Physiologic measurements of a patient that indicate the status of the body’s life sustaining functions.
Data Element
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BMI
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Submitted By: Joel Andress
/ Centers for Medicare and Medicaid Services (CMS) Center for Clinical Standards and Quality (CCSQ)
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Data Element Information |
Rationale for Separate Consideration |
USCDIv1 only requires BMI percentile for ages 2-20. Recommend expanding to include BMI (as a number) for the adult population. USCDIv1 also requires all data necessary to calculate a BMI (age (DOB), birth sex, height and weight) but not BMI. |
Use Case Description(s) |
Use Case Description |
BMI for adults is used in quality measurement among CMS quality measures in IQR and QPP. As obesity is a challenge for adults in the united states, this important vital sign is captured for assessment of appropriate care for those adults with certain BMI levels. |
Estimate the breadth of applicability of the use case(s) for this data element
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Providers participating in CMS quality reporting programs (QPP) currently capture, access and exchange BMI results (or associated data elements for calculation) in the adult population.
eCQI resource center, includes measure specifications for CMS program eCQMs: https://ecqi.healthit.gov/ecqms (i.e. CMS 771) |
Link to use case project page |
https://ecqi.healthit.gov/ecqms |
Healthcare Aims |
- Improving the health of populations
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Maturity of Use and Technical Specifications for Data Element |
Applicable Standard(s) |
LOINC
https://vsac.nlm.nih.gov/valueset/expansions?pr=all&rel=Latest&q=2.16.840.1.113883.3.526.3.320
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Additional Specifications |
HL7 FHIR US Core Implementation Guide STU3 based on FHIR R4, Observation Vital Sign BMI Profile, http://hl7.org/fhir/R4/bmi.html
HL7 FHIR QI Core Implementation Guide STU4 based on FHIR R4, Observation Profile http://hl7.org/fhir/us/qicore/StructureDefinition-qicore-observation.html
CMS Quality Data Model (QDM) version 5.5 Guidance, physical exams performed (https://ecqi.healthit.gov/sites/default/files/QDM-v5.5-Guidance-Update-May-2020-508.pdf)
HL7 C-CDA Release 2.0 (http://www.hl7.org/implement/standards/product_brief.cfm?product_id=492)
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Current Use |
Extensively used in production environments |
Supporting Artifacts |
Vital signs widely available in EHR systems. BMI, based on standard terminology, supported in observation profiles in EHR systems. Used in CMS measurement, and therefore captured by providers participating in quality reporting programs.
https://fhir.cerner.com/millennium/r4/diagnostic/observation/ https://fhir.epic.com/Specifications?api=968
https://mydata.athenahealth.com/fhirapidoc
https://ecqi.healthit.gov/ecqms
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Extent of exchange
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5 or more. This data element has been tested at scale between multiple different production environments to support the majority of anticipated stakeholders. |
Supporting Artifacts |
Vital signs, including adult BMI results are electronically exchanged for quality measurement used across CMS programs via QRDA files and other file architecture.
Vital Sign data can also be electronically transferred via C-CDA for clinical care coordination
https://ecqi.healthit.gov/qrda
http://www.hl7.org/implement/standards/product_brief.cfm?product_id=7
https://ecqi.healthit.gov/qrda
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Potential Challenges |
Restrictions on Standardization (e.g. proprietary code) |
No challenges anticipated |
Restrictions on Use (e.g. licensing, user fees) |
None |
Privacy and Security Concerns |
This data, like any patient data, should be exchanged securely. Current processes exist, governed by CMS and ONC, to securely transfer this data. |
Estimate of Overall Burden |
Minimal burden estimated; BMI used for quality measurement, and associated data elements needed for calculation already required by USCDI v1 |
Other Implementation Challenges |
N/A |
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Submitted by nedragarrett_CDC on
CDC's Comment for draft USCDI v6
CDC is requesting that BMI be added for consideration to USCDI V6 to inform hospital and ambulatory medical care survey data collection efforts.
Justification: NAMCS Health Center Component releases Vitals, including BMI information, as a data table via restricted use data files. Inclusion of this data element would improve accuracy of reporting vitals in official federal statistics produced by NAMCS data.