Submitted by nedragarrett_CDC on 2022-09-28
CDC's comment on behalf of CSTECSTE Comment:
- CSTE strongly recommends that pregnancy status be included in USCDI v4. However, a single variable is not sufficient to capture critical data that are needed for a large variety of conditions affecting the public's health, including maternal mortality, Hepatitis B and C, COVID-19, Zika, syphilis, and influenza, to name only a few.
- CSTE urges the inclusion of the following variables in the core data for exchange - as defined by the ONC Public Health Task Force on Capturing Pregnancy Data in Electronic Health Records and found here https://www.healthit.gov/sites/default/files/facas/HITJC_PHTF_Meeting_Slides_2017-03-30_0.pdf
- https://www.healthit.gov/topic/federal-advisory-committees/collaboration-health-it-policy-and-standards-committees (See May 19 transmittal letter to the NC. Click on charge 1 - Capturing Pregnancy Status, see MS Excel Spreadsheet)
- Pregnancy Status - Yes, No, Possible, Unknown
- Date pregnancy status recorded
- Estimated delivery date
- Pregnancy outcome
- Date of pregnancy outcome and optionally
- Postpartum status (this is important since if the mother recently gave birth and is diagnosed with a condition that could affect the neonate, public health action might be indicated).
- Currently there are large gaps in the ability for data from electronic health records or ELR to capture sufficient pregnancy information to identify cases and measure the burden and outcome of medical conditions and infections in pregnancy on a population level. Standardizing these data for exchange would be a substantial step forward.
- Finally, it is very important for electronic health records to develop a way to link the mother and infant records. A unique identifier for the mother which can be included in the infant's record, and a similar unique identifier for the infant which can be included in the mother's records would help to rectify this problem, which would be beneficial for both clinical care as well for public health when we receive data on mothers and infants but cannot link them (important for diseases such as HIV, listeria, Zika, syphilis, Hepatitis B, and others)
Submitted by RUy on 2022-09-30
LOINC 10162-6 is referenced in IHE, but not 82810-3 or LL4129-4This submission references IHE specifications that state LOINC 10162-6 "History of pregnancies Narrative", which is an unstructured, free-text note capture of the history of pregnancy, and not the status of the current pregnancy episode of the patient. We advise transparency in the advised stated standard terminology, codes that represent pregnancy status at the patient level, captured as structured data, existing in multiple HL7/FHIR IGs and in production by government agencies, academia and community health centers.