Representing Transportation Insecurity

Type	Standard / Implementation Specification	Standards Process Maturity	Implementation Maturity	Federally required	Cost	Test Tool Availability
Standard	LOINC®	Final	Production	No	Free	No
Standard	ICD-10-CM	Final	Production	No	Free	No
Standard	SNOMED CT® U.S. Edition	Final	Production	No	Free	No
Standard	HCPCS Level II	Final	Production	No	Free
Standard	CPT®	Final	Production	No	$

Limitations, Dependencies, and Preconditions for Consideration	Applicable Value Set(s) and Starter Set(s)
Transportation insecurity is defined by the HL7 Gravity Project as uncertain, limited, or no access to safe, reliable, accessible, affordable, and socially acceptable transportation infrastructure and modalities necessary for maintaining one’s health, well-being, or livelihood. LOINC is used for Social Determinants of Health (SDOH) observations (assessment instrument panels, questions, and answers.) SNOMED CT U.S. Edition is used for SDOH observations, conditions, goals, and interventions. ICD-10-CM is used for SDOH diagnoses. CPT and HCPCS Level II are used for SDOH interventions and procedures. Implementation information for Transportation Insecurity exchange can be found in Structure and Exchange of Social Determinants of Health Information. For more information about observations and observation values, see Appendix III for an informational resource developed by the Health IT Standards Committee.	Transportation Insecurity Screening Assessments (LOINC) Transportation Insecurity Screening Assessments Questions (LOINC) Transportation Insecurity Screening Assessments Answers (LOINC) Transportation Insecurity Diagnoses (ICD-10-CM, SNOMED CT) Transportation Insecurity Goals (SNOMED CT) Transportation Insecurity Procedures (CPT, HCPCS, SNOMED CT) Transportation Insecurity Service Requests (CPT, HCPCS, SNOMED CT)

Limitations, Dependencies, and Preconditions for Consideration

Applicable Value Set(s) and Starter Set(s)

Transportation insecurity is defined by the HL7 Gravity Project as uncertain, limited, or no access to safe, reliable, accessible, affordable, and socially acceptable transportation infrastructure and modalities necessary for maintaining one’s health, well-being, or livelihood.
LOINC is used for Social Determinants of Health (SDOH) observations (assessment instrument panels, questions, and answers.)
SNOMED CT U.S. Edition is used for SDOH observations, conditions, goals, and interventions.
ICD-10-CM is used for SDOH diagnoses.
CPT and HCPCS Level II are used for SDOH interventions and procedures.
Implementation information for Transportation Insecurity exchange can be found in Structure and Exchange of Social Determinants of Health Information.
For more information about observations and observation values, see Appendix III for an informational resource developed by the Health IT Standards Committee.

Transportation Insecurity Screening Assessments (LOINC)
Transportation Insecurity Screening Assessments Questions (LOINC)
Transportation Insecurity Screening Assessments Answers (LOINC)
Transportation Insecurity Diagnoses (ICD-10-CM, SNOMED CT)
Transportation Insecurity Goals (SNOMED CT)
Transportation Insecurity Procedures (CPT, HCPCS, SNOMED CT)
Transportation Insecurity Service Requests (CPT, HCPCS, SNOMED CT)

Comment

Submitted by Ashley_Ashworth_OHA on 2021-09-30

Oregon Health Authority ISA Comments

Oregon is pursuing multiple approaches to address unmet needs related to SDOH. We support the inclusion of standards for representing housing insecurity, representing food insecurity, and representing transportation insecurity. Although PRAPARE is one commonly used screening tool, other validated tools also are in widespread use. We encourage the inclusion of coding for additional screening tools as available, building on the work of the Gravity Project.

OHA ISA Comments on letterhead__0.pdf

Submitted by ragnhildurb on 2020-11-10

Comments from the Alliance for Nursing Informatics

Thank you for the opportunity to provide comments on the Interoperability Standards Advisory (ISA) and the Standards Version Advancement Process (SVAP).

ANI strongly endorses social determinants of health (SDOH) as a key interoperability need for better care and health nationwide, amplified as a need during the COVID-19 public health emergency. While SDOH data elements are present within the ISA, but adoption is low, and standards are not federally required. Therefore, ANI strongly supports further development to include SDOH standards in regulations and as federal program requirements.

Please see attachment for our full comments.

ANI COMMENTS on ISA-SVAP _FINAL_1.pdf

Submitted by mattreid on 2020-03-26

The AMA requests that the…

The AMA requests that the Current Procedural Terminology (CPT) code set be added to the standards listed in Section I: Representing Transportation Insecurity. The CPT Evaluation and Maintenance services include assessing a patient’s level of transportation insecurity. Care plan services also address transportation needs.

CPT is a comprehensive and regularly curated uniform language that accurately describes medical, surgical, and diagnostic services and provides for reliable communication among users. It has an extremely robust and mature development process with open and transparent meetings and clinical input from national medical specialties and relevant stakeholders. It is the most widely adopted outpatient procedure code set. Use of the CPT code set is federally required under HIPAA.