Submitted by pwilson@ncpdp.org on 2023-04-17
Submitted By: Keith W. Boone / Audacious Inquiry | |
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Data Element Information | |
Use Case Description(s) | |
Use Case Description | Facility level data is associated with laboratory tests (the testing facility), and health care provider locations, including hospitals, ambulatory providers, long-term and post acute care, and pharmacy providers. Location data is used to support reporting of data for public health and emergency response (e.g., situation awareness reporting). See https://build.fhir.org/ig/HL7/fhir-saner/ for details (note that (minus) - is a legal character in URLs, had to use a bit.ly link to get past validation errors in URL) |
Estimate the breadth of applicability of the use case(s) for this data element | Hospitals in the US (Approximately 7000), Laboratories (260,000), pharmacies (88,000), ambulatory physicians (260,000). |
Link to use case project page | https://bit.ly/SANERBUILD |
Healthcare Aims |
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Maturity of Use and Technical Specifications for Data Element | |
Applicable Standard(s) | Various: FHIR DSTU2, 3 and 4, CDA Release 2.0, HL7 V2 PL Data Type https://bit.ly/FHIRLocation |
Additional Specifications | V3.1.0: https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-location.html V3.0.0: http://hl7.org/fhir/us/core/2019Sep/StructureDefinition-us-core-location.html V2.1.0: http://hl7.org/fhir/us/core/2019Jan/StructureDefinition-us-core-location.html V2.0.0: http://hl7.org/fhir/us/core/STU2/StructureDefinition-us-core-location.html |
Current Use | Extensively used in production environments |
Supporting Artifacts |
Widely available within EHR Systems, but not necessarily searchable. https://open.epic.com/Interface/FHIR#Location https://mydata.athenahealth.com/static/apidoc/ig-ge-location.html https://fhir.cerner.com/millennium/r4/encounters/encounter/ (Reference to a Location resource) https://developer.allscripts.com/FHIR?PageTitle=Resources https://api.evident.com/dstu2/encounter (Location as an embedded resource) https://www.questdiagnostics.com/dms/Documents/care360/Terms-Conditions/Quanum_EHR_FHIR_API.pdf (Quest only supports Location name in Immunizations) https://bit.ly/USCore31 |
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 US Core Connectathon report out: https://drive.google.com/file/d/1WNYWLEf28j8DPyDachC8jpk-QbkyuPxP/view https://bit.ly/2DTBheD |
Potential Challenges | |
Restrictions on Standardization (e.g. proprietary code) | None |
Restrictions on Use (e.g. licensing, user fees) | None |
Privacy and Security Concerns | Locations associated with Critical Access Hospitals, and single provider facilities may constitute PHI (in geographic locations with limited populations) and/or Individual Identifiable Information (e.g., for HCPs working from a combined home/office facility). |
Estimate of Overall Burden | Most electronic systems provide the capacity to store location and organization information. Many EHRs already provide access to the Location resource via READ operations, some (e.g., Epic, AthentaHealth) provide search capabilities as well. This information is routinely communicated in HL7 V2 Messages, CDA Documents and some FHIR API transactions. To address gaps, implementers would need to modify interfaces (e.g., for CDA or HL7 V2), or add an endpoint. Estimated effort (based on past experience building EHR systems) is about one two-week sprint to implement the capability by a developer. |
Other Implementation Challenges | Standards for location identifier may need flexibility depending on use of Location for reportiong, as there are a number of distinct location identifier systems which may be necessary for different reporting use cases. For example, CDC/NHSN assigns identifiers for HAI reporting, CLIA assigns identifiers to laboratories, CMS provides location identifiers, et cetera. |
Submitted by yale-coredQMRoadmap on 2023-09-19
CMS-CCSQ Support for Facility Identifier for USCDI v5
CMS-CCSQ is pleased to see that Facility Identifier data element was added to USCDI v4. However, we recommend that the Facility Identifier data element be limited to capturing an individual facility instead of an organization or health system (with multiple facilities). We also recommend the NHSN OrgID be added to the Facility Identifier data element in addition to existing standards to capture individual facilities. This recommendation is a slight change from the CMS-CDC recommendation for draft USCDI v4 where NHSN OrgID was recommended under the Organization/Hospital Identifier. Additional discussion amongst CMS and CDC concluded that NHSN OrgID can more adequately capture an individual hospital or individual facility and that the CCN, which is currently in the Facility Identifier data element, is more appropriate as an organizational identifier.