Submitted by jpatterson@mitre.org on
PACIO Recommends Advancing Purpose of Capture to Level 1
- Data Class: Provenance
- Data Element: Purpose of Capture (Level 0)
- Recommendation: Advance Purpose of Capture from Level 0 to Level 1.
- Rationale: The PACIO Project Community* recommends advancing the Purpose of Capture from Level 0 to Level 1. Purpose of Capture is integral to inform clinical decision-making -- Information used in decision-making integrates data that are gathered by various disciplines for various purposes that can be influenced by scope of practice, patient need, and other factors. For example, a gait assessment completed by a physical therapist as part of a standardized gait assessment with the purpose of assessing progress of a therapy modality may include different information than a gait assessment completed by a nurse during an intake assessment with the purpose of assessing fall risk. Purpose of Capture provides important contextual information about the collected information that can help clinicians determine its relevance to their clinical decision-making, and how it might also be repurposed for other uses across health care settings and domains. This is particularly relevant for patients obtaining care across multiple settings, including post-acute care, and from various types of healthcare providers who vary in domains and scopes of practice. For example, a gait assessment completed by one practitioner may have a different purpose than a gait assessment completed by a different practitioner (e.g., for understanding progress in physical therapy vs. identifying fall risk). Understanding the purpose of the captured data can also help avoid duplicative assessments or services, as well as understand the specificity and depth of the data collected. Ultimately, these understandings based on purpose impacts if and how a healthcare provider can use the data in their decision-making and care provision. Therefore, the PACIO Project supports the advancement of Purpose of Capture from Level 0 to Level 1.
- This recommendation is supported by CMS-CCSQM that stated in a comment for this data element that “CMS-CCSQ supports the PACIO Project’s recommendation of the advancement of the Purpose of Capture data element from Level 0 to Level 1. This data element represents necessary metadata around documents to validate and accurately understand the information that is gathered from numerous sources”.
- * 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.
Submitted by rdillaire on
CMS-CCSQ Recommends the advancement of Purpose of Capture to Lv1
Recommendation: CMS CCSQ recommends the Signature and Purpose of Capture elements be advanced to Level 1.
Rationale: Vocabulary and functional standards are not sufficiently advanced to merit inclusion in USCDI v6, but merit elevation to Level 1 to advance further discussion and consideration in the future. Signature is required as part of the MDS, IRF-PAI, LCDS, and Hospice Item Set (HIS) assessments. We emphasize the importance of capturing Signature as an individual data element when it is not already exchanged or captured as part of another data element, such as a document, note, or order.
The following LOINC codes can be leveraged to support this data element:
i. 85814-2 (IRF-PAI Signature of persons completing the assessment).
ii. 85647-6 (Signature of person collecting or coordinating collection of assessment information Provider).
iii. 85648-4 (Signature of persons completing the assessment).
iv. 70127-6 (Signature verifying assessment completion).