Physical place of available services or resources.
Data Element
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Facility Contact Information
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| Submitted By: Keith W. Boone
/ Audacious Inquiry
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| Data Element Information |
| Data Element Description |
Telephone or other contact information for the 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
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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
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| 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
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| 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
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| Extent of exchange
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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
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| 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. |
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Submitted by LisaRNelsonRI on
Generalize Facility Telecom
Facility Telecom
Phone or email contact information for a physical place of available services or resources.
Comment: This is another example of data element bloat.
Recommendation: USCDI could be streamlined by avoiding the creation of repetitive data elements that are really the same data element used over and over in different contexts. See comments recommending creation of a new Telecom Information data element in the Healthcare Information Attribute data class.
Additional Note: The Telecom Information data element should not be limited to email and phone. Many other Telecom endpoint types exist. By defining a generalize Telecom Information data element, a more comprehensive list of contact point types and uses could be included without burdening USCDI with unnecessary complexity. The value set of Telecom systems needs to be opened up to include more than phone, fax, email, pager, url, sms, and other. Additional modern telecom information might include some contact types traditionally referenced and digital “endpoints” similar to, but more specific than, the email and url telecom types. For example, a patient or provider may have a Direct address which could be included in their communications as a more specific type of email communication point. A patient or provider may have a FHIR endpoint they would want to publicize in their available telecom options supporting communication.
As the number and type of different digital communication options grows, addressing Telecom Information in a more standardized and comprehensive manner will simplify the number of USCDI data elements.