| Interoperability Standards Platform (ISP)

Data Element

Submitted By: Swapna Abhyankar / Regenstrief Institute, LOINC Document Ontology Subcommittee
Data Element Information
Rationale for Separate Consideration	This data element has some overlap with the Procedures Data Class. However, the broad use of imaging in the U.S. Healthcare System and its unique elements are the basis for proposing a separate USCDI Class to focus specifically on the elements related to imaging.
Use Case Description(s)
Use Case Description	Imaging studies are performed and exchanged every day across healthcare systems, settings, and specialties.
Estimate the breadth of applicability of the use case(s) for this data element	These data elements are broadly used every day across healthcare systems, settings, and specialties and would be used by a large proportion of USCDI stakeholders.
Healthcare Aims	Improving patient experience of care (quality and/or satisfaction) Reducing the cost of care Improving provider experience of care
Maturity of Use and Technical Specifications for Data Element
Applicable Standard(s)	Logical Observation Identifiers Names and Codes (LOINC®) Database version 2.69 https://loinc.org/oids/1.3.6.1.4.1.12009.10.2.5/
Additional Specifications	LOINC Type 2 imaging procedures value set available from: https://loinc.org/oids/1.3.6.1.4.1.12009.10.2.5/ FHIR ValueSet: https://fhir.loinc.org/ValueSet/loinc-imaging-document-codes/ HL7 C-CDA implementation guides related to imaging, as well as FHIR resources across versions, including the US Core, that are related to imaging.
Current Use	Extensively used in production environments
Supporting Artifacts	Imaging studies are performed and exchanged every day across healthcare systems, settings, and specialties. These data elements would be used by a large proportion of USCDI stakeholders.
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.
Supporting Artifacts	Imaging studies are performed and exchanged every day across healthcare systems, settings, and specialties. These data elements would be used by a large proportion of USCDI 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
Estimate of Overall Burden	Minimal – already being used

Comment

Submitted by brianscarpelli on 2024-04-17

Comments of the Connected Health Initiative

The Connected Health Initiative supports adding the Current Procedural Terminology (CPT) code set to the Applicable Vocabulary Standards listed in Diagnostic Imaging – Diagnostic Imaging Test as the CPT code set contains a comprehensive and regularly curated list of several hundred diagnostic and interventional radiology procedures.

Submitted by brianscarpelli on 2024-04-17

Comments of the Connected Health Initiative

The Connected Health Initiative supports adding the Current Procedural Terminology (CPT) code set to the applicable vocabulary standards for Diagnostic Imaging – Diagnostic Imaging Test, as the CPT code set contains a comprehensive and regularly curated list of several hundred diagnostic and interventional radiology procedures.

Submitted by mattreid on 2024-04-09

Applicable vocabulary standards for Diagnostic Imaging

The AMA requests that the Current Procedural Terminology (CPT) code set be added to the applicable vocabulary standards for Diagnostic Imaging – Diagnostic Imaging Test. The CPT code set contains a comprehensive and regularly curated list of several hundred diagnostic and interventional radiology procedures. (See our previous comment on 4/17/2023 for additional information.) The following are research examples where EHR data, including CPT diagnostic imaging test codes, were used for the data analysis.

Hsu J, Pacheco JA, Stevens WW, Smith ME, Avila PC. Accuracy of phenotyping chronic rhinosinusitis in the electronic health record. Am J Rhinol Allergy. 2014 Mar-Apr;28(2):140-4. doi: 10.2500/ajra.2014.28.4012. PMID: 24717952; PMCID: PMC5517777.
Zhang R, Narra VR, Kansagra AP. Large-Scale Assessment of Scan-Time Variability and Multiple-Procedure Efficiency for Cross-Sectional Neuroradiological Exams in Clinical Practice. J Digit Imaging. 2020 Feb;33(1):143-150. doi: 10.1007/s10278-019-00252-w. PMID: 31292770; PMCID: PMC7064664.
Virk SS, Diwan A, Phillips FM, Sandhu H, Khan SN. What is the Rate of Revision Discectomies After Primary Discectomy on a National Scale? Clin Orthop Relat Res. 2017 Nov;475(11):2752-2762. doi: 10.1007/s11999-017-5467-6. Epub 2017 Aug 28. PMID: 28849429; PMCID: PMC5638742.

Submitted by mattreid on 2023-04-17

Support to include CPT as an applicable vocabulary standard

The American Medical Association requests that the Current Procedural Terminology (CPT) code set be added to the Applicable Vocabulary Standards listed in Diagnostic Imaging – Diagnostic Imaging Test. The CPT code set contains a comprehensive and regularly curated list of several hundred diagnostic and interventional radiology procedures. The CPT code set was added in 2019 to the Interoperability Standards Advisory (ISA) vocabulary list for Representing Imaging Diagnostics, Interventions and Procedures. In a 2013 study, CPT was an important component needed to study the effect of health information exchanges in reducing diagnostic imaging for back pain in the emergency department (Bailey JE, Pope RA, Elliott EC, Wan JY, Waters TM, Frisse ME. Health Information Exchange Reduces Repeated Diagnostic Imaging for Back Pain. Annals of Emergency Medicine. 2013;62(1):16-24. doi: 10.1016/j.annemergmed.2013.01.006). The CPT code set is a comprehensive and regularly curated uniform language that provides reliable communication among users. It has an extremely mature development process with open and transparent meetings and clinical input from national medical specialties and relevant stakeholders.