Assessments of a health-related matter of interest, importance, or worry to a patient, patient’s family, or patient’s healthcare provider that could identify a need, problem, or condition.

Data Element
Depression Screening
Description

Assessment of clinical depression using standardized tools.
Submitted By: Grace Glennon, on behalf of NCQA / NCQA
Data Element Information
Use Case Description(s)
Use Case Description Depressive disorders are common mental disorders that occur in people of all ages. Major depressive disorder (MDD) is the second leading cause of disability worldwide, affecting an estimated 120 million people (Murray et al., 2013). The lifelong prevalence is estimated to range from 10–15 percent (Lepine and Briley, 2011). In the United States, 15.7 percent of people report that at some point in their lifetime they were told by a health care professional that they had depression (CDC, 2009). Depression has an impact on almost all other aspects of life and health.
The U.S. Preventive Service Task Force (USPSTF) gave a Grade B recommendation to screening for depression in the general adult population, including pregnant and postpartum women, as well as adolescents aged 12-18 years of age. Guidelines and literature indicate screening tools, feasible for use in the primary care setting, can accurately identify depressed individuals and treatment can improve depression outcomes. Moreover, exchange of the data is critical to support quality care across providers—collaboration between a primary care doctor, case manager and a mental health specialist to screen for depression, monitor symptoms, provide treatment and refer to specialty care as needed are essential.
While gaps in care still exist for the screening, diagnosis and treatment of depression, depression screening are routinely conducted in primary care settings across adolescents and adults. Depression screening is also included in the Medicare Annual Wellness visit.
Estimate the breadth of applicability of the use case(s) for this data element (Level 1) – Use cases apply to several care settings or specialties.
Use Case Description Depression screening, monitoring, and follow-up remain important quality measurement areas. NCQA HEDIS includes several depression-related measures that require the screening for depression among adolescents and adults as well as prenatal and postpartum screenings. Depression quality measures also exist across other clinician and hospital-based quality programs.
Estimate the breadth of applicability of the use case(s) for this data element An estimate 10-15% of all Americans are affected by Major Depressive Disorder. Screening for depression is recommended for all adolescents and adults.
ONC Priority
  • Address behavioral health integration with primary care and other physical care
  • Mitigate health and health care inequities and disparities
Maturity of Use and Technical Specifications for Data Element
Applicable Standard(s) LOINC
https://loinc.org/
Additional Specifications Depression screening and related screening results can be exchanged via FHIR US Core IG.
Specifically, US Core Observation and QuestionnaireResponse profiles can be utilized .
Current Use (Level 2) Captured, stored, or accessed in multiple production EHRs or other HIT modules from more than one developer
Extent of exchange (Level 2) Between more than two production EHRs or other HIT modules using available interoperability standards
Supporting Artifacts Depression screening measures are currently included in NCQA HEDIS and reported by health plans using the electronic clinical data systems (ECDS) reporting, which leverages clinical data from EHRs. HEDIS is one of health care’s most widely used performance improvement tools. More than 200 million people are enrolled in plans that report HEDIS results.
https://www.ncqa.org/hedis/the-future-of-hedis/hedis-electronic-clinical-data-system-ecds-reporting/
Potential Challenges
Restrictions on Standardization (e.g. proprietary code) No restrictions
Restrictions on Use (e.g. licensing, user fees) None
Privacy and Security Concerns Exchange of patient health information, including mental health information, should follow HIPPA Privacy Rules.
Estimate of Overall Burden An NCQA-led learning collaborative with health plans in 2022 did indicate that many health plans do still struggle to report depression-related measures due to the lack of access to clinical data sources where the results of patient-reported tools were documented and the unavailability of the results of patient-reported tools in usable data fields, indicating there is still work to be done to transform depression screening information into useable, and exchangeable data. However, the screening tools used are relatively short, so collection of information should not be burdensome. Depression screening is recommended for all adolescents and adults, and therefore should be happening as part of routine care. Some health care providers and plans utilize web-based portals to complete screenings in which patients do not have to be in-person, which also supports low-burden data collection and multiple options for data collection.
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 2 - Data element is captured, stored, or accessed in multiple production EHRs or other HIT modules from more than one developer.
Criterion #3
Maturity - Current Exchange		 Level 2 - Data element is electronically exchanged between more than two production EHRs or other HIT modules of different developers using available interoperability standards.
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.
Evaluation Comment This submission represents a specialized use or subset of the existing data element Mental/Cognitive Status in USCDI v4 https://www.healthit.gov/isa/taxonomy/term/1616/uscdi-v4.

Comment

Log in or register to post comments