Information about a condition, diagnosis, or other event, situation, issue, or clinical concept that is documented.

Data Element

Information from the submission form

Date of Onset

Comment

Suggest changing the definition

MedMorph supports the addition of the Date of Onset element, but suggests a slight change to the definition. The word "capture" can be easily confused with the recorded date. Also, using "diagnosis" in the definition is more specific than intended. At this point in care, it is simply the onset of the condition or problem. Suggested Definition: The estimated date, actual date or date-time the condition began.  

Unified Comment from CDC

  • CDC considers this element to be high priority and strongly recommends its inclusion in the USCDI V3.  
  • CSTE supports inclusion of this measure into USCDI v3: Date of onset for conditions is extremely important and we are very supportive of this element being included in USCDI.
  1. Ensure date of onset is NOT the same as date of diagnosis – date of onset is considered date of first clinical sign or symptom
  2. Frequently date of onset would be captured in clinical notes field (unstructured data) so this would be beneficial to PH for a date of onset to be captured per condition.

Unified Comment from CDC

  • General Comment: Date of Onset currently does not  have a definition.  
  • Proposed Definition: The estimated date, actual date or date-time the condition began.  
  • Additional Use Cases:The Making EHR Data More Available for Research and Public Health (MedMorph) project's goal is to create a reliable, scalable, and interoperable method to get electronic health record data for multiple public health and research scenarios (use cases). MedMorph has identified Central Cancer Registry Reporting, Healthcare Surveys,  Hepatitis C Reporting, electronic Initial Case Reporting (eICR), Multiple Chronic Conditions (MCC) eCare Plan, Message Mapping Guide (MMG) for COVID 19, PCORnet, Birth and Birth Defect Reporting use cases that support the adoption of this data elements.  
  • Applicable Standard: http://hl7.org/fhir/condition-definitions.html#Condition.onset_x  
  • Technical Specifications using this data element:  
  1. HL7 CDA ® Release 2 Implementation Guide: Reporting to Public Health Cancer Registries from Ambulatory Healthcare Providers, Release 1, DSTU Release 1.1 – US Realm: https://www.hl7.org/implement/standards/product_brief.cfm?product_id=398  
  2. HL7 CDA® R2 Implementation Guide: National Health Care Surveys (NHCS), R1 STU Release 3 - US Realm: https://www.hl7.org/implement/standards/product_brief.cfm?product_id=385  
  3. C-CDA (HL7 CDA® R2 Implementation Guide: Consolidated CDA Templates for Clinical Notes - US Realm): http://www.hl7.org/implement/standards/product_brief.cfm?product_id=492  
  4. HL7 FHIR® Implementation Guide: Electronic Case Reporting (eCR) - US Realm: http://hl7.org/fhir/us/ecr/STU1/  
  5. HL7 CDA® R2 Implementation Guide: Public Health Case Report, Release 2 - US Realm - the Electronic Initial Case Report (eICR): https://www.hl7.org/implement/standards/product_brief.cfm?product_id=436  
  6. HL7 CDA® R2 Implementation Guide: Ambulatory and Hospital Healthcare Provider Reporting to Birth Defect Registries Release 1 ,  
  7.  STU 2 -US Realm: https://www.hl7.org/implement/standards/product_brief.cfm?product_id=428  
  8. HL7 FHIR® Implementation Guide: Birth Defect Reporting Implementation Guide 0.1.0: https://build.fhir.org/ig/HL7/fhir-birthdefectsreporting-ig/index.html  
  9. HL7 FHIR® Implementation Guide: Common Data Models Harmonization FHIR Implementation Guide (Release 0.1.0): http://hl7.org/fhir/us/cdmh/2019May/  
  10. Vital Records Birth and Fetal Death Reporting - https://build.fhir.org/ig/HL7/fhir-bfdr/index.html  
  11. HL7 Version 2.6 Implementation Guide: Vital Records Birth and Fetal Death Reporting, Release 1 STU Release 2 - US Realm https://www.hl7.org/implement/standards/product_brief.cfm?product_id=320
  • This element is used by CMS Quality Reporting and is marked Required or MustSupport in the FHIR QI Core IG

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