|Type||Standard / Implementation Specification||Standards Process Maturity||Implementation Maturity||Adoption Level||Federally required||Cost||Test Tool Availability|
|Limitations, Dependencies, and Preconditions for Consideration||Applicable Value Set(s) and Starter Set(s)|
Submitted by gldickinson on 2020-10-23
Preserving Clinical ContextGeneral Comments: USCDI specifies lots of clinical data classes and data elements
- Resolving to myriad de-coupled fragments
- With vanishingly little focus on:
- Clinical context and vital inter-relationships, e.g., between problems, diagnoses, complaints, symptoms, encounters, allergies, medications, vaccinations, assessments, clinical decisions, orders, results, diagnostic procedures, interventions, observations, treatments/therapies, referrals, consults, protocols, care plans and status...
- Elements and context + purpose of capture: e.g., blood pressure, its measurement (systolic, diastolic), its unit of measure (mm/Hg), its reason for capture, its context of capture (sampling site, sampling method, patient position, at rest/during/post exercise...
Submitted by mattreid on 2020-03-26
The AMA requests that the…The AMA requests that the Current Procedural Terminology (CPT) code set be added to the standards listed in Section I: Representing Patient Allergies and Intolerances; Food Substances. The Allergy and Clinical Immunology CPT codes (95004 – 95199) identify patient assessment and intervention for allergy testing, ingestion challenge testing, and allergen immunotherapy, including food substances. CPT is a comprehensive and regularly curated uniform language that accurately describes medical, surgical, and diagnostic services and provides for reliable communication among users. It has an extremely robust and mature development process with open and transparent meetings and clinical input from national medical specialties and relevant stakeholders. It is the most widely adopted outpatient procedure code set. Use of the CPT code set is federally required under HIPAA.
Submitted by cmcdonald on 2018-10-01
Should use the American Allergy and Immunology list
It is short (but longer than the one below), uncluttered by special forms of food and is authoritative. While any food can cause an adverse reaction, eight types of food account for about 90% of all reactions:
Eggs, Milk, Peanuts, Tree nuts, Fish, Shellfish, Wheat, Soy
Submitted by gdixon on 2018-09-12
What is the state of UNII, its not listed
What is the state of UNII, its not listed? UNII has been problematic when implementing related to the volume of choices. SNOMED has a similar issue. Establish a top used list for Food Substances as core implementation list. Allow outliers where needed, this will improve implementation and interoperability.
Submitted by kwboone on 2017-11-20
Food substances too broad
There are over 4000 of these codes in SNOMED CT. It is still way to broad to be useful. Would suggest that a value set that would be useful would cover top 100 food items. Avoid repetition like
|256349002||Peanut - dietary (substance)|
|229889003||Peanut brittle (substance)|
|102260001||Peanut butter (substance)|
|412047006||Peanut containing products (substance)|
How many different ways do we need to say an interpret Peanut containing products? Would you feed peanuts to someone with a peanut butter allergy? That kind of clinical decision making needs to go into the making of these value sets.
UNII code system and value set is specific to FDA Product labeling and is not all that helpful for clinical use. SNOMED CT is much better suited for this purpose.
Submitted by cmcdonald on 2018-10-01
UNII has broad coverage and…
UNII has broad coverage and connections to many other code systems and to chemical structures. Also includes what food and/or allergens. Would not dismiss it out of hand.
Submitted by email@example.com on 2021-09-29
NCPDP CommentsNCPDP supports ONC’s recommendations.