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Encounter Information

Data Element

Information from the submission form

Encounter Location
Identifies the location of the encounter, and the period of time spent in that location. This may include a general location (i.e. hospital), as well as a location within the healthcare facility (i.e. ICU ward).

Comment

MedMorph's need for Encounter Location Address

The MedMorph project needs the location address for the Encounter. The existing Encounter Location element is pertaining to a location type of Encounter, such as a hospital or ICU ward. Due to the granularity and specificity of the existing Encounter Location element, we recommend that Encounter Location Address be a distinct element. If this recommendation is not accepted, then we suggest the current definition for Encounter Location be revised to include the setting (type) and address for the Encounter Location. A proposed definition is: "Identifies the location of the encounter. This should include an address, general location (e.g., hospital), and a location within the healthcare facility (e.g., ICU ward)." We recommend to remove the ", and the period of time spent in that location" since this part of the definition appears to be covered by the Location Associated Time Period element.

MedMorph's need for Place of Birth

Encounter Location by itself is not sufficient. The type of location (e.g. hospital, home, car, etc.) is needed, not just the location.  Can the narrative be expanded as “Identifies the location of the encounter, and the period of time spent in that location. This may include a general location (e.g. hospital), as well as a location within the healthcare facility (e.g. ICU ward), and non-hospital physical types such as house or vehicle” A more fitting label for this element should be 'Birth/Delivery Location Type'. This item is captured on the national standard worksheets for jurisdictions to report a live birth and fetal death. As commented on other birth reporting data elements submitted to USCDI, it is important to recognize that birth and delivery events information may be captured within specific areas of a healthcare system such as labor and delivery summaries and prenatal care records. To help lessen the burden of implementations and queries of these events is the reason to propose a new Delivery and Pregnancy Information class where data elements like Birth/Delivery Location Type may be captured. National worksheets for reporting of live birth and fetal death: https://www.cdc.gov/nchs/data/dvs/facility-worksheet-2016-508.pdf, https://www.cdc.gov/nchs/data/dvs/fetal-death-facility-worksheet-2019-508.pdf Additional relevant specification for this data element includes HL7 and IHE standards listed below. HL7 Version 2.6 Implementation Guide: Vital Records Birth and Fetal Death Reporting, Release 1 STU Release 2 - US Realm: https://www.hl7.org/implement/standards/product_brief.cfm?product_id=320 IHE Quality, Research and Public Health Technical Framework Supplement – Birth and Fetal Death Reporting-Enhanced (BFDR-E) Revision 3.1: https://www.ihe.net/uploadedFiles/Documents/QRPH/IHE_QRPH_Suppl_BFDR-E.pdf Vital Records Common Profiles Library FHIR IG: http://build.fhir.org/ig/HL7/fhir-vr-common-ig/branches/master/index.html Vital Records Birth and Fetal Death Reporting:  https://build.fhir.org/ig/HL7/fhir-bfdr/index.html Birth Defect Reporting FHIR IG: https://build.fhir.org/ig/HL7/fhir-birthdefectsreporting-ig/index.html HL7 CDA® R2 Implementation Guide: Ambulatory and Hospital Healthcare Provider Reporting to Birth Defect Registries Release 1 , STU 2 -US Realm: https://www.hl7.org/implement/standards/product_brief.cfm?product_id=428 Below lists examples of artifacts of where this data element is collected. EPIC stork module (obstetrics) for birth reporting: https://www.epic.com/software#PatientEngagement EPIC FHIR APIs for patient, vitals, obstetric details: https://fhir.epic.com/Specifications?api=932 https://fhir.epic.com/Specifications?api=968 https://fhir.epic.com/Specifications?api=966 BFDR-E in ISA: https://www.healthit.gov/isa/reporting-birth-and-fetal-death-public-health-agencies

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