Preferred Names, Preferred Pronouns, and Gender Identity in the Electronic Medical Record and Laboratory Information System: Is Pathology Ready?

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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Bibliographic Details
Published in:Journal of pathology informatics Vol. 8; no. 1; p. 42
Main Authors: Imborek, Katherine L., Nisly, Nicole L., Hesseltine, Michael J., Grienke, Jana, Zikmund, Todd A., Dreyer, Nicholas R., Blau, John L., Hightower, Maia, Humble, Robert M., Krasowski, Matthew D.
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01-01-2017
Wolters Kluwer India Pvt. Ltd
Medknow Publications & Media Pvt. Ltd
Medknow Publications & Media Pvt Ltd
Elsevier
Subjects:
Blood transfusion
Clinical laboratory information system
Electronic health records
Gender aspects
gender dysphoria
Gender identity
Hematology
Laboratories
Laboratory tests
Literature reviews
medical informatics
Medical records
Medicine
Middleware
Pathology
Policies
Risk assessment
Sex
Software
Technical Note
gender dysphoria
Clinical laboratory information system
medical informatics
electronic health records
transgender
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Summary: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.
ISSN:2153-3539
2229-5089
2153-3539
DOI:10.4103/jpi.jpi_52_17