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This file is created on 2021-05-10 07:03:24pm

About the ISA

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ISA Structure

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ISA Timeline and Comment Process

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Data Element: Medications

Challenge to capturing medications is those that medications that don't make the typical clinically documented med list such as herbal and at times OTC medications.  These often are documented narratively in nurses or physician notes dependent on the type of EMR or documentation system. 

Data Element: Patient's Goals

Patient's goals are likely to be robustly documented in the Nurses Care Plan, depending on the type of EMR.   Would want to be able to capture current and active goals and those goals that have been completed or resolved. 

Data Element: Health Concerns

This data element may have merit, especially if there are differences in the data element for Patient Goals and Encounter Diagnosis; but may be redundant...Also, maybe difficult to capture if it is not entered in a discrete field as part of the Nursing Care Plan or Physician Treatment Plan

Support of the Gravity Project’s Submission to Include SDOH

To: The Honorable Donald Rucker, M.D. National Coordinator for Health Information Technology U.S. Department of Health and Human Services 330 C Street SW, 7th Floor Washington, D.C.  20201   Re: In Support of the Gravity Project’s Submission to Include Social Determinants of Health in the U.S. Core Data for Interoperability   Dear National Coordinator Rucker: I write on behalf of the Gravity Project to ask for your quick help with a major opportunity—adding structured social determinants of health (SDOH) data to the U.S. Core Data for Interoperability (USCDI). The Gravity Project has done considerable groundwork and submitted the SDOH data elements to the Office of the National Coordinator (ONC), and ONC, in turn, has elevated the submission to the next step. The Gravity Project’s submissions would add critical domains such as food insecurity, housing instability, transportation insecurity, social isolation, and stress to the USCDI, integrated with core clinical activities such as assessments, diagnoses, interventions, and outcomes.  As a healthcare provider for many years, I have seen firsthand the impact SDOH has on managing care and improving outcomes for patients. The challenges with meeting the needs of all seeking care have been exacerbated by COVID and have highlighted the inequities in the healthcare system. Addressing SDOH will be essential to ensure adequate care is received by all by including data elements to accurately and timely identify social needs and match those needs with community resources. The inclusion of SDOH as a new data class in USCDI, as proposed by the Gravity Project, will provide a consistent method to document and communicate these factors during a health care encounter. The Gravity Project has over 1,200 collaborators nationwide, representing diverse stakeholders who are committed to the goals of this project, standardize data collection and coding, and seamlessly exchanging SDOH data among all caregivers.   Sincerely,  Dr. Lisa Lucas National Director Healthcare Informatics SAS Institute        

FAQs

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Home

Interoperability Standards Advisory (ISA)

isa-gearThe Interoperability Standards Advisory (ISA) process represents the model by which the Office of the National Coordinator for Health Information Technology (ONC) will coordinate the identification, assessment, and determination of "recognized" interoperability standards and implementation specifications for industry use to fulfill specific clinical health IT interoperability needs.

News & Updates

The 2021 ISA Reference Edition is now available. Read more about the latest updates in the Health IT Buzz Blog. The SVAP Approved Standards for 2020 are now available.

The Draft USCDI Version 2 is open for public comment until April 15, 2021.

Interoperability for COVID-19 Novel Coronavirus Pandemic is now available.

About ISA

The ISA is frequently updated to include improvements made based on recommendations received from public comments and subject matter expert feedback. Read more about the ISA's purpose and scope.

about-isa

 

ISA Structure

The ISA is organized and structured into four sections - read more about the ISA's structure and informative characteristics about standards/implementation specifications.

isa-structure

Table of Contents

The Table of Contents of ISA's sections.
 


 

isa-table-of-contents

ISA Publications

View the most recent and historical ISA publications.

isa-publications

Recent Updates

Check here regularly for the latest updates to the ISA.

isa-recent-updates

Timeline and Comment Process

Learn more about the ISA's annual timeline and how to comment.

isa-timeline-and-comment-process

ISA FAQs

View a list of frequently asked questions and answers on the ISA.

isa-faqs

Structure

Comment

Timeline and Comment Process

Comment

Data Element: Medications

Challenge to capturing medications is those that medications that don't make the typical clinically documented med list such as herbal and at times OTC medications.  These often are documented narratively in nurses or physician notes dependent on the type of EMR or documentation system. 

Data Element: Patient's Goals

Patient's goals are likely to be robustly documented in the Nurses Care Plan, depending on the type of EMR.   Would want to be able to capture current and active goals and those goals that have been completed or resolved. 

Data Element: Health Concerns

This data element may have merit, especially if there are differences in the data element for Patient Goals and Encounter Diagnosis; but may be redundant...Also, maybe difficult to capture if it is not entered in a discrete field as part of the Nursing Care Plan or Physician Treatment Plan

Support of the Gravity Project’s Submission to Include SDOH

To: The Honorable Donald Rucker, M.D. National Coordinator for Health Information Technology U.S. Department of Health and Human Services 330 C Street SW, 7th Floor Washington, D.C.  20201   Re: In Support of the Gravity Project’s Submission to Include Social Determinants of Health in the U.S. Core Data for Interoperability   Dear National Coordinator Rucker: I write on behalf of the Gravity Project to ask for your quick help with a major opportunity—adding structured social determinants of health (SDOH) data to the U.S. Core Data for Interoperability (USCDI). The Gravity Project has done considerable groundwork and submitted the SDOH data elements to the Office of the National Coordinator (ONC), and ONC, in turn, has elevated the submission to the next step. The Gravity Project’s submissions would add critical domains such as food insecurity, housing instability, transportation insecurity, social isolation, and stress to the USCDI, integrated with core clinical activities such as assessments, diagnoses, interventions, and outcomes.  As a healthcare provider for many years, I have seen firsthand the impact SDOH has on managing care and improving outcomes for patients. The challenges with meeting the needs of all seeking care have been exacerbated by COVID and have highlighted the inequities in the healthcare system. Addressing SDOH will be essential to ensure adequate care is received by all by including data elements to accurately and timely identify social needs and match those needs with community resources. The inclusion of SDOH as a new data class in USCDI, as proposed by the Gravity Project, will provide a consistent method to document and communicate these factors during a health care encounter. The Gravity Project has over 1,200 collaborators nationwide, representing diverse stakeholders who are committed to the goals of this project, standardize data collection and coding, and seamlessly exchanging SDOH data among all caregivers.   Sincerely,  Dr. Lisa Lucas National Director Healthcare Informatics SAS Institute        

FAQs

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Vocabulary/Code Set/Terminology

Allergies and Intolerances

Representing Patient Allergic Reactions

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Representing Patient Allergies and Intolerances; Environmental Substances

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Representing Patient Allergies and Intolerances; Food Substances

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Representing Patient Allergies and Intolerances; Medications

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Tighten up the applicable starter sets

The various identified "starter value sets" in this section presents a confusing overlapping collection. The three items listed as "representing drug classes" are not equivalent and only the SNOMED CT (SCT) Product hierarchy is actually aligned with actual drug class concepts. SNOMED CT Drug product class concepts are uniquely valuable because NLM links SCT product class concepts to the appropriate RXNorm drug ingredients to support Drug class to RxNorm or even NDC codes identification via available APIs at RxClass. The other two suggested sets (Common Drug Classes for Allergy and Intolerance documentation and Common Drug Substances for Allergy and Intolerance documentation) do not represent useful drug classes and should not be listed in the Drug Classes for Allergy and Intolerance documentation section. For the Representing Medication section, the listed set Clinical Drug Ingredient (2.16.840.1.113762.1.4.1010.7) (RxNorm ingredient codes) is a subset of all potential drug ingredient RxNorm codes that was based on a historical review of common drug ingredients listed as causes of allergy or intolerance in clinical records done a number of years ago. While this list has not been updated, it is useful. I suggest adding to the suggestions in this section the set you will remove from the "class" set as it is the list of every ingredient or related code type in RxNorm - over 25,000 codes. This is the Common Drug Substances for Allergy and Intolerance documentation (2.16.840.1.113762.1.4.1186.1) set.

Clinical Notes

Representing Clinical Notes

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Cognitive Status

Representing Patient Cognitive Status

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COVID-19 Novel Coronavirus Pandemic

COVID-19 Novel Coronavirus Pandemic

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Demographics

Representing Patient Contact Information for Telecommunications

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Representing Nutrition Assessment, Diagnosis, Interventions and Monitoring/Evaluation

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Emergency Medical Services

Representing Health Care Data for Emergency Medical Services

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Encounter Diagnosis, Assessment and Plan

Representing Assessment and Plan of Treatment

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Representing Patient Dental Encounter Diagnosis

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Representing Patient Medical Encounter Diagnosis

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Family Health History

Representing Patient Family Health History

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Functional Status/Disability

Representing Patient Functional Status and/or Disability

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Goals

Representing Patient Goals

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Health Care Providers, Family Members, and Other Caregivers

Representing Health Care Providers

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Representing Provider Role in Team Care Settings

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Representing Relationship Between Patient and Another Person

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Health Concerns

Representing Patient Health Concerns

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Imaging (Diagnostics, Interventions and Procedures)

Representing Imaging Diagnostics, Interventions and Procedures

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Immunizations

Representing Immunizations – Administered

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Representing Immunizations – Historical

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Industry and Occupation

Representing Patient Industry and Occupation

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Laboratory

Representing Laboratory Tests

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Representing Laboratory Values/Results

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Medications

Representing Patient Medications

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Nursing

Representing Clinical/Nursing Assessments

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Representing Nursing Interventions

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Representing Outcomes for Nursing

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Representing Patient Problems for Nursing

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Patient Clinical “Problems” (i.e., conditions)

Representing Patient Clinical “Problems” (i.e., Conditions)

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Preferred Language

Representing Patient Preferred Language (Presently)

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Pregnancy Status

Representing Patient Pregnancy Status

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Procedures

Representing Dental Procedures Performed

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Representing Medical Procedures Performed

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Provenance

Representing Data Provenance

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Public Health Emergency Preparedness and Response

Representing Healthcare Personnel Status

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Representing Hospital/Facility Beds Utilization

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Representing Laboratory Operations (Population Laboratory Surveillance)

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Representing Population-Level Morbidity and Mortality

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Race and Ethnicity

Representing Patient Race and Ethnicity

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Research

Representing Data for Biomedical and Health Services Research Purposes

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Sex at Birth, Sexual Orientation and Gender Identity

Representing Patient Gender Identity

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Representing Patient Sex (At Birth)

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Representing Patient-Identified Sexual Orientation

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Social, Psychological, and Behavioral Data

Representing Alcohol Use

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Representing Depression

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Representing Drug Use

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Representing Exposure to Violence (Intimate Partner Violence)

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Representing Financial Resource Strain

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Representing Food Insecurity

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Representing Housing Insecurity

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Representing Level of Education

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Representing Physical Activity

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Representing Social Connection and Isolation

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Representing Stress

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Representing Transportation Insecurity

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Tobacco Use

Representing Patient Electronic Cigarette Use (Vaping)

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Removed Reference

Removed “See LOINC projects in the Interoperability Proving Ground” since LOINC has been removed from the Standards in this section.

Representing Patient Second Hand Tobacco Smoke Exposure

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Representing Patient Tobacco Use (Smoking Status)

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Units of Measure

Representing Units of Measure (For Use with Numerical References and Values)

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Vital Signs

Representing Patient Vital Signs

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Content/Structure

Admission, Discharge, and Transfer

Sending a Notification of a Long Term Care Patient’s Admission, Discharge and/or Transfer Status to the Servicing Pharmacy

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Sending a Notification of a Patient’s Admission, Discharge and/or Transfer Status to Other Providers

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Sending a Notification of a Patient’s Encounter to a Record Locator Service

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Care Coordination for Referrals

Referral from Acute Care to a Skilled Nursing Facility

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Referral to a Specialist - Request, Status Updates, Outcome

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Referral to Extra-Clinical Services - Request, Updates, Outcome

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Care Plan

Documenting and Sharing Care Plans for a Single Clinical Context

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Documenting and Sharing Medication-Related Care Plans by Pharmacists

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Documenting Care Plans for Person Centered Services

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Domain or Disease-Specific Care Plan Standards

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Sharing Patient Care Plans for Multiple Clinical Contexts

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Clinical Decision Support

Communicate Appropriate Use Criteria with the Order and Charge to the Filling Provider and Billing System for Inclusion on Claims

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Provide Access to Appropriate Use Criteria

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Sharable Clinical Decision Support

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Documentation of Clinical Notes

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Clinical Quality Measurement and Reporting

Reporting Aggregate Quality Data for Quality Reporting Initiatives

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Reporting Patient-level Quality Data for Quality Reporting Initiatives

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Sharing Quality Measure Artifacts for Quality Reporting Initiatives

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Data Provenance

Establishing the Authenticity, Reliability, and Trustworthiness of Content Between Trading Partners

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Diet and Nutrition

Exchanging Diet and Nutrition Orders Across the Continuum of Care

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Drug Formulary & Benefits

Allows Pharmacy Benefit Payers to Communicate Formulary and Benefit Information to Prescriber Systems

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Electronic Prescribing

Allows a Long Term or Post-Acute Care to Request to Send an Additional Supply of Medication

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