Data Element
Sexual Activity
Description

Information on the sexual activity of the patient
Submitted By: Raymonde Uy / National Association of Community Health Centers (NACHC)
Data Element Information
Data Element Description Information on the sexual activity of the patient
Use Case Description(s)
Use Case Description The Use Case for sexual health and activity is to best identify patients at risk for STIs and unintended pregnancy and to appropriately engage patients in ongoing sexual screening and contraceptive services. This is important for primary and preventive care as well as for both research and public health use cases.

1. https://ecqi.healthit.gov/mcw/2020/ecqm-dataelement/assessmentperformedsexuallyactive.html
2. https://www.ncbi.nlm.nih.gov/medgen/537028
3. https://dphhs.mt.gov/Portals/85/hrd/documents/MTDAPHRequiredClinicalDataElements20180907.xlsx

Note: *eCQM Data Element “Assessment, Performed: Sexually Active” is limited to vaginal intercourse, and does not capture or include sexual activity data elements that are related to sexually transmitted infections secondary to sexual activity aside from vaginal intercourse.
Estimate the breadth of applicability of the use case(s) for this data element Most healthcare institutions caring for sexually-transmitted conditions and all federally qualified health centers (FQHCs) gather data about sexual activity. This encompasses, in 2019, 29 million patients at 1400+ FQHCs with more than 13000 health care delivery sites. The evaluation of social determinants of health, however, should be considered a required component of a patient-centered, value-based approach to care and therefore should be potentially relevant for any patient or care setting.
Healthcare Aims
  • Improving patient experience of care (quality and/or satisfaction)
  • Improving the health of populations
  • Reducing the cost of care
  • Improving provider experience of care
Maturity of Use and Technical Specifications for Data Element
Applicable Standard(s) SNOMED CT: (Parent code and all children codes in the hierarchy)
414254005 - Finding of frequency of sexual activity (finding)
162171002 - Currently not sexually active (finding)
228453005 - Sexually active (finding)

*LOINC
64728-9 - Have you ever had vaginal intercourse [PhenX]

*Note
Montana's Department of Public Health and Human Services (DPHHS) includes SNOMED CT codes in their “Adolescent Wellness” Registry, addressing the “STI Screening” measure, together with the “Chlamydia Screening in Women” measure.
Additional Specifications http://build.fhir.org/ig/hspc/ACOG-OPA-IG/output/
Current Use Extensively used in production environments
Extent of exchange 5 or more. This data element has been tested at scale between multiple different production environments to support the majority of anticipated stakeholders.
Potential Challenges
Restrictions on Standardization (e.g. proprietary code) None
Restrictions on Use (e.g. licensing, user fees) None
Privacy and Security Concerns This information can be seen as 'sensitive' information.
Estimate of Overall Burden Minimal

Comment

Submitted by RUy on

Reaffirming support for reproductive health data elements

The National Association of Community Health Centers (NACHC) remains steadfast in its commitment to advocating for and prioritizing Women's Health, Reproductive Health, and Social Determinants of Health (SDOH) data elements. Recognizing the critical role that these factors play in shaping the clinical outcomes of community health center patients, NACHC continues to emphasize the need for comprehensive, accurate, and interoperable data. By reaffirming our support for these essential elements, we aim to drive informed decision-making, policy development, and targeted interventions that address the root causes of health disparities. This underscores NACHC's belief in the transformative potential of this data element in building healthier, more equitable communities.

See attached letter of support containing comments on data elements across USCDI submissions and versions.

2023-09-20 NACHC USCDIv5 Letter of Support_9.pdf

Submitted by RUy on

Sexual Activity as an SDOH data element for reproductive care

Standardizing data related to sexual activity is crucial for identifying and addressing a wide range of health concerns, including sexually transmitted infections, reproductive health, and sexual dysfunction

SNOMED-CT code 414254005, "sexual history and examination", can be used to document information related to sexual activity, including sexual orientation, frequency of sexual activity, and use of contraceptives.

SNOMED-CT code 162171002, "sexual function examination", can be used to document information related to sexual function and dysfunction, including erectile dysfunction or sexual pain disorders.

SNOMED-CT code 228453005, "history of sexually transmitted disease", can be used to document a patient's history of sexually transmitted infections, which is essential for guiding diagnosis and treatment.

Incorporating these codes into standardized data elements for interoperability across EHR systems can improve the consistency and accuracy of documentation, facilitate the exchange of information between providers, and support population health management efforts. By recognizing the importance of sexual activity data and using standardized SNOMED-CT codes to document this information, healthcare providers can deliver more comprehensive and patient-centered care.

Submitted by RUy on

Sexual Activity as SDOH data element under USCDI or ISA

NACHC would like to resupport this data element for consideration / inclusion to USCDIv3.

All federally qualified health centers (FQHCs) gather SDOH data, which includes a focus on this data element through the PRAPARE screening tool. This data is relevant to and encompasses in 2019 29 million patients at 1400+ FQHCs with more than 13000 health care delivery sites. 

If this data element is not considered for addition to USCDI, we would like to comment on it's addition to ISA as a coded data element under SDOH, with applicable standards and representation accross ICD-10-CM, SNOMED-CT and LOINC.

Please see attached document supporting this. 

2022-09-30 NACHC USCDIv3 Letter of Support_17.pdf

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