Data Element
Travel History Location
Description

A location in a person’s travel history either as an address or as a coded location.
Submitted By: Craig Newman / Altarum
Data Element Information
Use Case Description(s)
Use Case Description Exposures to environmental and communicable disease threats through travel play an important role in many public health events and have a significant impact on routine reporting as well. For both reasons it is important for public health investigators to receive discrete travel history information about patients. This information is particularly important in electronic case reporting and during outbreaks.
Estimate the breadth of applicability of the use case(s) for this data element Travel history would be reported in all jurisdictions as part of electronic case reporting.
Healthcare Aims
  • Improving patient experience of care (quality and/or satisfaction)
  • Improving the health of populations
  • Improving provider experience of care
Maturity of Use and Technical Specifications for Data Element
Applicable Standard(s) 1. SNOMED: 420008001 |Travel (event)|
2. Geographical location history (https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.114222.4.11.3201)
3. ISO 3166 country codes (https://www.iso.org/iso-3166-country-codes.html)
Additional Specifications HL7 FHIR® Implementation Guide: Electronic Case Reporting (eCR) - US Realm
HL7 CDA® R2 Implementation Guide: Public Health Case Report, Release 2 - US Realm - the Electronic Initial Case Report (eICR)
Current Use Extensively used in production environments
Supporting Artifacts Used as part of electronic case reporting
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 Somewhere between 56 and 2400 public health agencies and 5000 reporting sites.
Potential Challenges
Restrictions on Standardization (e.g. proprietary code) None
Restrictions on Use (e.g. licensing, user fees) None
Privacy and Security Concerns No concerns over and above the typically privacy and security considerations associated with any health related data.
Estimate of Overall Burden These data elements are straightforward in nature and should not present a large burden to implement provided the EHR system is capturing the data.

Comment

Submitted by BLampkins_CSTE on

CSTE Comment - v6

CSTE supports inclusion of this data element in USCDI V6. Please see previously submitted CSTE comments for additional recommendations.

Submitted by nedragarrett_CDC on

CDC's Consolidated Comment for USCDI v4

  • To align with the most current value set available, please update USCDI Level 2/Comment value set for Travel Purpose: (https://www.healthit.gov/isa/taxonomy/term/3616/comment) to the PHIN VADS value set for Travel Purpose PHVS_TravelPurpose_CDC
  •  Comments from NACCHO: NACCHO recommends inlcusion of this data element. NACCHO expects this field to be added to the USCDI v4 Core. This data element will support the early and rapid identification of potential disease outbreaks.

Submitted by nedragarrett_CDC on

CDC's Consolidated Comment

  • Strongly recommend inclusion of this data element along with travel history dates as part of USCDI v3. Not only is this information important for public health, but also plays an important role in developing a differential diagnosis list as some infectious diseases are more common or only found internationally. Additionally, these concepts are built into national case notifications to CDC for 25 reportable conditions using the case notification HL7 message mapping guide format. Anticipate within the next couple of years to make travel history available for all notifiable conditions as it is not only important for general surveillance, but also for work done at CDC related to global migration and quarantine e.g., it helps to identify post-exposure prophylaxes needs and plays critical role in outbreak response such as Ebola and/or early SARS-CoV-2 response.

CSTE Comment:

  • Agree with CDC: Strongly recommend inclusion of this data element along with travel history location as part of USCDI v3. Not only is this information important for public health, but also plays an important role in developing a differential diagnosis list as some infectious diseases are more common or only found internationally. Additionally, these concepts are built into national case notifications to CDC for 25 reportable conditions using the case notification HL7 message mapping guide format. Anticipate within the next couple of years to make travel history available for all notifiable conditions as it is not only important for general surveillance, but also for work done at CDC related to global migration and quarantine e.g., it helps to identify post-exposure prophylaxes needs and plays critical role in outbreak response such as Ebola and/or early SARS-CoV-2 response.
  • For travel history it  is important to capture the dates the person was in the location/destination (start date and end date) - also important to phrase the question so that it does not always represent travel FROM the US to another country and back as many individuals who may have been residing in another country or another relevant location may present for care. Recommend the question be asked as whether time was spent recently in a foreign country or another location outside of the jurisdiction.

Submitted by nedragarrett_CDC on

Unified Comment from CDC

  • CDC considers this element to be high priority and strongly recommends its inclusion in the USCDI V3
     
  • CSTE supports inclusion of this measure into USCDI v3: Indicating international travel flag and country visited (with dates of travel and return to US) would be beneficial for some diseases. In general, public health would capture this information during a case investigation and think it might be a burden for clinical care to capture ALL travel (domestic and international) but in some cases, charts are reviewed for travel or the provider is interviewed for patient travel hx, so agree this is useful for some conditions

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