Type | Standard / Implementation Specification | Standards Process Maturity | Implementation Maturity | Adoption Level | Federally required | Cost | Test Tool Availability |
---|---|---|---|---|---|---|---|
Standard
|
Final
|
Production
|
Yes
|
Free
|
N/A
|
||
Standard
|
Final
|
Production
|
Yes
|
Free
|
N/A
|
Limitations, Dependencies, and Preconditions for Consideration |
Applicable Value Set(s) and Starter Set(s)
|
---|---|
|
|
Comment
Submitted by gldickinson on
Preserving Clinical Context
General Comments:
USCDI specifies lots of clinical data classes and data elements
- Resolving to myriad de-coupled fragments
- With vanishingly little focus on:
- Clinical context and vital inter-relationships, e.g., between problems, diagnoses, complaints, symptoms, encounters, allergies, medications, vaccinations, assessments, clinical decisions, orders, results, diagnostic procedures, interventions, observations, treatments/therapies, referrals, consults, protocols, care plans and status...
- Elements and context + purpose of capture: e.g., blood pressure, its measurement (systolic, diastolic), its unit of measure (mm/Hg), its reason for capture, its context of capture (sampling site, sampling method, patient position, at rest/during/post exercise...
It is crucial to consider and determine/resolve how clinical content and context are bound together and preserved in USCDI. The ultimate end user (often a clinician) must be able to readily discern context and inter-relationships – otherwise USCDI places an undue (and often unresolvable) burden on this user. Only the source EHR/HIT system can structure clinical content and context properly. Once data is stuffed into the USCDI framework and related exchange artifact (e.g., FHIR resources) this opportunity is forever lost.
Submitted by pwilson@ncpdp.org on
NCPDP Comment
While use of ICD-10 is limited, when transmitting diagnosis information it is required. HIPAA mandates the use of ICD-10 for pharmacy claims using NCPDP standards. SNOMED is optional. Adoption level for ICD-10 for the pharmacy is 5.
Submitted by mcpatric on
NLM ICD9CM to SNOMED CT maps
Regarding the 3rd bullet about handling legacy content, NLM has maps from ICD-9-CM diagnosis and procedure codes to SNOMED CT to facilitate code translation and integration with newly collected SNOMED CT data:
Submitted by pwilson@ncpdp.org on
NCPDP Comments
NCPDP supports ONC’s recommendations.