Provider-authored request for the delivery of patient care services.

Usage notes: Orders convey a provider’s intent to have a service performed on or for a patient, or to give instructions on future care.

Data Element
Medical Device Order
Description
Provider-authored request for medical devices, such as for therapeutic footwear or walking aids.
Submitted By: Grace Glennon, on behalf of NCQA / NCQA
Data Element Information
Data Element Description Provider-authored request for medical devices, such as for therapeutic footwear or walking aids.
Use Case Description(s)
Use Case Description Medical device orders represent another important type of order for appropriate care and patient support. Like other orders, medical device orders are routinely happening across care settings. These orders can be captured and exchanged via standard vocabulary (SNOMED).
NCQA is currently developing a digital HEDIS measure for foot exam and appropriate follow-up in persons with diabetes, as diabetes remains a prevalent and costly disease among adults in the United States. Medical device orders for therapeutic footwear are an important component to this measure. The American Diabetes Association clinical guidelines for patients with diabetes recommends specialized therapeutic footwear for people with diabetes at high risk for ulceration, including those with loss of protective sensation, foot deformities, ulcers, callous formation, poor peripheral circulation, or history of amputation—this data supports adherence to ADA guidelines.
Estimate the breadth of applicability of the use case(s) for this data element (Level 2) – Use cases apply to most care settings or specialties.

Order information are documented, utilized and exchanged across care settings including primary care, outpatient and acute care settings, and utilized for payment.
ONC Priority
  • Mitigate health and health care inequities and disparities
  • Address the needs of underserved communities
Maturity of Use and Technical Specifications for Data Element
Applicable Standard(s) SNOMED CT
Additional Specifications FHIR US Core (6.1.0, 7.0.0) ServiceRequest- must have a code defining what is being requested
QI Core 6.0.0 DeviceRequest – must have a code defining the device requested
Current Use (Level 2) Captured, stored, or accessed in multiple production EHRs or other HIT modules from more than one developer
Extent of exchange (Level 2) Between more than two production EHRs or other HIT modules using available interoperability standards
Supporting Artifacts Providers serving the general population are currently collecting this data to support routine patient care, particularly for many prevalent chronic conditions like diabetes. Orders information is routinely exchanged to adhere to clinical guidelines and support patient care.
Potential Challenges
Restrictions on Standardization (e.g. proprietary code) No restrictions.
Restrictions on Use (e.g. licensing, user fees) No restrictions.
Privacy and Security Concerns Exchange of patient health information should follow HIPPA Privacy Rules.
Estimate of Overall Burden Given that USCDI already includes other orders elements, exchanged via the same structure as this orders element, implementation burden should be low.
Other Implementation Challenges No other known challenges.
ASTP Evaluation Details
Each submitted Data Element has been evaluated based on the following criteria. The overall Level classification is a composite of the maturity based on these individual criteria. This information can be used to identify areas that require additional work to raise the overall classification level and consideration for inclusion in future versions of USCDI
Criterion #1
Maturity - Current Standards		 Level 2 - Data element is represented by a terminology standard or SDO-balloted technical specification or implementation guide.
Criterion #2
Maturity - Current Use 		Level 2 - Data element is captured, stored, or accessed in multiple production EHRs or other HIT modules from more than one developer.
Criterion #3
Maturity - Current Exchange		 Level 2 - Data element is electronically exchanged between more than two production EHRs or other HIT modules of different developers using available interoperability standards.
Criterion #4
Use Case(s) - Breadth of Applicability		 Level 2 - Use cases apply to most care settings or specialties.

Comment

Submitted by pwilson@ncpdp.org on

NCPDP Comment

NCPDP recommends adding UDI and NDC to Applicable Vocabulary Standard(s). This would enable the exchange of data related to digital therapeutics, especially prescription digital therapeutics.

Submitted by NCQA on

NCQA recommendation: medical device orders terminology

Recommendation: Add SNOMED and HCPCS terminology to applicable vocabulary standard.

 

Rationale: Including applicable terminology for USCDI data elements supports consistent implementation. SNOMED and HCPCS represents appropriate terminology to capture device orders. NCQA is developing several new measures that include device orders, with SNOMED and HCPCS terminology in use and aligned to the FHIR standard.

Submitted by NCQA on

NCQA USCDI v7 recommendation for Medical Device Orders

Recommendation: Add an additional element to USCDI v7 in the Orders data class for Medical Device Orders, defined as a provider-authored request for medical devices, such as for therapeutic footwear or walking aids (Vocabulary standards: SNOMED CT).

Rationale: Medical device orders represent another important type of order for appropriate care and patient support. These orders can be captured and exchanged via standard vocabulary. NCQA is currently developing a measure for foot exam and appropriate follow-up in persons with diabetes, as diabetes remains a prevalent and costly disease among adults in the United States. 

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