Physical place of available services or resources.

Data Element

Information from the submission form
Facility Type
Description
Category describing available services or resources. Examples include but are not limited to laboratory, pharmacy, hospital, ambulatory providers, long-term and post-acute care, and pharmacy.
Submitted By: Keith W. Boone / Audacious Inquiry
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)
Estimated number of stakeholders capturing, accessing using or exchanging 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
  • Improving the health of populations
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
Number of organizations/individuals with which this data element has been electronically exchanged 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.

Comment

Submitted by nedragarrett_CDC on 2021-09-28

Unified Comment from CDC

  • Additional Use Case: This is a standard data item used by central cancer registries in all states. Data received through data exchange from medical facilities (e.g., laboratories, hospitals, physician EHRs, etc.) to central cancer registries for CDC and NCI’s national cancer surveillance systems, as required by law.   
  • CSTE supports inclusion of this measure into USCDI v3: Very useful for this information to be captured in some way and then subsequently used in reporting to PH.

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