Analysis of clinical specimens to obtain information about the health of a patient.

Data Element
Accession number
Description
The unique identifier for a single instance of a specimen received by a laboratory and its analysis.
Submitted By: Riki Merrick / Association of Public Health Laboratories
Data Element Information
Use Case Description(s)
Use Case Description Often LIS are not patient centric, like EHR-s, but specimen centric, so this identifier is used as the primary key to locate all data that belongs to this specimen. To support communication between provider and lab and between lab and public health agency this identifier is very important. It must be stressed, that this identifier should be unique within the assigning authority and not reused over time (though that may still be a practice in some labs).
Estimate the breadth of applicability of the use case(s) for this data element This element should be associated with EVERY lab test and its related data elements, so will be in EHR-s, LIS, PHR, Surveillance system and disease registries.
Link to use case project page http://www.hl7.org/implement/standards/product_brief.cfm?product_id=98 LRI: http://www.hl7.org/implement/standards/product_brief.cfm?product_id=279 FHIR observation in US Core lab observation profile: https://build.fhir.org/ig/HL7/US-Core/Struct
Use Case Description This also applies to lab data exchanges between lab and providers
LRI: http://www.hl7.org/implement/standards/product_brief.cfm?product_id=279
FHIR observation in US Core lab observation profile: https://build.fhir.org/ig/HL7/US-Core/StructureDefinition-us-core-observation-lab.html references the specimen, but it is not a must support element at this time; the FHIR specimen resource refers to this element as specimen.accessionIdentifier
Estimate the breadth of applicability of the use case(s) for this data element This element should be associated with EVERY lab test and its related data elements, so will be in EHR-s, LIS, PHR, Surveillance system and disease registries.
Healthcare Aims
  • Improving patient experience of care (quality and/or satisfaction)
  • Improving the health of populations
  • Improving provider experience of care
Maturity of Use and Technical Specifications for Data Element
Applicable Standard(s) N/A
Additional Specifications N/A
Current Use This data element has been used at scale between multiple different production environments to support the majority of anticipated stakeholders
Extent of exchange 5 or more. This data element has been tested at scale between multiple different production environments to support the majority of anticipated stakeholders.
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 should already be widely used - what may still need to be expanded is the persistence of the assigning authority with the identifier.
ONC Evaluation Details
Each submitted Data Element has been evaluated based on the following criteria. The overall Level classification is a composite of the maturity based on these individual criteria. This information can be used to identify areas that require additional work to raise the overall classification level and consideration for inclusion in future versions of USCDI
Criterion #1
Maturity - Current Standards		 Level 0 - Data element is not represented by a terminology standard or SDO-balloted technical specification or implementation guide.
Criterion #2
Maturity - Current Use 		Level 1 - Data element is captured, stored, or accessed in at least one production EHR or HIT module.
Criterion #3
Maturity - Current Exchange		 Level 1 - Data element is electronically exchanged between two production EHRs or other HIT modules using available interoperability standards.
Criterion #4
Use Case(s) - Breadth of Applicability		 Level 2 - Use cases apply to most care settings or specialties.
Evaluation Comment A data element called "accession number" is indeed widely used in labs, but tighter definition needs to de developed and applied for this to be incorporated into USCDI at a higher level.

Comment

Submitted by Riki Merrick on 2022-09-30

APHL Comments on ISA 2022

APHL still supports inclusion of this data element in the Laboratory class of USCDI V4.

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