Submitted by aphillips@imoh… on
Data Class: Health Status
Data Class: Health Status
Data Element: Health Concerns (reclassified?)
Level 2 Data Element: Functional Status (see Functioning Data Class)
Level 2 Data Element: Disability Status (see Functioning Data Class)
Level 2 Data Element: Mental Function (see Functioning Data Class)
Level 2 Data Element: Pregnancy Status (see Pregnancy Information Data Class)
Data Element: Smoking Status (reclassified?)
IMO would like clarification from the ONC if the Data Class for Health Status, introduced in the January 2022 Draft USCDI V3, will be eliminated in the final USCDI V3 publication in July of 2022 if the proposed Level 2 Data Class, Functioning is finalized?
Submitted by LisaRNelson on
Health Status
In USCDI V3, Health Concerns are categorized under both Health Status and Problems, making this notion less clear for implementers.
There is a subtle relationship between Encounter Diagnoses, Problems, and Health Concerns. When an encounter diagnosis is an issue that requires follow-up and management over a span of time, the encounter diagnosis goes onto something called a “Problem List” which practitioners use to track progress as they manage the ongoing problem which the patient was diagnosed to have. When a patient has been diagnosed with a long-term condition that includes other risks and issues to be addressed or when a patient’s social condition includes risk factors that should be addressed to ensure optimal health outcomes, these health concerns also become part of the issues addressed in a patient’s care plan.
For clarity, consider moving Health Concerns out of the Health Status category. Having it here confuses things. A health status describes the assessment of the person’s health in a certain area or dimension of wellness. Based on that health status, there may or may not be a health concern that needs to be addressed. Not all issues that are assessed to exist need to be addressed, mitigated, or resolved. For a variety of reasons, it may not be appropriate to make the issue a health concern that needs a plan and should be worked on to be changed.
While ICD-10 is the better single vocabulary for coding diagnoses, problems, and health concerns for which the patient will receive care services, SNOMED CT is ideally positioned to provide the clinical vocabulary for addressing clinical findings which are documented to describe a person’s health status. In fact, many health status assessment tools use a combination of SNOMED CT and LOINC to effectively express and exchange health status assessment information. Separating the uses of ICD-10 for diagnoses and the use of SNOMED CT for clinical findings would eliminate the requirement to translate between these two code systems. ICD-10 and SNOMED CT do not align well. Removing the need to map between when populating a single data element would offer a significant reduction in the burden to provide coded information for interoperability.
USCDI V3 Comment 20220429_2.pdf