Pharmacologic agents used in the diagnosis, cure, mitigation, treatment, or prevention of disease.

Data Element

Additional Information

Indication
Description
Sign, symptom, or medical condition that leads to the recommendation of a treatment, test, or procedure.

Comment

NCPDP Comments

  • NCPDP recommends adding SNOMED CT and ICD10 as data elements/code sets to further adhere to the standardized code lists that have been created to identify services or products provided to the patient. NCPDP SCRIPT standard data element “indication” uses SNOMED CT in the “SIG” directions for use and ICD10 in the NCPDP SCRIPT “Diagnosis” field.
    • "Currently, most prescriptions lack a key piece of information needed for safe medication use: the patient-specific drug indication. Integrating indications could pave the way for safer prescribing in multiple ways, including avoiding look-alike/sound-alike errors, facilitating selection of drugs of choice, aiding in communication among the healthcare team, bolstering patient understanding and adherence, and organizing medication lists to facilitate medication reconciliation. Although strongly supported by pharmacists, multiple prior attempts to encourage prescribers to include the indication on prescriptions have not been successful.” https://pubmed.ncbi.nlm.nih.gov/29674327/  

Medications Indication terminology standard

This field is for general comments on this specific data element. To submit new USCDI data classes and/or data elements, please use the USCDI ONDEC system: https://healthit.gov/ONDEC Recommend adding SNOMED CT and ICD-10 as the terminology standards to be used for Indication data element of Medications Data Class.

CDC's Consolidated Comment

Reason for medication prescription or administration is particularly important as medications can be used for multiple conditions, and for off-label use. Documentation of the specific reason a medication is prescribed is integral to understanding a patient’s specific condition. Collected for Tuberculosis (TB) and Latent Tuberculosis Infection (LTBI) Surveillance and are included in the TB and LTBI Message Mapping Guides (MMG). https://ndc.services.cdc.gov/mmgpage/tuberculosis-and-latent-tb-infection-message-mapping-guide/ Additional Technical Specifications: HL7 FHIR Health Care Surveys Content Implementation Guide (http://hl7.org/fhir/us/health-care-surveys-reporting/2022Jan/).

Unified Comment from CDC

  • Additional Use Case: Information about medications prescribed, administered, and reasons for prescribing are collected as part of CDC's routine nationally notifiable condition surveillance for HIV, tuberculosis and sexually transmitted diseases. This information is collected to understand trends in treatment initiation and completion (as applicable), and as part of a health department's case management work.  
  • Number of stakeholders who capture, access, use or exchange this data element: All US States and DC are funded through CDC’s Division of HIV Prevention, Division of TB Elimination and Division of STD Prevention flagship Notice of Funding Actions to perform surveillance activities, including collection of these data for surveillance purposes.  
  • Healthcare Aims: Improving patient experience of care, Improving health of populations, Reducing cost of care, Improving provider experience of care  
  • Use of data element: Extensively used in production environments  
  • Exchange of data element: The Multiple Chronic Conditions eCare Plan project successfully tested this element at the Sep 2020 and Jan 2021 FHIR connectathons and has implemented it at the OHSU testing site.   
  • CSTE supports inclusion of this measure into USCDI v3:  helpful for PH to know if treatment was administered or prescribed to indicate a need to contact patient and connect with other wraparound services/linkage to care (e.g., STIs, Hepatitis C/B)

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