Preferred names, preferred pronouns, and gender identity in the electronic medical record and laboratory information system: Is pathology ready?

Background: Electronic medical records (EMRs) and laboratory information systems (LISs) commonly utilize patient identifiers such as legal name, sex, medical record number, and date of birth. There have been recommendations from some EMR working groups (e.g., the World Professional Association for T...

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Main Authors: Katherine L Imborek, Nicole L Nisly, Michael J Hesseltine, Jana Grienke, Todd A Zikmund, Nicholas R Dreyer, John L Blau, Maia Hightower, Robert M Humble, Matthew D Krasowski
Format: Article
Language:English
Published: Elsevier 2017-01-01
Series:Journal of Pathology Informatics
Subjects:
Online Access:http://www.jpathinformatics.org/article.asp?issn=2153-3539;year=2017;volume=8;issue=1;spage=42;epage=42;aulast=Imborek
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author Katherine L Imborek
Nicole L Nisly
Michael J Hesseltine
Jana Grienke
Todd A Zikmund
Nicholas R Dreyer
John L Blau
Maia Hightower
Robert M Humble
Matthew D Krasowski
author_facet Katherine L Imborek
Nicole L Nisly
Michael J Hesseltine
Jana Grienke
Todd A Zikmund
Nicholas R Dreyer
John L Blau
Maia Hightower
Robert M Humble
Matthew D Krasowski
author_sort Katherine L Imborek
collection DOAJ
description Background: Electronic medical records (EMRs) and laboratory information systems (LISs) commonly utilize patient identifiers such as legal name, sex, medical record number, and date of birth. There have been recommendations from some EMR working groups (e.g., the World Professional Association for Transgender Health) to include preferred name, pronoun preference, assigned sex at birth, and gender identity in the EMR. These practices are currently uncommon in the United States. There has been little published on the potential impact of these changes on pathology and LISs. Methods: We review the available literature and guidelines on the use of preferred name and gender identity on pathology, including data on changes in laboratory testing following gender transition treatments. We also describe pathology and clinical laboratory challenges in the implementation of preferred name at our institution. Results: Preferred name, pronoun preference, and gender identity have the most immediate impact on the areas of pathology with direct patient contact such as phlebotomy and transfusion medicine, both in terms of interaction with patients and policies for patient identification. Gender identity affects the regulation and policies within transfusion medicine including blood donor risk assessment and eligibility. There are limited studies on the impact of gender transition treatments on laboratory tests, but multiple studies have demonstrated complex changes in chemistry and hematology tests. A broader challenge is that, even as EMRs add functionality, pathology computer systems (e.g., LIS, middleware, reference laboratory, and outreach interfaces) may not have functionality to store or display preferred name and gender identity. Conclusions: Implementation of preferred name, pronoun preference, and gender identity presents multiple challenges and opportunities for pathology.
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spelling doaj.art-4e17578a7f20435083bb42ffaf7194542022-12-22T00:26:21ZengElsevierJournal of Pathology Informatics2153-35392153-35392017-01-0181424210.4103/jpi.jpi_52_17Preferred names, preferred pronouns, and gender identity in the electronic medical record and laboratory information system: Is pathology ready?Katherine L ImborekNicole L NislyMichael J HesseltineJana GrienkeTodd A ZikmundNicholas R DreyerJohn L BlauMaia HightowerRobert M HumbleMatthew D KrasowskiBackground: Electronic medical records (EMRs) and laboratory information systems (LISs) commonly utilize patient identifiers such as legal name, sex, medical record number, and date of birth. There have been recommendations from some EMR working groups (e.g., the World Professional Association for Transgender Health) to include preferred name, pronoun preference, assigned sex at birth, and gender identity in the EMR. These practices are currently uncommon in the United States. There has been little published on the potential impact of these changes on pathology and LISs. Methods: We review the available literature and guidelines on the use of preferred name and gender identity on pathology, including data on changes in laboratory testing following gender transition treatments. We also describe pathology and clinical laboratory challenges in the implementation of preferred name at our institution. Results: Preferred name, pronoun preference, and gender identity have the most immediate impact on the areas of pathology with direct patient contact such as phlebotomy and transfusion medicine, both in terms of interaction with patients and policies for patient identification. Gender identity affects the regulation and policies within transfusion medicine including blood donor risk assessment and eligibility. There are limited studies on the impact of gender transition treatments on laboratory tests, but multiple studies have demonstrated complex changes in chemistry and hematology tests. A broader challenge is that, even as EMRs add functionality, pathology computer systems (e.g., LIS, middleware, reference laboratory, and outreach interfaces) may not have functionality to store or display preferred name and gender identity. Conclusions: Implementation of preferred name, pronoun preference, and gender identity presents multiple challenges and opportunities for pathology.http://www.jpathinformatics.org/article.asp?issn=2153-3539;year=2017;volume=8;issue=1;spage=42;epage=42;aulast=ImborekClinical laboratory information systemelectronic health recordsgender dysphoriamedical informaticstransgender
spellingShingle Katherine L Imborek
Nicole L Nisly
Michael J Hesseltine
Jana Grienke
Todd A Zikmund
Nicholas R Dreyer
John L Blau
Maia Hightower
Robert M Humble
Matthew D Krasowski
Preferred names, preferred pronouns, and gender identity in the electronic medical record and laboratory information system: Is pathology ready?
Journal of Pathology Informatics
Clinical laboratory information system
electronic health records
gender dysphoria
medical informatics
transgender
title Preferred names, preferred pronouns, and gender identity in the electronic medical record and laboratory information system: Is pathology ready?
title_full Preferred names, preferred pronouns, and gender identity in the electronic medical record and laboratory information system: Is pathology ready?
title_fullStr Preferred names, preferred pronouns, and gender identity in the electronic medical record and laboratory information system: Is pathology ready?
title_full_unstemmed Preferred names, preferred pronouns, and gender identity in the electronic medical record and laboratory information system: Is pathology ready?
title_short Preferred names, preferred pronouns, and gender identity in the electronic medical record and laboratory information system: Is pathology ready?
title_sort preferred names preferred pronouns and gender identity in the electronic medical record and laboratory information system is pathology ready
topic Clinical laboratory information system
electronic health records
gender dysphoria
medical informatics
transgender
url http://www.jpathinformatics.org/article.asp?issn=2153-3539;year=2017;volume=8;issue=1;spage=42;epage=42;aulast=Imborek
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