Data Element

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Comments to Date of Diagnosis Data Element

As APTA noted previously, “diagnosis” needs to be better defined. For instance, will ONC allow more than one diagnosis to be reported? A physician may diagnose a patient with X, Y, and Z; the patient then sees a physical therapist, and the physical therapist identifies several musculoskeletal diagnoses. In this instance, are all diagnoses reported including all comorbidities? APTA also suggest that ONC clarify that more than one clinician is eligible to populate this field. ONC also should clarify how comorbidities should be tracked and whether these diagnoses/conditions are reported. Finally, we suggest that ONC address how “errors” will be resolved, for instance, when the date of diagnosis may vary between the date of diagnosis in an EHR and the date that the patient reports that they were diagnosed.

As noted elsewhere, …

As noted elsewhere, “diagnosis” needs to be better defined. For instance, will ONC allow more than one diagnosis to be reported? A physician may diagnose a patient with X, Y, and Z; the patient then sees a physical therapist, and the physical therapist identifies several musculoskeletal diagnoses. In this instance, are all diagnoses reported including all co-morbidities? We also suggest that ONC clarify that more than one clinician is eligible to populate this field. ONC also should clarify how comorbidities should be tracked and whether these diagnoses/conditions are reported. Finally, we suggest that ONC address how “errors” will be resolved, for instance, when the date of diagnosis may vary between the date of diagnosis in an EHR and the date that the patient reports that they were diagnosed.

Suggested modification to metric definition

I also agree with MedMorph's suggestion.  Clinically the Date of Onset, often marked by the earliest date of symptoms, laboratory/imaging abnormalities, or morphologic changes, is distinct from the Date of Diagnosis, typically by a healthcare professional.

MedMorph's support of Date of Diagnosis

The MedMorph Project supports the addition of Date of Diagnosis, but requests slight tweaking of the definition.The current definition is very similar to the Date of Onset and includes extraneous information that should not be included in the definition. Suggested definition: The date of initial diagnosis by a recognized medical practitioner for the diagnosis, whether clinically or microscopically/laboratory confirmed.

MedMorph's Date of Diagnosis

We agree with MedMorph's recommendations for the two mentioned data submissions, the two data elements mirror each other too closely and the definition should be revisited, based on the review of the submissions we've received.

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