Submitted by HCapon on 2023-09-20 PACIO Recommendation for PMOLST Data Element Data Class: Orders (Level 0) Data Element: Portable Medical Orders for Life-Sustaining Treatments (Level 0) Recommendation: Remove the Portable Medical Orders for Life-Sustaining Treatments data element under the Orders Data Class in Level 0 and do not consider this data element for inclusion for future versions of USCDI. Rationale: The PACIO (Post-Acute Care Interoperability) Project, established February 2019, 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. Conceptually, including data elements for “Orders for End of Life Care” (Level 2) and “Portable Medical Orders for Life-Sustaining Treatment” (Level 0) in the USCDI is duplicative. Our preferred language would be “Portable Medical Orders” rather than “Orders for End of Life Care,” because we have found jurisdictions that utilize “Portable Medical Orders” during encounters that are NOT related to EOL care. “Portable Medical Orders” would be more broadly applicable than either “Orders for End of Life Care” or “Portable Medical Orders” for Life-Sustaining Treatments, but in any case, only one data element should be included in future versions of USCDI to represent this concept.