Data used to categorize individuals for identification, records matching, and other purposes.

Data Element
Country of Nationality
Description

The patient's country of nationality.
Submitted By: Sarah Gaunt
Data Element Information
Use Case Description(s)
Use Case Description This data element in used in electronic case reporting (eCR) which provides case reports to state, tribal, local, or territorial (STLT) public health agencies (PHA) for up to 292 reportable diseases and conditions. Submission of reports of persons with these conditions is required by law in every US State and Territory. Public health epidemiologists have identified the data elements necessary to be included in electronic case reports from healthcare organizations and providers. The transition is underway from providing these reports via fax, mail, email, or phone to using data available in the electronic health records to submit reports electronically to all PHAs. As of September 13, 2020, over 9,300 healthcare facilities are using eCR to submit these data. Once received at the PHA, this data is use for surveillance, case management and public health response efforts such as contact tracing or other mitigation efforts. Specific to this data element: This is particularly important for people who travel across borders often and/or spend significant periods of time in another country.
Estimate the breadth of applicability of the use case(s) for this data element This data is exchanged as part of the extensive implementation of electronic case reporting in the US. Target is nationwide, currently 5400+ sites are reporting. There are between 56 and 2400 public health agencies using this data. Electronic case reporting is also cited in the Cares Act regulations.
Link to use case project page https://www.cdc.gov/ecr/index.html
Healthcare Aims
  • Improving patient experience of care (quality and/or satisfaction)
  • Improving the health of populations
  • Improving provider experience of care
Maturity of Use and Technical Specifications for Data Element
Applicable Standard(s) HL7 FHIR® Implementation Guide: Electronic Case Reporting (eCR) based on FHIR R4
HL7 CDA® R2 Implementation Guide: Public Health Case Report - the Electronic Initial Case Report (eICR) HL7
FHIR: Country of Nationality profile HL7
CDA: Country of Nationality template
SNOMED: 186034007 |Ethnicity / related nationality data (observable entity)|
https://www.hl7.org/implement/standards/product_brief.cfm?product_id=519
https://www.hl7.org/implement/standards/product_brief.cfm?product_id=436
http://thisfieldcomesupifyes.com
Additional Specifications HL7 FHIR® Implementation Guide: Electronic Case Reporting (eCR) based on FHIR R4
HL7 CDA® R2 Implementation Guide: Public Health Case Report - the Electronic Initial Case Report (eICR) HL7
FHIR: Country of Nationality profile
HL7 CDA: Country of Nationality template
Current Use Extensively used in production environments
Supporting Artifacts Soon to be published: HL7 FHIR® Implementation Guide: Electronic Case Reporting (eCR) STU Release 2
Soon to be published: HL7 CDA® R2 Implementation Guide: Public Health Case Report - the Electronic Initial Case Report (eICR) Release 1, STU Release 3.0
https://www.hl7.org/implement/standards/product_brief.cfm?product_id=519
https://www.hl7.org/implement/standards/product_brief.cfm?product_id=436
https://www.hl7.org/implement/standards/product_brief.cfm?product_id=519 https://www.hl7.org/implement/standards/product_brief.cfm?product_id=436
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.
Supporting Artifacts See above
Potential Challenges
Restrictions on Standardization (e.g. proprietary code) None
Restrictions on Use (e.g. licensing, user fees) None
Privacy and Security Concerns None
Estimate of Overall Burden These data elements are straightforward in nature and should not present a large burden to implement provided the EHR system is capturing the data.
Other Implementation Challenges None
ONC Evaluation Details
Each submitted Data Element has been evaluated based on the following criteria. The overall Level classification is a composite of the maturity based on these individual criteria. This information can be used to identify areas that require additional work to raise the overall classification level and consideration for inclusion in future versions of USCDI
Criterion #1
Maturity - Current Standards		 Level 2 - Data element is represented by a terminology standard or SDO-balloted technical specification or implementation guide.
Criterion #2
Maturity - Current Use 		Level 1 - Data element is captured, stored, or accessed in at least one production EHR or HIT module.
Criterion #3
Maturity - Current Exchange		 Level 0 - Data element is electronically exchanged in limited environments, such as connectathons or pilots.
Criterion #4
Use Case(s) - Breadth of Applicability		 Level 0 - Use cases apply to a limited number of care settings or specialties, or data element represents a specialization of other, more general data elements.

Comment

Log in or register to post comments