Physical place of available services or resources.

Data Element
Facility Identifier
Description (*Please confirm or update this field for the new USCDI version*)

Sequence of characters representing a physical place of available services or resources.

Submitted By: Keith W. Boone / Audacious Inquiry
Data Element Information
Data Element Description An identifier which uniquely identifies this facility.
Use Case Description(s)
Use Case Description Facility level data is associated with laboratory tests (the testing facility), and health care provider locations, including hospitals, ambulatory providers, long-term and post acute care, and pharmacy providers.
Location data is used to support reporting of data for public health and emergency response (e.g., situation awareness reporting).

See https://build.fhir.org/ig/HL7/fhir-saner/ for details (note that (minus) - is a legal character in URLs, had to use a bit.ly link to get past validation errors in URL)
Estimate the breadth of applicability of the use case(s) for this data element Hospitals in the US (Approximately 7000), Laboratories (260,000), pharmacies (88,000), ambulatory physicians (260,000).
Link to use case project page https://bit.ly/SANERBUILD
Healthcare Aims
  • Improving the health of populations
Maturity of Use and Technical Specifications for Data Element
Applicable Standard(s) Various:

FHIR DSTU2, 3 and 4, CDA Release 2.0, HL7 V2 PL Data Type
https://bit.ly/FHIRLocation
Additional Specifications V3.1.0: https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-location.html
V3.0.0: http://hl7.org/fhir/us/core/2019Sep/StructureDefinition-us-core-location.html
V2.1.0: http://hl7.org/fhir/us/core/2019Jan/StructureDefinition-us-core-location.html
V2.0.0: http://hl7.org/fhir/us/core/STU2/StructureDefinition-us-core-location.html
Current Use Extensively used in production environments
Supporting Artifacts Widely available within EHR Systems, but not necessarily searchable.
https://open.epic.com/Interface/FHIR#Location
https://mydata.athenahealth.com/static/apidoc/ig-ge-location.html
https://fhir.cerner.com/millennium/r4/encounters/encounter/ (Reference to a Location resource)
https://developer.allscripts.com/FHIR?PageTitle=Resources
https://api.evident.com/dstu2/encounter (Location as an embedded resource)
https://www.questdiagnostics.com/dms/Documents/care360/Terms-Conditions/Quanum_EHR_FHIR_API.pdf (Quest only supports Location name in Immunizations)
https://bit.ly/USCore31
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 See US Core Connectathon report out: https://drive.google.com/file/d/1WNYWLEf28j8DPyDachC8jpk-QbkyuPxP/view

https://bit.ly/2DTBheD
Potential Challenges
Restrictions on Standardization (e.g. proprietary code) None
Restrictions on Use (e.g. licensing, user fees) None
Privacy and Security Concerns Locations associated with Critical Access Hospitals, and single provider facilities may constitute PHI (in geographic locations with limited populations) and/or Individual Identifiable Information (e.g., for HCPs working from a combined home/office facility).
Estimate of Overall Burden Most electronic systems provide the capacity to store location and organization information. Many EHRs already provide access to the Location resource via READ operations, some (e.g., Epic, AthentaHealth) provide search capabilities as well. This information is routinely communicated in HL7 V2 Messages, CDA Documents and some FHIR API transactions. To address gaps, implementers would need to modify interfaces (e.g., for CDA or HL7 V2), or add an endpoint. Estimated effort (based on past experience building EHR systems) is about one two-week sprint to implement the capability by a developer.
Other Implementation Challenges Standards for location identifier may need flexibility depending on use of Location for reportiong, as there are a number of distinct location identifier systems which may be necessary for different reporting use cases. For example, CDC/NHSN assigns identifiers for HAI reporting, CLIA assigns identifiers to laboratories, CMS provides location identifiers, et cetera.

Comment

Submitted by nedragarrett_CDC on

CDC-CMS Joint Priority Data Element for USCDI v4

We support the CMS comment ‘CMS-CCSQ Support for Facility/Organization Identifier: USCDIv3’ on 2022-03-22 that Facility/Organization Identifiers are critical component of EHR for providing high quality care to patients, reducing disparities, SDOH data analysis, promoting interoperability and data aggregation. HIPAA requires that health care providers have standard NPI that identify them on all standard transactions.  We recommend adding the ‘Facility/Organization Identifiers’ to USCDI data classes. We suggest the following definition of this data class: ‘Facility/Organization Identifiers in EHRs are standardized codes, names and other attributes that provide a unique data pointer to a healthcare facility/organization where patient’s care has occurred.’ 

We found a similar concept description in the Level 2 under the ‘Facility Level Data’. Because a potential ambiguity of the ‘Facility Level Data’ term (i.e., it could mean aggregate level facility data rather than unique identifiers) we strongly suggest replacing it with proposed by CMS title ‘Facility/Organization Identifiers’. Based on the recent experience in management of the COVID-19 EHRs and ONC requirements on EHR aggregation and reporting data for situational awareness, we propose that the following data elements and associated vocabulary standards should be included into the Facility/Organization Identifiers data class:

  1. Organization/Facility name, LOINC 76469-6
  2. Organization/Facility Email address, LOINC 90054-8
  3. Organization/Facility Phone number, LOINC 90053-0
  4. Organization/Facility Address, LOINC 90052-2
  5. Organization/Facility ZIP code , LOINC 76695-6
  6. National Provider ID (NPI), LOINC 45952-9
  7. CCN (CMS Certification Number), LOINC 69417-4


Additional applicable standards and additional specifications:

  1. FHIR DSTU2, 3 and 4, CDA Release 2.0, HL7 V2 PL Data Type https://bit.ly/FHIRLocation,
  2. Resource Profile: FHIR 5.0.1 - STU5 Release US, US Core Location Profile  https://open.epic.com/Interface/FHIR#Location
  3. FHIR 4.3.0: R4B – STU, Resource Organization - Detailed Descriptions     https://hl7.org/fhir/organization-definitions.html
  4. HHS.gov. Health Information Privacy. Other Administrative Simplification Rules. https://www.hhs.gov/hipaa/for-professionals/other-administration-simplification-rules/index.html



This element is also shared priority for both CDC and CMS as outlined in the joint support letter

Submitted by nedragarrett_CDC on

CDC-CMS Joint Priority Data Element

 Both CDC and CMS support inclusion of this element in v3. More details are provided in the joint letter sent to ONC. 

Submitted by sg999 on

CMS-CCSQ Support for Facility/Organization Identifier: USCDIv3

Identifiers are critical for billing, linking billing/clinical EHRs, supporting data aggregation across data sources and reducing burden, as well as attribution and tracking of data. All of these activities are necessary for providing high quality care to patients, reducing disparities, promoting interoperability and communicating across silos. Facility identifiers are also critical for public health reporting and tracking, an ONC stated priority for USCDI version 3.

CMS specifically prioritizes exchange of CMS Certification number (CCN), Provider Transaction number (PTAN), and National Provider Identifier (NPI)—unique identifiers for a healthcare organization.

Maturity:

  • Current standards:
  • Current uses, exchange, and use cases: CCN, PTAN, and NPI are exchanged across the nation for CMS reporting to appropriately attribute outcomes and measure results.  Exchange of these identifiers supports facility-specific quality, prior authorization activities, and other assessments that are limited without this information.

Submitted by nedragarrett_CDC on

Unified Comment from CDC

  • General Comment: This comment supports the promotion of the Data Class Patient Demographics - Data Element Identifier to USCDI V3 as well as the additional Data Element of Identifier System, including the allowance of multiple instances of Identifier/ Identifier System pairs per patient (approach 1). We believe that this will allow needed flexibility to accommodate use and exchange of the variety of patient identifiers in current use in the US. An example of this approaches is: Identifier: 333224444, Identifier System: http://hl7.org/fhir/sid/us-ssn.
     
  • If ONC does not choose to incorporate approach 1, (Identifier + Identifier System), in USCDI V3, we recommend allowing for the following Patient Demographic Data Class Data Elements in USCDI V3: Medicare Patient Identifier, Medical Record Number and Social Security Number. (approach 2) We believe that allowing for both approaches would be confusing, so we recommend choosing one or the other.
     
  • Additional Use Case: This is a standard data (FIN or NPI) item used by central cancer registries in all states according to the North American Association of Central Cancer Registries (NAACCR) standard. Data received through data exchange from medical facilities (e.g., laboratories, hospitals, physician EHRs, etc.) to central cancer registries for CDC and NCI’s national cancer surveillance systems, as required by law.  
     
  • CSTE supports inclusion of this measure into USCDI v3: Very useful for this information to be captured in some way and then subsequently used in reporting to PH.

Submitted by pwilson@ncpdp.org on

NCPDP Comment

NCPDP SCRIPT transactions uses the NPI type 2 and proprietary Facility ID values. NCPDP request these values be added to Draft Version 2.

Log in or register to post comments

FormGuide

Help

1. Optional: Background Text / Cover Letter

The "Optional Background Text / Cover Letter" field provides space for additional context or introductory information related to your comment.

If you wish to provide context, explanation, or an introduction to your comment, enter this information in the field labeled "Optional Background Text / Cover Letter." This is entirely optional and is most useful when submitting multiple related comments or when additional background would help reviewers understand your feedback.

If you are only commenting on a single data class or element, you may leave this field blank.

2. Select the Data Class

To specify which data class your comment addresses:

  1. In the "Data Class" drop-down menu, select the appropriate data class you want to comment on.
  2. If you are providing a general comment that is not specific to a data element, select "General" from the options. Comments with this designation will be displayed on the USCDI landing page.
  3. Note that the Data Class field will automatically populate based on your current location in the platform:
    1. If you are on a data class page, the field will be set to that specific data class
    2. If you are on a data element page, the corresponding data class will be pre-selected
       

3. Select the Data Element

To specify which data element your comment addresses:

  1. In the "Data Element" drop-down menu, select the specific data element you want to comment on.
  2. The drop-down menu will display only the elements available under the data class you selected in the previous step.
  3. You can use the search function within the drop-down to quickly locate a specific data element.
  4. If you are commenting on the data class itself rather than a specific element, you may leave this field blank.

Note: Comments on a specific data element will appear on the respective data element page, while comments on a data class (without a specific element selected) will appear on the landing page for that data class.
 

Data Class and Data Element

Fig 1 The "Data Class" and "Data Element" dropdown menus allow users to specify the exact content they wish to comment on.

4. Optional: Propose New Data Class or Element

If you cannot find the appropriate data class or element for your comment:

  1. Instead of clicking the "Comment On An Existing Data Class Or Element" button, click the adjacent button labeled "Propose a New Data Class or Data Element."
  2. This will redirect you to the ONDEC (ONC New Data Element and Class) Submission System.
  3. In the ONDEC system, follow the provided instructions to submit your proposal for a new data class or element.
  4. Once your proposal is submitted through ONDEC, it will be reviewed separately from the commenting process.
Propose New Data Class or Element

Fig 2 The "Propose a New Data Class or Data Element" button redirects users to the ONDEC Submission System for proposing new data elements not currently available in the system.

5. Complete the Comment Form

Fill out the required fields in the comment form:

Subject: Enter a brief, descriptive title that summarizes your comment. This helps reviewers quickly understand the nature of your feedback.

Comment: In this field, provide the full details of your comment or feedback. Be as clear and specific as possible about your suggestions, concerns, or observations. Include any relevant details that support your position.

6. Optional: Add Additional Comments

If you need to comment on multiple data classes or elements:

  1. After completing your first comment, click the link labeled "Comment on another data element" at the bottom of the form.
  2. A new comment section will appear, allowing you to enter details for your additional comment.
  3. For each additional comment, you must select the appropriate data class and data element from the drop-down menus.
  4. Complete the Subject and Comment fields for your additional comment.
  5. Repeat this process for each additional comment you wish to submit.

Fig 3 The "Comment on another data element" link enables users to create multiple comments addressing different elements within a single submission.

7. Optional: Upload Supporting Files

The platform allows you to upload supporting documentation to enhance your comment:

  • Locate the "File Upload" section at the bottom of the comment form.
  • Click to upload any files (such as PDFs or documents) that provide additional context, evidence, or clarification for your comment.

Important: If you have already entered your comments using the form fields, there is no need to upload duplicate content in PDF format. The file upload feature is intended for supplementary materials only. Please avoid uploading files that contain the same information already provided in your comment text.

Upload Supporting Files

Fig 4 The "File Upload" section permits users to attach supporting documentation that supplements their written comments.

8. Optional: Save and Exit

If you need to pause your work and return to complete your comment later:

  1. Click the "Save and Exit" button at the bottom of the form.
  2. Your comment will be saved as a draft that you can access and complete later.
  3. When you return to the platform, you will see a red triangle with an exclamation mark next to the “Return to saved Comment” button, indicating that you have saved comments in draft status.
  4. Click this button to continue working on your draft.
  5. You will be taken to a review page where you can:
    1. Select "Submit Comment" to officially submit your feedback.
    2. Click "Edit" to return to the comment form and make changes
    3. Select "Discard Draft" to delete the saved draft and start fresh

Fig 5 A red triangle with exclamation mark indicator appears next to the “Return to saved Comment” button when draft comments are saved in the system.

9. Review and Submit

Once you have completed your comment:

  1. Click the "Review and Submit" button at the bottom of the form.
  2. This will take you to a review screen displaying your comment(s) in full.
  3. Review all information for accuracy and completeness.
  4. On this review screen, you have three options: 
    1. Click "Submit Comment" to officially submit your feedback
    2. Click "Edit" to return to the comment form and make changes
    3. Click "Discard Draft" to delete the comment and start fresh
  5. The review screen also includes a "Print" button that allows you to create a printed copy of your comments for your records. 
  6. If you choose to submit, your comment will be recorded in the system and made available for review by the appropriate stakeholders.
Review and Submit

Fig 6 The review screen allows users to verify comment content and make any necessary modifications before final submission.

USCDI Comments

Close

Add a New Comment

Review comment and Submit

Edit
Comment #1