Problems
Information about a condition, diagnosis, or other event, situation, issue, or clinical concept that is documented.
Data Element
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Additional Information
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Date of Resolution
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Date field associated with a past/resolved medical problem, typically coded using ICD, which specifies the date that the problem resolved.
| Submitted By: Steven Lane
/ Sutter Health
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| Data Element Information |
| Rationale for Separate Consideration |
This is related to the Date of Onset and the Date of Diagnosis associated with problems/diagnoses on the active Problem List and in the Past Medical History list. Rather than simply capturing the date that a diagnosis was deleted from or resolved off of the problem list and added to the Past medical history list, this would allow the specific documentation of the date that a previously active problem was resolved, whether or not the problem is to be maintained as a part of the displayed Past Medical History. |
| Use Case Description(s) |
| Use Case Description |
This would allow the specific documentation of the date that a previously active problem was resolved, whether or not the problem is to be maintained as a part of the displayed Past Medical History. Capturing this data would allow clinicians, data analysts, researchers and decision support apps to calculate the duration of an illness. This data element could also be populated by individuals/patients as part of patient generated health data in situations where patients may track their illnesses and report their resolution. |
| Estimated number of stakeholders capturing, accessing using or exchanging
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Potentially tens of thousands of clinicians would populate this data element in the course of clinical care documentation. This data element would be maintained with diagnoses once they have resolved, whether they are maintained as a data element associated with resolved diagnoses as part of an historical problem list or as part of a Past Medical History listing of past diagnoses. |
| Healthcare Aims |
- Improving patient experience of care (quality and/or satisfaction)
- Improving the health of populations
- Improving provider experience of care
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| Maturity of Use and Technical Specifications for Data Element |
| Applicable Standard(s) |
Date
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| Additional Specifications |
N/A |
| Current Use |
Not currently captured or accessed with an organization |
| Number of organizations/individuals with which this data element has been electronically exchanged
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N/A |
| Potential Challenges |
| Restrictions on Standardization (e.g. proprietary code) |
N/A |
| Restrictions on Use (e.g. licensing, user fees) |
N/A |
| Privacy and Security Concerns |
N/A |
| Estimate of Overall Burden |
EHR vendors would need to add an additional date field to associate with diagnoses in the Problem List and Past Medical History. Users would need to be trained in the use of the new data field. |
| Other Implementation Challenges |
The field would ideally support fuzzy dates as the precise date of resolution of a given condition may not be known or knowable. |
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Submitted by Kara Rose on 2021-03-12
It is unclear when a past…
It is unclear when a past medical problem is “resolved.” We recommend that ONC define “resolved” and outline criteria for what constitutes a “resolved condition.” For instance, if a patient does not return for additional visits, does that mean the condition should be classified as “resolved,” when in fact, the condition may not have been resolved but the clinician does not know because the patient never returned. Additionally, we recommend that ONC include a data element for “condition status.” Providers could use this to signal “we don’t know what happened after this point,” and then the resolution date would be null. We note that FHIR has two “status” data elements on condition – one for clinical status and the other for verification status.