Assessments of a health-related matter of interest, importance, or worry to a patient, patient’s family, or patient’s healthcare provider that could identify a need, problem, or condition.

Data Element
Terminal Illness Status
Description

Recommended to have element for Terminal Illness Status in this Data Class in USCDI V3. This is a matter of interest to Next of Kin/Related Parties and of high value to Care Team (needed for revised Care Plan) and would immensely help with timely and seamless Transition and Coordination of Care between different settings and care givers.
Submitted By: Dave Shekhar
Data Element Information
Use Case Description(s)
Use Case Description This data element is of extreme interest to Next of Kin/Related Parties and of high value to Care Team (needed for revised Care Plan) and would immensely help with timely and seamless Transition and Coordination of Care between different settings and care givers.
Estimate the breadth of applicability of the use case(s) for this data element 8+. Multiple stakeholders, including PCP, Care Manager, Inpatient facilities, LTC facility, SNF, Labs, Radiology centers, ED.
Supporting Attachments Terminal Illness Status.txt
Healthcare Aims
  • Improving patient experience of care (quality and/or satisfaction)
  • Improving the health of populations
  • Reducing the cost of care
  • Improving provider experience of care
Maturity of Use and Technical Specifications for Data Element
Applicable Standard(s) Terminal illness (Code 300936002) SNOMED code.

https://www.hipaaspace.com/medical_billing/coding/snomed/300936002

https://www.findacode.com/snomed/162607003--terminal-illness-early-stage.html

https://build.fhir.org/ig/cqframework/opioid-cds-r4/ValueSet-limited-life-expectancy-conditions.html
https://www.hipaaspace.com/medical_billing/coding/snomed/300936002
Additional Specifications CDC Opioid Prescribing Support Implementation Guide
Current Use In limited use in production environments
Supporting Artifacts CDC : Opioid Prescribing Support Implementation Guide

https://build.fhir.org/ig/cqframework/opioid-cds-r4/ValueSet-limited-life-expectancy-conditions.html
https://build.fhir.org/ig/cqframework/opioid-cds-r4/index.html
Extent of exchange 2-3
Supporting Artifacts Please note: Not aware of exact number of Prod environments for CDC Opioid Prescribing Support Implementation Guide
https://build.fhir.org/ig/cqframework/opioid-cds-r4/ValueSet-limited-life-expectancy-conditions.html
Potential Challenges
Restrictions on Standardization (e.g. proprietary code) No restrictions. Part of SNOMED-CT.
Restrictions on Use (e.g. licensing, user fees) License required to use SNOMED-CT codes which is already procured by NLM.
Privacy and Security Concerns No concerns. This data element should be encouraged to be exchanged.
Estimate of Overall Burden Minimal as other initiates like Cures Act, FHIR R4 mandates, CMS-9115 etc already faciliates lot of ground and foundation work.
Other Implementation Challenges No challenge to implementation. Aligns with PI and other ONC and CMS mandates.
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 2 - Data element is 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 1 - Use cases apply to several care settings or specialties.
Evaluation Comment This data element is evaluated at Level 1 given its somewhat limited extent of use and exchange, as well as it's limited use in primarily in end of life care. Of note, this data element could be included in other existing data elements such as Functional Status or Problems.

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