My organisation bought a new electronic health record from the biggest EHR company and there's something really cool that is totally different from the half dozen systems I've used before: there are multiple sex and gender fields so the medical record can accurately show the patient's preferred name, correct pronoun, medical-care relevant, and organ-specific information. So if I understand right, front end staff will just see correct pronoun. Medical providers can see a flag indicating trans.

I need more details but seems like a huge improvement in what I've ever seen before which is just wrong name, wrong gender, or occasionally right gender (depending on who registered the patient) and notes in the chart that are sometimes really problematic. This system seems to model doing things right so can also teach the providers and staff as they use the system

Seeing this I'm soooo appreciative of the trans healthcare activists and advocates who have been pushing through a deeply transphobic and conservative system. This information is at the top of everyone's chart. It's the first thing everyone looks at. It seems like a huge deal to what everyone from registration clerks to doctors will be expected to communicate

@Latkes omg. This has been such a huge problem for us, despite having a fancy gender clinic we can't seem to get it right w/ front office staff in the rest of the hospital. We are transitioning in the next couple years to be 100% Epic (right now we schedule & bill w/ Epic but use Cerner for the actual medical stuff) so maybe we can actually fix it!

@mcmoots yeah we just bought epic and will transition out of Cerner. I hate that Epic is such a monster/monopoly but in so many ways it is so much better.

@mcmoots For this (and some other) issues I'm pretty sold on the idea that the structure of the chart can serve as a sort of authority that models appropriate behavior for the staff and providers

@Latkes That's great! I worked on an EHR system maybe seven years ago and the listed genders were something like male, female, other, and unknown. Just not having a binary choice seemed great at the time. Now actually having a flag and pronouns? Just fantastic.

@julianproxy Wow. I've never seen a non binary choice! I don't think our new system will have either... But I think there will be a free text field?

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