| Submitted By: Riki Merrick / Association of Public Health Laboratories | |
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| 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). |
| Estimated number of stakeholders capturing, accessing using or exchanging | 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 |
| Estimated number of stakeholders capturing, accessing using or exchanging | 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 |
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| 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 |
| Number of organizations/individuals with which this data element has been electronically exchanged | 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 4 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 |
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| Maturity – Standards/Technical Specifications | Level 1/2 - Must be represented by a vocabulary standard or an element of a published technical specification |
| Maturity - Current Use | Level 2 - Used at scale in more than 2 different production environments |
| Maturity - Current Exchange | Level 2 - Demonstrates exchange between 4 or more organizations with different EHR/HIT systems |
| Breadth of Applicability - # Stakeholders Impacted | Level 2 - Used by a majority of patients, providers or events requiring its use |
Submitted by Riki Merrick on 2022-09-30
APHL Comments on ISA 2022
APHL supports inclusion of this data element in the Laboratory class of USCDI V4, because it is the main way laboratories identify related lab data records in their system. For lab reports that are de-identified, for example for public health reporting to federal agencies or for research, this identifier is often the only means to link related results on the same specimen together. It may also be used as a proxy for the patient identifier, which is a CLIA required element in systems, that do not support patient administrative functionality.