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[Gnumed-devel] Gender as "required"

From: James Busser
Subject: [Gnumed-devel] Gender as "required"
Date: Tue, 22 Jan 2008 21:39:27 -0800

was: modification request: display of DOB and Gender

I would like to present an argument for why gender, although it should be available and usually completed in the "Register new patient" widget", should not be "required" i.e. that it be permitted to be null.

I cannot imagine the front line staff asking a patient "what is your sex"? I would bet money that if it does not happen to be contained on a patient's ID presented to the front desk, the front desk staff simply judge it from the name and/or phenotype of the person, and assign a value on that basis.

Therefore, when entered, there may be no actual *authenticity* to the entry.

When a front desk staff would not be sure the gender of a patient, they are presently forced to ask the patient -- which, in crowded reception areas, or even privately, could be embarrassing to one or the other -- or to put in a guess.

When trying to obtain information from my patient from another agency, I have been asked the patient's name, and date of birth, health number or agency number, and sometimes address or phone information, but never their sex/gender.

Gender in the backend does not really protect against duplicate patient creation, because I cannot imagine you would truly have two patients with the same name and date of birth who would be legitimately differentiated by actually being of 2 different sex/ genders.

So the main purpose that gender would seem to serve is to assist what clinical decision support systems (reproductive health screening, cancer screening etc) that may be able to be interfaced to GNUmed later and, to a lesser extent, statistics.

If we made it gender not required, it can still be left, through social control practices, for the front desk staff to be directed to enter it routinely (as they do the other information like address and phone numbers) *except* they would omit it when they may truly be unsure. This would assist those instances I myself experience when referred a new patient with partial information --- typically with a foreign name, whose gender cannot be surmised --- who otherwise cannot be entered into the system, and cannot be scheduled, on account of a piece of information that the desk staff are missing.

The absence of a value for gender would be signaled easily enough by the absence of the automatic title/salutation (Mr/Ms) and, as well, if the below display suggestion is implemented that combines the display of DOB with Gender and Age, the null gender could be denoted with "?"

On 22-Jan-08, at 8:50 PM, James Busser wrote:

This would permit us to combine the newly reclaimed 70 pixels of width with the "Age" space, to provide a combination of Age + Gender + DOB, pushing Caveat slightly to the right if needed, to yield:

        YYYY-MM-DD Gender YYageMMage
        e.g. 1958-05-14 M 59y8m
I would abbreviate Gender in this display to the first character (in many cases, regardless of language, this will be M or F, or rarely T).

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