Condition, diagnosis, or reason for seeking medical attention.

Data Element

Date of Onset

Comment

CDC's Comment for draft USCDI v6

The inclusion of  "Onset Date"  is supported by CDC, as this element is a critical date value for public health data collection, including case reporting and case notification for many reportable and notifiable conditions. 
For example, please view the elCR Data Elements site: https://build.fhir.org/ig/HL7/case-reporting/eicr_data_elements.html

ANI's comment on USCDI v6: Date of onset

The Alliance for Nursing Informatics (ANI)  supports this inclusion as it is a key clinical data point for chronic disease management and outcomes analysis. Implementation guidance should clarify how estimated dates are handled and ensure consistent documentation practices across systems. Please see previously submitted ANI comments for additional recommendations.

CSTE Comment - v6

CSTE supports inclusion of this data element in USCDI V6. Please see previously submitted CSTE comments for additional recommendations.

CDC's comment on behalf of CSTE for USCDI v5

CSTE strongly encourages the inclusion of date of onset in USCDI v5. This is one of the most important data elements for public health. Date of onset often is the defining date for the beginning of a reportable condition and is used to classify cases and detect outbreaks and clusters. Exposures must be investigated in relation to the onset date. If the onset date is not captured as a distinct structural data point, public health staff must dig for it in notes or other parts of the medical record and it is inevitably vague and sometimes missing. Date of diagnosis is not the same as date of onset. Date of onset is defined as the first clinical symptom or sign for a particular condition. It would be highly beneficial if date of onset could be captured for each problem/diagnosis or condition noted in the medical record but if this is not possible it should at a minimum be noted for the primary diagnosis of the patient encounter.

CDC's comment on behalf of CSTE for USCDI v4

CSTE strongly encourages the inclusion of date of onset in USCDI v4. This is one of the most important data elements for public health. Date of onset often is the defining date for the beginning of a reportable condition and is used to classify cases and detect outbreaks and clusters. Exposures must be investigated in relation to the onset date. If the onset date is not captured as a distinct structural data point, public health staff must dig for it in notes or other parts of the medical record and it is inevitably vague and sometimes missing. Date of diagnosis is not the same as date of onset. Date of onset is defined as the first clinical symptom or sign for a particular condition. It would be highly beneficial if date of onset could be captured for each problem/diagnosis or condition noted in the medical record but if this is not possible it should at a minimum be noted for the primary diagnosis of the patient encounter.

Level 2 Data Element: Date of Onset

IMO does not support the Date of Onset as a proposed Level 2 Data Element in USCDI V3. While it is specified as a search parameter in the FHIR US Core Implementation Guide (4.0.0 STU4 Release), it is not universally recorded in all ONC Certified HIT, and there is no standard for exchange in ONC requirements for HIT Certification

 

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