HL7 Gender Harmony SFCU Issues - Proposing an Alternative - updated

Hey Francis,
Thanks for this summary.

I just wanted to make a clarification on 2 B's point - "since shielding reproductive organs is no longer recommended"
I think this is only in reference to newer x-ray and imaging technologies because they use less radiation than older machines and procedures.

Therefore, shielding will be still recommended for older machines and procedures in order to protect patients. And since many legacy machines and systems will continue to be in use for the foreseeable future, especially in poorer communities and healthcare organizations, discussions of shielding are important to have.

That is my understanding of what was discussed in the meeting, but radiology is not speciality, so I might be incorrect on this.
I'll stop there.

Hi folks

Thanks Joanie for posting the SFCU discussion notes from Jan 5/2023: confluence.hl7.org/display/VOC/2023-01-05+GI-SFCU+Subgroup+Meeting+Agenda+and+Noteslink

My understanding of the issues and options discussed at that meeting are below. Please add/edit/comment as you see fit:

1. There are questions about changing the data element name from SCFU to Clinical Characteristics for Diagnostics, Analytics, Testing and Settings or CCDATS – (a) should it be at the patient or order entry level? (b) how broad should it be, e.g. what about missing non-reproductive organs such as kidney? (c) this change may need to go back to ballot again

2. There are questions about the proposed SFCU/CCDATS value set with multi-selections: (a) the options seem mixed with some at patient level and others at order entry levels, (b) the distinction between internal/external reproductive organs in imaging is becoming less relevant since shielding reproductive organs is no longer recommended, (c) this change may need to go back to ballot again

3. Discussed suggestions to address these issues include: (a) revise CCDATS name to say Clinically Relevant Characteristics for Diagnostics, Analytics, Testing and Settings or CRCDATS, (b) leave the name SFCU as is but adopt the proposed value set, (c) restrict the use of SFCU/CCDATS/CRCDATS to sex-related tests and interventions only, (d) limit SFCU/CCDATS/CRCDATS use to patient level only, (e) change the value option Unknown to Unknown clinical characteristics, (f) clarify the definition for Unknown to “ensure clinically relevant characteristics are known before proceeding with treatment”

Francis Lau, on behalf of the UVic Digital Health Equity Team

Hello folks,

If anyone is interested in reviewing the minutes of the HL7 Gender Harmony SFCU subgroup, those minutes can be found here: confluence.hl7.org/display/VOC/2023-01-05+GI-SFCU+Subgroup+Meeting+Agenda+and+Notes .

The majority of the discussion was focused on the proposed SFCU alternative that has already been posted.

If you have any questions, comments, or concerns, feel free to post to this thread for discussion.


Best Regards,
Joanie Harper

Specialist, Standards,
Canada Health Infoway

Happy New Year!

Just a reminder that the Gender Harmony subgroup call for Sex For Clinical Use is scheduled for January 5th at 2:30pm ET.
Here is the zoom link for the meeting - us02web.zoom.us/j/82612447163 .

We had some really good discussion in the meetings prior to Christmas and we would like to keep that momentum going.
If you can attend the meeting tomorrow, it would be greatly appreciated.


Best Regards,
Joanie Harper

Specialist, Standards,
Canada Health Infoway

Thank you to all who attended the SFCU subgroup meeting today. I think it was another very good conversation.

From the discussion, there were changes made to a few of the definitions. The changes are the red text.
Please let me know if there is anything that I missed.

Proposed Value Set: Clinical Characteristics for Diagnostics, Analytics, Testing and Settings
Apply female reference ranges or settings
Available data indicates that diagnostics, analytics, treatments, and settings should consider best practices associated with female reference populations.
Apply male reference ranges or settings
Available data indicates that diagnostics, analytics, treatments, and settings should consider best practices associated with male reference populations.
Apply specified reference ranges or settings (see comment)
Available data (see comment) indicates that diagnostics, analytics, treatments, and settings best practices may be undefined or not aligned with existing sex-derived reference populations. Individuals or systems providing care should review the comment data and then either use default behavior that is safe for all populations, individually review treatment options with the patient, or ensure clinically relevant characteristics are known (e.g. reproductive organs, anatomical inventory, hormonal inventory, surgical history) before proceeding with treatment.
Apply reference ranges or settings applicable to internal reproductive organs
Available data indicates that diagnostics, analytics, treatments, and settings should consider best practices associated with populations having internal reproductive organs.
Apply reference ranges or settings applicable to external reproductive organs
Available data indicates that diagnostics, analytics, treatments, and settings should consider best practices associated with populations having external reproductive organs.
Apply reference ranges or settings applicable to a female hormone profile
Available data indicates that diagnostics, analytics, treatments, and settings should consider best practices associated with populations having a female hormone profile.
Apply reference ranges or settings applicable to a male hormone profile
Available data indicates that diagnostics, analytics, treatments, and settings should consider best practices associated with populations having a male hormone profile.
Unknown clinical characteristics
The clinical characteristics cannot be determined because there are no relevant evidence or documentation, or the evidence or documentation are not sufficient to determine a value. Individuals or systems providing care should either use default behavior that is safe for all populations, individually review treatment options with the patient, or ensure clinically relevant characteristics are known (e.g. reproductive organs, anatomical inventory, hormonal inventory, surgical history) before proceeding with treatment.


I wish everyone joy and happiness in the holiday season and I look forward to working with you in the new year.

Best Regards,
Joanie Harper

Specialist, Standards,
Canada Health Infoway

Hi Joanie, thanks so much for working on the proposed SFCU alternative and posting it to the SGWG forum. Here is my understanding of what's being proposed and my comments for everyone to consider:

1. The data element name Sex for Clinical Use will be changed to Clinical Characteristics for Diagnostics, Analytics, Testing and Setting, or CCDATS

2. The proposed value set for CCDATS is as follows (for definitions please refer to Joanie's earlier posting):

2a. Apply female reference ranges or settings
2b. Apply male reference ranges or settings
2c. Apply specified reference ranges or settings (see comment)
2d. Apply reference range or settings applicable to internal reproductive organs
2e. Apply reference range or settings applicable to external reproductive organs
2f. Apply reference range or settings applicable to a female hormone profile
2g. Apply reference range or settings applicable to a male hormone profile
2h. Unknown

3. I think the proposed alternative does adequately address the issues that we have raised earlier with SFCU. One other issue is the need to allow multiple selections from the list of value options.

4. For SGWG members please review the proposed alternative to see if you find it acceptable and/or if you have other concerns that need to be addressed. I also urge everyone to attend the upcoming Thursday SFCU subgroup meeting where the proposed alternative will be discussed. Here is the zoom link to the Thursday Dec 22 meeting at 230pm ET- us02web.zoom.us/j/82612447163

Thanks-Francis on behalf of the UVic GSSO team