| Submitted By: Dr Susan A Matney / Intermountain Healthcare | |
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| Data Element Information | |
| Use Case Description(s) | |
| Use Case Description | Pain is the most common symptom documented in healthcare and often considered “the fifth” vital sign. It is tracked and trended over time in every EHR. |
| Estimate the breadth of applicability of the use case(s) for this data element | Millions |
| Link to use case project page | https://confluence.hl7.org/display/CIC/Pain+Assessment+PSS |
| Supporting Attachments |
TheEconomicCostsOfPain.pdf |
| Healthcare Aims |
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| Maturity of Use and Technical Specifications for Data Element | |
| Applicable Standard(s) | LOINC: 38208-5 Pain severity – Reported https://loinc.org/38208-5/ |
| Additional Specifications | This data element are included in an HL7 FHIR® Implementation Guide Project Scope Statement: Pain Assessment |
| Current Use | Extensively used in production environments |
| Supporting Artifacts |
• Commonly occurring problem: 126 million adults in US reported some level of pain within a 3-month period ( Nahin RL. Estimates of pain prevalence and severity in adults: United States, 2012. J Pain. 2015 Aug;16(8):769-80. doi: 10.1016/j.jpain.2015.05.002. Epub 2015 May 29. PMID: 26028573; PMCID: PMC4562413.) • Significant economic cost attributed to pain ($560-635 million/2010) (Gaskin DJ, Richard P. The economic costs of pain in the United States. J Pain. 2012 Aug;13(8):715-24. doi: 10.1016/j.jpain.2012.03.009. Epub 2012 May 16. PMID: 22607834.) https://pubmed.ncbi.nlm.nih.gov/26028573/ Gaskin & Richard, 2012: https://pubmed.ncbi.nlm.nih.gov/22607834/ |
| Extent of exchange | N/A |
| Potential Challenges | |
| Restrictions on Standardization (e.g. proprietary code) | None |
| Restrictions on Use (e.g. licensing, user fees) | None |
| Privacy and Security Concerns | None |
| Estimate of Overall Burden | Limited burden |
| Other Implementation Challenges | There are many different pain severity scores (e.g. FACES for children) and the one submitted here is the common one used for adults. |
Physiologic measurements of a patient that indicate the status of the body’s life sustaining functions.
Data Element |
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Pain Severity
Description
This element is used to describe how intense or severe the sensation of pain is on a 1-10 scale.
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Submitted by GayDolin on 2023-09-12
Pain concepts should not be brought forward as a vital sign
Please see: https://jira.hl7.org/browse/CDA-20320 Pain is a subjective symptom. Vital signs are objective measures Due to the Opioid epidemic there are concerns and mandates from many medical associations against considering pain a vital sign. Pain as a vital sign was lobbied by the pharma companies to increase the market for their products For example:- https://www.jointcommission.org/-/media/tjc/documents/corporate-communication/pain-management-standards-and-responses-to-myths-final-feb-2020.pdf
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5878703/
- https://thedo.osteopathic.org/2016/07/pain-is-not-a-vital-sign-lets-not-treat-it-as-one-ama-says/#:~:text=In%20June%2C%20the%20American%20Medical,from%20professional%20standards%20and%20usage.%E2%80%9D
Pain should NOT be brought forward as a vital sign as a USCDI Data element