Submitted by Svellanky on 2022-09-29
CMS-CCSQ Support for Orders for End of Life Care for USCDI v4Orders for end-of-life care (comfort care, palliative care, hospice) include information that has the power to actionably communicate an individual’s wishes at their end of life and is yet to be represented in USCDI. These data need to be interoperable and exchangeable to reduce discordance between care provided and patient wishes, and to enhance value of care at end of life. This data element was previously identified as a joint CMS-CDC priority and supports advancing patient care quality, which aligns with the purpose of the USCDI (setting a foundation for broader sharing of electronic health information to support patient care). Maturity: ONC recently advanced this data element to Level 2 based on maturity of standards.
- Current standards:
- Newly added—HL7 FHIR US CORE Implementation Guide STU 5, Service Request Profile (http://hl7.org/fhir/us/core/StructureDefinition-us-core-servicerequest.html)
- HL7 FHIR QI Core Implementation Guide STU4 based on FHIR R4, Service Request Profile (HL7.FHIR.US.QICORE\QICoreServiceRequest - FHIR v4.0.1)
- Concepts captured in mature terminology: LOINC, Systematized Nomenclature of Medicine (SNOMED)
Submitted by PACIO-Project on 2022-09-29
PACIO Support to Advance Orders for End of Life CareAdvance the “Orders for End of Life Care” data element under the Order data class to USCDI v4. It is recognized that the previous concept of “Portable Medical Orders for Life-Sustaining Treatments” was too narrowly focused and additional practitioner-authored orders related to goals of care and specific medical treatments or interventions should be included. These orders for end of life care are established by a practitioner regarding treatments that restore, sustain, or prolong a patient’s life. These types of medical orders are intended to be consistent with the patient’s instructions and wishes. The PACIO Community strongly recommends this data element be promoted to USCDI V4.