| Submitted By: Craig Newman / Altarum | |
|---|---|
| Data Element Information | |
| Use Case Description(s) | |
| Use Case Description | An expectant mother’s pregnancy attributes are crucial for providing the best possible pre-natal care. As well, after delivery, Public Health needs to capture this data as part of birth certification, fetal death reporting and birth defect reporting. In particular, birth certification forms the basis of the patient census required by a large number of other Public Health programs including newborn screening, birth defect reporting and immunization registries making it critical that birth certification is as automated, timely and accurate as possible. |
| Estimated number of stakeholders capturing, accessing using or exchanging | Consumption of this data is widespread. Every jurisdiction in the country captures birth certification information and immunization adminstration. Most also capture birth defects and fetal deaths. Healthcare systems which provide care for expectant mothers should be collecting this data. |
| Healthcare Aims |
|
| Maturity of Use and Technical Specifications for Data Element | |
| Applicable Standard(s) | LOINC codes exist for each of the proposed data elements: 8665-2 - Last menstrual period start date 11778-8 - Delivery date Estimated 56077-1 - Body weight --pre current pregnancy https://loinc.org/ |
| Additional Specifications | Vital Records Common Profiles Library FHIR IG - http://build.fhir.org/ig/HL7/fhir-vr-common-ig/branches/master/index.html Birth Defect Reporting FHIR IG - https://build.fhir.org/ig/HL7/fhir-birthdefectsreporting-ig/index.html Vital Records Birth and Fetal Death Reporting - https://build.fhir.org/ig/HL7/fhir-bfdr/index.html |
| Current Use | This data element has been used at scale between multiple different production environments to support the majority of anticipated stakeholders |
| Supporting Artifacts |
This data is exchanged routinely as part of birth certification, fetal death reporting and birth defect reporting, however these workflow typically are executed on paper or via flat files rather than through electronic interoperability. |
| Number of organizations/individuals with which this data element has been electronically exchanged | N/A |
| Potential Challenges | |
| Restrictions on Standardization (e.g. proprietary code) | None |
| Restrictions on Use (e.g. licensing, user fees) | None |
| Privacy and Security Concerns | No concerns over and above the typically privacy and security considerations associated with any health related data. |
| Estimate of Overall Burden | These data elements are straightforward in nature and should not present a large burden to implement provided the EHR system is capturing the data as part of caring for the woman. |
Observations
Data Element |
Information from the submission form |
|---|---|
|
Estimated Date of Delivery
|
The expected date of delivery (i.e. the due date).
|
Submitted by maria.michaels… on 2020-11-09
Support for this element is…
Support for this element is submitted on behalf of MedMorph project which includes relevant specifications and supporting artifacts. We propose a new Delivery and Pregnancy Information class where data elements like Estimated Date of Delivery may be captured. Annually there are approximately 3.7 million births in the United States. It is important to note that 57 jurisdictions are required to report data elements like Estimated Date of Delivery to local and nationally levels. Consumption of these types of data are widespread and every jurisdiction in the country captures birth certification information. Accurate pregnancy dating is important to improve outcomes and is a research and public health imperative. Among other things this type of delivery and pregnancy Information provide key birth statistics that identify public health trends on fertility rates, when prenatal care was initiated, and percent of newborns born preterm. Additionally, given the current pandemic real time birth reporting for public health is paramount in assessing the medical care for both expectant mothers and newborns. While the proposed data class ‘Observation’ can capture data elements such as Estimated Date of Delivery it is important to recognize that birth and delivery events are information that 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 we propose a new Delivery and Pregnancy Information class where data elements like Estimated Date of Delivery may be captured. 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 The use of the Estimated Date of Delivery data element includes widespread use, required to be reported nationally and is routinely collected on EHR/HIT systems. Below lists examples of artifacts of where this data element is collected. Facility worksheet information: https://www.cdc.gov/nchs/data/dvs/facility-worksheet-2016-508.pdf https://www.cdc.gov/nchs/data/dvs/fetal-death-mother-worksheet-english-2019-508.pdf 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