Data Element

Information from the submission form

Durable Medical Power of Attorney
A person uses a durable medical power of attorney to appoint one or more people to serve as advocates or “healthcare agents” empowered to make medical treatment decisions on behalf of that person if the person is incapacitated and cannot communicate with medical personnel.


PACIO support for modification to Healthcare Agent & Level 2

The PACIO Project strongly supports modification of the “Durable Medical Power of Attorney” data element to “Healthcare Agent” and advancement to USCDI Level 2. Established February 2019, the PACIO Project is a collaborative effort between industry, government, and other stakeholders, with the goal of establishing a framework for the development of FHIR implementation guides to facilitate health information exchange. The PACIO community is open to all interested parties and currently includes over 50 individuals and organizations. On behalf of the PACIO Project leadership team, the PACIO Community voted 9/29/21 and unanimously supports the document and recommendations as posted 9/28/21 by Lisa R Nelson. PACIO members were involved in the creation of that document based on experiences in advance directive content adjudication and FHIR implementation guide development.

Modify this data element and move to USCDI Level 2

While the concept of “Durable Medical Power of Attorney” remains important to be included in the USCDI, further community discussion led to modifying the data element from “Durable Medical Power of Attorney” to “Healthcare Agent”.  The notion of “Durable Medical Power of Attorney” is better described as a collection of data elements which may establish one or more “Healthcare Agents” and may include additional details about the specific powers or limitations associated with that established role. The concept of “Durable Medical Power of Attorney” would more accurately be described as a data bundle because it includes multiple data elements, the most prominent being “Healthcare Agent”.  Over the past year multiple organizations have used both CDA and FHIR standards to share this important patient-generated information.  In addition, the CDA guidance has been balloted twice within HL7, the FHIR IG is preparing to be balloted in January 2022. We strongly recommend the “Durable Medical Power of Attorney” data element be modified to  “Healthcare Agent” and for it to be advanced to USCDI Level 2.

USCDIv3 ADI_Comments_20210927v3_2.pdf

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