Submitted by HCapon on
PACIO Comments on Author Role
- Data Class: Provenance
- Data Elements: Author Role (Draft V5)
- Recommendation: Include Author Role in the final draft of Version 5 but specify that this data element captures the role the author is currently performing.
- Rationale: The PACIO (Post-Acute Care Interoperability) Project, established February 2019, is a collaborative effort between industry, government, and other stakeholders, with the goal of establishing a framework for the development of FHIR implementation guides to facilitate health information exchange.
- The PACIO Community applauds the inclusion of Author Role in USCDI. The language in the description of this data element suggests that it is capturing the category of the actor. We believe that this element should capture the actual role the author is fulfilling when they are recording or attesting to information as this could be dynamic throughout a period of care or an encounter. As examples, a family member should be able to record “primary caregiver” in addition to being a relation, and a nurse on a team of nurses should be able to record which job or role they were fulfilling when a given activity takes place as these roles might change during a shift.
Submitted by nachcinformatics on
Author and Author Role
NACHC strongly supports the need for provenance in healthcare data including the addition of Author and Author Role as described below.
Provenance: Author and Author Role [New Data Elements]
https://www.healthit.gov/isa/taxonomy/term/1171/draft-uscdi-v5
https://www.healthit.gov/isa/taxonomy/term/2201/draft-uscdi-v5
HL7 applauds the addition of Author and Author Role so that now individual clinicians can be identified, as well as patients and their caregivers. The ability to recognize patients and caregivers as authors paves the way to including more patient contributed health data in a medical record. The ability to individually identify a data author provides richer information to patients. HL7 highlights one nuance to consider: if an author is external to an organization or leaves an organization, they might not have an organizational ID or system ID. Patients and caregivers would most likely also not have identifiers while clinicians may have an NPI/license number/certificate number. An author could potentially be a device as well, such as a patient’s Fitbit. HL7 recommends that it be made more explicit in USCDI v5 that a device could author data.
In addition, the inclusion of new fields in the Provenance class can better enable communication of patient generated health data. However, in USCDI v5 as in v4, several of the new fields represent data types that might be especially sensitive to the patient. Some examples in V5 include Pronoun, Name to Use, and Sex for Clinical Use. ONC should consider appropriate protection of these specific data items, while balancing all healthcare stakeholder interests.