Collecting the right information, including gender, helps to create respectful environments by making sure information that people wish to share is accurately recorded. This also ensures we have the right information to support decision making at the patient and the system levels. Measuring differences in health outcomes between people of all genders helps to address these differences and provide better health services.
Configure the Single Digital Patient Record in line with best practice standards for collecting gender and sex data in an inclusive, respectful way
Lead: Single Digital Patient Record Implementation Authority; NSW Health agencies
Work with partners to update human capital management systems such as StaffLink to capture gender and pronouns in line with best practice standards
Lead: Ministry of Health: Workforce Planning and Talent Development; eHealth NSW
Update data tools to display intersectional gender and sex data for use by NSW Health staff
Lead: Ministry of Health: Workforce Planning and Talent Development; System Information and Analytics; Centre for Epidemiology and Evidence; Agency for Clinical Innovation
Information about gender and sex is highly personal. Privacy and security of health data are critical. Health services need to gather information about gender and sex for 3 main reasons.
In some cases, existing information systems do not account for the full diversity of gender in the population.
Information systems can also affect patients' trust in the health system. For example, a patient's preferred name might be different from their legal name. Making it easy to record, view and use a person's preferred name will help people feel welcome and respected. This will limit the occurrence of people being called the wrong name and needing to correct others once or more. Australian research suggests that 30% of people would be preferred to be called by a name other than their legal name.17
The Australian Bureau of Statistics has set out a standard which outlines the national best practice for asking questions about gender and sex.18 This includes providing free text options to allow different answers and giving an option to not respond. NSW Health has begun integrating this standard into our systems. An example is the wording used in the question regarding gender in our NSW Emergency Department Patient Survey program.
Source: Emergency Department Patient Survey19
The System Performance Support Branch at the Ministry of Health has updated the Patient Flow Portal Application to allow clinicians to record the pronouns of patients. This means that other staff members can more easily see the patient's pronouns. By doing so, it minimises the risk of misgendering the patient or the patient needing to correct a staff member.
The Single Digital Patient Record in NSW Health will enhance how people experience and deliver care by providing a full picture of a patient's story in one place. This will unify access to clinical information, regardless of where consumers and families go to seek care. It will also provide an opportunity to embed best practice for collecting gender and sex information, including pronouns and preferred names and make it available to staff to use appropriately at the point of care. NSW Health is working in partnership with the NSW community to achieve this, including the LGBTIQ+ community.
This system will have a phased rollout to local health districts, which is expected to be complete by 2028. Once in place, there will be opportunities for more detailed statewide analysis of gender impacts.
Staff across NSW Health want to make sure that they and their colleagues have their gender information properly recognised by internal human resources systems. By updating our systems, we can ensure that staff are recognised accurately and respectfully for their gender. This includes providing options for displaying pronouns and ensuring staff can select options for gender that match their identity.
"The knowledge that my gender identity is not properly recognised reminds me that there will always be a part of me that is excluded, othered, forgotten, unwelcome … In the absence of accurate data, people create stories to bridge the gaps. This can lead to inaccurate decision making, ineffective policy proposals and miseducation within healthcare. We need to start telling a truthful story." Beatrix (they/them), NSW Health staff
"The knowledge that my gender identity is not properly recognised reminds me that there will always be a part of me that is excluded, othered, forgotten, unwelcome … In the absence of accurate data, people create stories to bridge the gaps. This can lead to inaccurate decision making, ineffective policy proposals and miseducation within healthcare. We need to start telling a truthful story."
More accurate data systems can enable better analysis to address gender disparities. Information on genders other than men and women can be used to identify health needs or workforce disparities for people of other genders. This could include many types of data, for example clinical safety data.
The HealthStats NSW website provides population data about a wide range of health indicators which inform policymaking in the health system, including separating data into male and female cohorts. At present, groups other than males and females are not available.
Systems including the Single Digital Patient Record are being updated to allow collection of more detailed information on gender to inform policy, deliver better health services and improve the health outcomes for our gender diverse population.
“There is a massive lack of data on gender diverse identities, both in relation to our workforce and our patients … To lack this data is to act in the dark when it comes to … understanding how best to meet the health needs of our patients." Ben (he/him), NSW Health staff
“There is a massive lack of data on gender diverse identities, both in relation to our workforce and our patients … To lack this data is to act in the dark when it comes to … understanding how best to meet the health needs of our patients."