The metadata, or extra information about data, regarding who created the data and when it was created.

Data Element
Purpose of Capture
Description

Purpose of Capture describes why a dataset or data elements were originated (collected, captured, sourced), updated, verified, attested, transformed... Often needed to ensure Purpose of Capture is equivalent or compatible with each potential Purpose of Use. Provenance set includes the who, what, when, where and why as metadata for USCDI data classes and data elements. Purpose of Capture is part of “why”. Purpose of Capture should be associated with each USCDI dataset or data element that has a unique provenance set. Occurs when data is originated (captured, collected or sourced), updated, verified, attested, transformed (e.g., to/from exchange artifact such as HL7 v2 message, document or FHIR resource instance). Note that Purpose of Capture may be intrinsic to what the source EHR/HIT system already knows, thus it will not require extra data collection (burden) by the clinician or other end user.
Submitted By: Gary Dickinson / EHR Standards Consulting
Data Element Information
Rationale for Separate Consideration Purpose of Capture anchors data classes and data elements to the reason they were originated (collected, captured, sourced). This is a must for transparency, assurance (trust) and data integrity and ensures that Purpose of Capture is equivalent or compat
Use Case Description(s)
Use Case Description All use cases (including health data/record exchange) where essential assurance of transparency, accountability, trust, traceability and data integrity is required.
Estimate the breadth of applicability of the use case(s) for this data element Any/all stakeholders for any/all use cases.
Healthcare Aims
  • Improving patient experience of care (quality and/or satisfaction)
  • Improving the health of populations
  • Reducing the cost of care
  • Improving provider experience of care
Maturity of Use and Technical Specifications for Data Element
Applicable Standard(s) N/A
Additional Specifications N/A
Current Use Extensively used in production environments
Supporting Artifacts FHIR Core Release 4.0.1 – Record Lifecycle Event Implementation Guide
ISO 21089:2018 – Trusted End-to-End Information Flows
ISO/HL7 10781 – Electronic Health Record System Functional Model, Release 2.1

http://hl7.org/fhir/ehrsrle/ehrsrle.html
Extent of exchange 5 or more. This data element has been tested at scale between multiple different production environments to support the majority of anticipated stakeholders.
Potential Challenges
Restrictions on Standardization (e.g. proprietary code) None
Restrictions on Use (e.g. licensing, user fees) None
Privacy and Security Concerns None. In fact enables health data/record audit events and audit logs (audit trails).
• Who did what when where and why (actions taken)
• Who documented what when where and why (health record entries)
Estimate of Overall Burden As stated previously, most all of the submitted Provenance elements are intrinsic to what the source EHR/HIT system already knows, thus will not require extra data collection (burden) by the clinician or other end user.
Other Implementation Challenges The usual resistance from certain stakeholders – those who believe Provenance is unnecessary – after all, who would believe that transparency, accountability, assurance, traceability and data integrity are essential/integral to trusted health data/record management and use?

Comment

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 yale-coredQMRoadmap on

CMS-CCSQ Support for Purpose of Capture: adv. Lev. 0 to Lev. 1

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. 

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