Stream: patient administration WG
Topic: Patient Form of Address
Simone Heckmann (Apr 05 2019 at 07:07):
I know we've had this discussion before at WGMs (in context of our lengthy gender debates...) but to my knowledge not with a definite solution.
But currently this has come up in Germany, since we have officialy introduced the "third" administrative gender "divers".
System vendors are now wondering how to address a person with an administrative gender of "other".
Some people have advised us to put Herr/Frau/Mr./Mrs. in the HumanName prefix. This solution however has a couple of downsides:
1. we don't have a standard qualifier for "salutation" to distinguish this prefix from actual name part prefixes
2. in German (and probably other languages as well), salutation is only half the answer, because basically every adjective needs to be gendered and even the salutation changes depending on casus.
3. it's not clear, how to use a prefix to express a patient's request to be addressed gender neutrally
Therefore we are leaning towards "extension".
Question: is this a potential candidate for standard extension, or is this something that should be defined with national scope?
Brian Postlethwaite (Apr 05 2019 at 08:20):
@Cooper Thompson any thoughts?
The patient station or title I've always thought of as prefix yes, and ever had other uses of it, but that's just my personal experience.
Simone Heckmann (Apr 05 2019 at 10:56):
FYI: By "we don't have a qualifier", I was referring to this extension: http://hl7.org/implement/standards/fhir/extension-iso21090-en-qualifier.html
Grahame Grieve (Apr 05 2019 at 12:22):
ask to add TITLE (from http://hl7.org/implement/standards/fhir/v3/EntityNamePartQualifier/cs.html) to the value set
Cooper Thompson (Apr 05 2019 at 13:57):
Is the German divers value for intersex or gender identity? I've seen conflicting info, so it isn't clear to me which it is.
Cooper Thompson (Apr 05 2019 at 14:05):
We use a discrete list of patient pronouns to drive form of address, rather than title, gender identity, or any of the other sex or gender values. Adding an extension to track preferred pronouns is probably a good idea. We haven't really encountered other systems that can consume patient pronouns, so we have not crossed the bridge of having to exchange that data yet.
Simone Heckmann (Apr 17 2019 at 06:52):
"Divers" is actually an administrative gender, so basically the equivalent of gender="other".
BTW we are currently tending towards creating an DE-realm extension "formOfAddress" of type coding with an extensible binding to the values male|female|neutral
Does anyone think this is useful enough to make it a standard extension?
Simone Heckmann (Apr 17 2019 at 11:33):
ask to add TITLE (from http://hl7.org/implement/standards/fhir/v3/EntityNamePartQualifier/cs.html) to the value set
TITLE is not the same thing as pronoun...
Simone Heckmann (Apr 17 2019 at 11:44):
An pronoun on the other hand is not really a name part. Systems who do not support the extension and therfore assume a prefix of "Mr. or Mrs." to be an actual name part, could easily end up with a douplicate "Mr./Mrs.", if they add/chose form of address based on administrative gender.
Also, my expectation for a prefix is that it can simply be concatenated with the name, whereas the form of address (at least in German) can be different depending on context.
To give you an example: We would write "Sehr geehrter Herr Mustermann", but in another context it would be "...hiermit berichten wir über Herrn Mustermann".
I would assume that auto generated salutation (e.g. in a letter) would be implemented as "if this than that" not as concatenation of name parts.
Last updated: Apr 12 2022 at 19:14 UTC
