Infoway Sex-Gender Working Group meeting on Tuesday, August 11th, 2020 at12 pm ET/9 am PT

Thank you, teammates, for the clarification. I also believe the 2-separate-fields approach is needed and was worried that we'd decided to change course. I'm not certain that the "overloading 1 field" option is necessarily a good option to entertain as an interstitial step... but it is worth discussing to determine a yes/no on this point.

I agree with the comments that mandating vendors to have sex and gender as two discrete data fields is the way to go for Canada. I think part of the discussion was on what kind of guidance and migration strategies can we offer to vendors and organizations that need to upgrade/change their EHRs to having sex and gender as discrete data fields. This will be more than just a technical upgrade but one that involves good planning, policy change, staff education, practice/attitude change, stakeholder engagement, public awareness, etc. .

I don't think we are suggesting putting sex and gender into the same field. They really are discrete concepts.

If a vendor does not have 2 fields available, I would see them as non-compliant to current standards. The US Meaningful Use/ISA requires discrete fields for sex and gender. I think Canada should be going this way as well, if we do not set a standard, there is minimal impetus for the vendors to make the change.

Hi all -- and I'm sorry to have missed what was, obviously, a very good meeting.
I have a clarification question regarding the summary minutes. Please can I ask specifically about this quote:

"Questions regarding implementation were raised such as how will this interact with HL7, and how should vendors with a single field manage change? Dorrell stated that one of the goals is to flatten via a translation table (many to one). For vendors, looking at different options for data entry if only one field. Appropriate and unambiguous back and front-end representation is required."

Are we looking for a way to try to "overload" both sex and gender into a single field... perhaps by doing a cross-product between the two concepts and creating a single code list that includes all the possible combinatorial pairs of these two concepts? I'm sorry if it is obvious to everyone but me... but do I correctly understand that this cross-product is the option that is being described?

Thanks and warmest regards,
Derek

Greetings all.
The notes and Infoway slide deck have been posted to the documents folder:
infocentral.infoway-inforoute.ca/en/resources/docs/sex-gender/sex-gender-meetings

I have also provided the notes and agenda below:

Agenda
1. Welcome
2. Gender, Sex and Sexual Orientation (GSSO) Mind Mapping
3. Group Discussion
4. Other Items
5. Adjournment

1. Welcome
Introduction and welcome.
2. Presentation – Gender, Sex and Sexual Orientation (GSSO) Mind Mapping-Nova Scotia Health Authority
NHS team provided an introduction to Enterprise Architect and the utility of the tool for mindmapping, modeling, collaboration, traceability, and other functions. This was followed by a presentation of the GSSO model beginning with the gender concepts mind map. Thomas then presented the sex model, including organ inventory, hormone inventory, and surgical inventory, and sexual orientation model..
3. Discussion
Dorrell addressed questions from CIHI and other participants related to identifiers, resources and different jurisdictions, as well as questions related to data modelling and the evolving nature of GSSO terminologies. The possibility of a pan-Canadian terminology server was raised. Questions regarding implementation were raised such as how will this interact with HL7, and how should vendors with a single field manage change? Dorrell stated that one of the goals is to flatten via a translation table (many to one). For vendors, looking at different options for data entry if only one field. Appropriate and unambiguous back and front-end representation is required. Aaron and Roz reviewed their involvement and provided their support. One presenter asked, where do we go from here? Do we share this? Do we adopt it as a pan-Canadian standard? Dorrell stated that ownership is the SGWG’s. Thinking bigger picture that just NS, as has had national input. The goal is sharing and developing toward pan-Canadian standards. There is a need to remember that a lot of this information should be entered via clinical documentation or by the patient. Education will be very important to provider to ensure appropriate understanding, use and documentation. Roz explained that this model is realistic, which is different than how GSSO is represented in EHRs currently. Aaron stated that this model should be integrated vertically and horizontally throughout Canada. Sees Canada as taking a leading role in the world. We should be able to teach other countries how to work with this information. Canada has something to share. Dorrell commented on the ability of EA to add new labels, references, lots of data, and makes the tool very flexible. Roz stated that this model can easily be modified for other countries. Dorrell stated that SNOMED CT would be beneficial because could create new concepts as they arise, and can be implemented via a terminology server. We heard that may office-based EMR vendors are using the International version of SNOMED CT, not the Canadian version. Andrea MacLean stated that this work is being raised with stakeholders and SDOs including DICOM, SNOMED, etc. She reminded the group that the SNOMED International strategy is out for review, and that Infoway will be providing feedback in the coming days. We are influencing the international standard. Linda Parisien has been working with International French version. Well on our way. Janine Kaye – some of the terms do not translate that well into French. Thinking about translations important.
4. Other Items
CIHR Stakeholder Consultation Session topics and schedule reviewed. WG schedule and presentations reviewed.
5. Adjournment

A reminder about our working group meeting on Tuesday, August 11th at 12pm ET/ 9 am PT. We will be having Dorrell Metcalfe, Thomas Armstrong and Keltie Jamieson from Nova Scotia Health Authority presenting on Gender, Sex and Sexual Orientation (GSSO) Mind Mapping. Below is the purposed agenda:
.
1. Welcome
2. Gender, Sex and Sexual Orientation (GSSO) Mind Mapping
3. Group Discussion
4. Other Items
5. Adjournment

One-time registration for the Zoom meeting is required for those that may be new to the group. Details can be found on the Infoway events calendar: infocentral.infoway-inforoute.ca/en/news-events/event-calendar/icalrepeat.detail/2020/08/11/3539/1322/sex-gender-working-group-meeting

Thanks,
Marcy