Representing Patient-Identified Sexual Orientation

Type	Standard / Implementation Specification	Standards Process Maturity	Implementation Maturity	Federally required	Cost	Test Tool Availability
Standard for observations	LOINC®	Final	Production	No	Free	N/A
Standard for observation values	SNOMED CT® U.S. Edition	Final	Production	Yes	Free	N/A
Standard for observation values	HL7® Version 3 Null Flavor	Final	Production	Yes	Free	N/A

Limitations, Dependencies, and Preconditions for Consideration	Applicable Value Set(s) and Starter Set(s)
An article in JAMIA provides helpful information for planning and implementing sexual orientation and gender identity data collection in electronic health records. For more information about observations and observation values, see Appendix III for an informational resource developed by the Health IT Standards Committee.	LOINC code: 76690-7 Sexual orientation ONC’s 2015 Edition certification requirements reference the following value set for sexual orientation. Codes from (i) through (iii) are SNOMED CT U.S. Edition and (iv) through (vi) are from HL7 Version 3: (i) Lesbian, gay or homosexual.38628009 (ii) Straight or heterosexual. 20430005 (iii) Bisexual. 42035005 (iv) Something else, please describe.nullFlavor OTH (v) Don’t know. nullFlavor UNK (vi) Choose not to disclose. nullFlavor ASKU SNOMED CT U.S. Edition code: Sexually attracted to neither male nor female sex 765288000 (Not required in ONC's 2015 Edition certification requirements)

Limitations, Dependencies, and Preconditions for Consideration

Applicable Value Set(s) and Starter Set(s)

An article in JAMIA provides helpful information for planning and implementing sexual orientation and gender identity data collection in electronic health records.
For more information about observations and observation values, see Appendix III for an informational resource developed by the Health IT Standards Committee.

LOINC code: 76690-7 Sexual orientation
ONC’s 2015 Edition certification requirements reference the following value set for sexual orientation. Codes from (i) through (iii) are SNOMED CT U.S. Edition and (iv) through (vi) are from HL7 Version 3:
- (i) Lesbian, gay or homosexual.38628009
- (ii) Straight or heterosexual. 20430005
- (iii) Bisexual. 42035005
- (iv) Something else, please describe.nullFlavor OTH
- (v) Don’t know. nullFlavor UNK
- (vi) Choose not to disclose. nullFlavor ASKU
SNOMED CT U.S. Edition code: Sexually attracted to neither male nor female sex 765288000 (Not required in ONC's 2015 Edition certification requirements)

Comment

Submitted by cmcdonald on 2018-10-01

The answer list for the…

The answer list for the LOINC term listed below System Answer ID 1 Bisexual /snomed.info/sct ©: 42035005 Bisexual (finding) LA22877-7 2 Heterosexual snomed.info/sct ©: 20430005 Heterosexual (finding) LA22876-9 Homosexual //snomed.info/sct ©: 38628009 Homosexual (finding) LA22875-1 Other LA46-8 5 Asked but unknown LA20384-6 Unknown ://snomed.info/sct ©: 261665006 Unknown (qualifier value) HL7 LA4489-6

Not aware that there is as of yet a federal requirement to use any particular list, SNOMED CT or otherwise.

Submitted by cgrasso on 2017-11-20

Sexual Orienation

We think that the Applicable Value Set(s) and Starter Set(s) provide appropriate answer options to measure sexual orientation. Knowledge of this information is essential to providing affirming culturally competent health care to lesbian, gay and bisexual patients.

Chris Grasso, MPH

Associate Vice President for Informatics and Data Services

Fenway Health

Submitted by kwboone on 2017-11-20

Please consider a separate…

Please consider a separate vocabulary term for asexual, a fairly common category.

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Representing Patient-Identified Sexual Orientation

Comment

The answer list for the…

Sexual Orienation

Please consider a separate…

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