • DSTU2
    • Patient Administration
    • FamilyMemberHistory
      Patient
      Person
      Practitioner
      RelatedPerson
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      The code values used in FHIR are more descriptive and clear with respect to the concepts (specifically "other" and "unknown").

      There is already a mapping for the v3 concepts (http://hl7-fhir.github.io/cm-administrative-gender-v3.html).

      (differentiating beteen UN and UNK is less than obvious)

      Most jurisdications/systems also use their own codes for this concept (as with many others), and will need to do their own internal mappings anyway.

      Including mappings where the other systems use more than just 4 values and need to process extensions on the other with the more defined concepts.

      This is the adminstrative gender, and not any form of clinical gender, where different valuesets may be ore appropriate (but the administrative side is always represented like this)

      No change will be made.

      Show
      The code values used in FHIR are more descriptive and clear with respect to the concepts (specifically "other" and "unknown"). There is already a mapping for the v3 concepts ( http://hl7-fhir.github.io/cm-administrative-gender-v3.html) . (differentiating beteen UN and UNK is less than obvious) Most jurisdications/systems also use their own codes for this concept (as with many others), and will need to do their own internal mappings anyway. Including mappings where the other systems use more than just 4 values and need to process extensions on the other with the more defined concepts. This is the adminstrative gender, and not any form of clinical gender, where different valuesets may be ore appropriate (but the administrative side is always represented like this) No change will be made.
    • Brian Postlethwaite/Andrew Torres: 8-0-0
    • Correction

      Existing Wording: Code Display Definition

      male Male Male

      female Female Female

      other Other Other

      unknown Unknown Unknown

      Proposed Wording: Harmonize or reuse "M", "F" rather than "male" and "female from Administrative Gender (HL7 V3) urn:oid:2.16.840.1.113883.1.11.1,

      Comment:

      Administrative Gender Value Set

      http://www.hl7.org/FHIR/2016Sep/valueset-administrative-gender.html

      is the mandatory encoding for:

      Patient.gender (Required) the most commonly used resource

      RelatedPerson.gender (Required)

      Practitioner.gender (Required)

      Person.gender (Required)

      FamilyMemberHistory.gender (Required)

      StructureDefinition FamilyMemberHistory-Genetic: FamilyMemberHistory.gender ((Required))

      Patient.contact.gender (Required)

      However this code is not consistent with US mandates to use Consolidatd-CDA which requires that " patient SHALL contain exactly one [1..1] administrativeGenderCode, which SHALL be selected from ValueSet Administrative Gender (HL7 V3) urn:oid:2.16.840.1.113883.1.11.1 DYNAMIC (CONF:2212-6394)."

      Furthermore, the code and display name for each "code" are identical except for capitalization: male for the code and Male for the display label. Most system already use M and F because they try to conserve screen space. Using an English word as a code is not consistent.

      Based on past discussions, this value set may require harmonization but recreating new codes specifically for FHIR does not make sense since most implementations already use M and F for administrative gender. New attributes such as gender at birth and gender identity have been added to better describe the patient but this value should still be backwards compatible and harmonized with V3/CDA and V2 as much as possible.

      The "required" administrative-gender Value Set is not consistent with US mandate to use Administrative Gender (HL7 V3) urn:oid:2.16.840.1.113883.1.11.1 and requires further harmonization.

      Summary:

      Gender code issue conflict with US requirements

            Assignee:
            Unassigned
            Reporter:
            Ioana Singureanu
            Watchers:
            3 Start watching this issue

              Created:
              Updated:
              Resolved: