Submitted by HCapon on
PACIO Comments on Advance Directive Observation
- Data Class: Observations (Currently Draft V5)
- Data Element: Advance Directive Observation (Currently Level 2)
- Recommendation: Include the Advance Directive Observation data element in the USCDI V5 under the new Observations Data Class. Clarify that this observation does not supersede the Advance Directive data element.
- 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 supports the inclusion of an Advance Directive data element in USCDI. With draft V5 we note that Advance Directive was changed to Advance Directive Observation. We believe that these two data elements do not reflect the same information. An Advance Directive Observation is a finding, such as “code status” or presence of an advance directive document. This is distinct from a data element that captures an advance directive document itself which we support in another comment. Both data elements are needed, but one cannot replace the other as they serve different purposes. We support the inclusion of an Advance Directive Observation data element but do not support it replacing the Advance Directive data element.
Submitted by nachcinformatics on
Observations
NACHC agrees that the Observation Data Class must be clarified to contain categories of observations much in the way that SDOH contains multiple data classes and is cross-cutting. We support the comment developed with HL7 below:
Observations (General) - [New Data Class]
https://www.healthit.gov/isa/uscdi-data-class/observations#draft-uscdi-v5
HL7 notes that the distinction between the new Observations data class and other data classes such as Laboratory and Vital Signs, is unclear considering Laboratory Test Results are categorized as Observations, as are Vital Signs. HL7 suggests that Vital Signs and Laboratory Test Results are included under Observations as references and also as specific data elements that are listed under Observations. This approach would provide greater clarity regarding to which other data classes they would apply.