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: 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
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Millions |
Link to use case project page |
https://confluence.hl7.org/display/CIC/Pain+Assessment+PSS |
Supporting Attachments |
TheEconomicCostsOfPain.pdf
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Healthcare Aims |
- Improving patient experience of care (quality and/or satisfaction)
- Improving the health of populations
- Reducing the cost of care
- Improving provider experience of care
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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/
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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/
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Extent of exchange
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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. |
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Submitted by GayDolin on
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:
Pain should NOT be brought forward as a vital sign as a USCDI Data element