Vital Signs

Please Include BMI in USCDI v5

Inclusion of BMI would allow for quicker querying of patients in FHIR via BMI rather than having to calculate BMI from the data elements “body height” and “body weight.” A potential benefit to patients is that the addition of BMI would provide more health information, especially as certain patients may not do the calculations themselves (e.g., patients outside of the 2-20 years range for which BMI percentile is included currently).

Please Include BMI in USCDI v4

Inclusion of BMI would allow for quicker querying of patients in FHIR via BMI rather than having to calculate BMI from the data elements “body height” and “body weight.” A potential benefit to patients is that the addition of BMI would provide more health information, especially as certain patients may not do the calculations themselves (e.g., patients outside of the 2-20 years range for which BMI percentile is included currently).

Support to Advance BMI in USCDI

This comment is in support of the advancement of Body Mass Index (BMI) in the United States Core Data for Interoperability.

As part of a research project sponsored by the National Committee of Quality Assurance (NCQA) and a regional health information exchange in New York, Diameter Health was requested to examine data included in clinical documents, such as C-CDA, for 474 distinct facilities in 2020. These clinical documents are shared through health information exchange with other healthcare organizations routinely, in part to fulfill requirements for use of certified health information technology to record and transmit data related to USCDI. These facilities represented a mix of ambulatory care, inpatient and post-acute settings in New York. The project was sponsored as part of the emerging program for Data Aggregator Validation (DAV) launched by NCQA (https://www.ncqa.org/programs/data-and-information-technology/hit-and-data-certification/hedis-compliance-audit-certification/data-aggregator-validation/). These comments represent the perspective of Diameter Health and are not meant to represent the opinions, perspectives or policy of any other organization.

Over the data analysis of 474 organizations having sampled 100 clinical documents from each, Diameter Health found that most organizations recorded and transmitted BMI information as part of care encounters. This information was available on approximately 60% of patient records and was shared on at least some patients for over 80% of facilities. This information was virtually always sent with the appropriate LOINC code. BMI has been historically included as part of the standard vital signs expected in clinical documents. HL7 validated examples already show the appropriate way to record and transmit this information (http://cdasearch.hl7.org/examples/view/Vital%20Signs/Panel%20of%20Vital%20Signs%20in%20Metric%20Units)

Diameter Health works with over 20 health information exchanges nationally as well as an array of health plans, health information technology vendors and governmental entities. The findings shared as part of this research supports observations from other clients.

Diameter Health strongly supports the continued elevation of BMI in the USCDI and we believe that the data from the field shows that this information is already widely recorded and exchanged among healthcare organizations. Please feel welcome to reach out if it would be helpful to share more details or to answer questions regarding this comment.