Activity performed for or on a patient as part of the provision of care.

Data Element
Location of Procedure
Description

Healthcare service location within a facility where the procedure was performed.
Submitted By: Sheila Abner / CDC/NHSN
Data Element Information
Data Element Description Healthcare service location within a facility where the procedure was performed.
Use Case Description(s)
Use Case Description Surgical site infections are reported to NHSN as part of nationwide healthcare-associated infections surveillance. Data reported to NHSN on surgical site infections associated with colon and abdominal hysterectomy operative procedures are submitted to CMS.

Data elements associated with orders for isolation / transmission precautions (status of patient on the following types of isolation precautions: contact, airborne, droplet) are needed for public health reporting on patients with suspected cases of contagious diseases. Feedback is requested regarding the most appropriate class for these data elements. Another option might be Encounter or possibly part of a new class such as Service Request.
Estimate the breadth of applicability of the use case(s) for this data element Beginning 15 years ago with 300 hospitals, NHSN now serves approximately 25,000 medical facilities tracking HAIs. Current participants include acute care hospitals, long-term acute care hospitals, psychiatric hospitals, rehabilitation hospitals, outpatient dialysis centers, ambulatory surgery centers, and nursing homes, with hospitals and dialysis facilities representing the majority of facilities reporting data. Participation among the other facility types is expected to continue to grow in coming years.
Link to use case project page https://www.cdc.gov/nhsn/index.html
Healthcare Aims
  • Improving patient experience of care (quality and/or satisfaction)
  • Improving the health of populations
  • Reducing the cost of care
  • Improving provider experience of care
Maturity of Use and Technical Specifications for Data Element
Applicable Standard(s) Location of Procedure: HSLOC (https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/hsloc.html)

Transmission-based precautions: SNOMED CT
Additional Specifications CDA IG: HL7 CDA® R2 Implementation Guide: Healthcare Associated Infection (HAI) Reports, Release 3 - US Realm (http://www.hl7.org/implement/standards/product_brief.cfm?product_id=426)
FHIR IG: Healthcare Associated Infection Reports Implementation Guide CI Build (http://hl7.org/fhir/us/hai/)
Current Use Extensively used in production environments
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.
Potential Challenges
Restrictions on Standardization (e.g. proprietary code) none known
Restrictions on Use (e.g. licensing, user fees) none known
Privacy and Security Concerns none known
Estimate of Overall Burden Moderate burden. Orders for isolation are currently irregularly implemented, so there is a need for more consistent documentation. Implementing appropriate transmission-based precautions is important for individual patient care as well as facility infection control. Easy access to isolation status of a patient for situational awareness is critical.
Other Implementation Challenges none known
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 0 - Use cases apply to a limited number of care settings or specialties, or data element represents a specialization of other, more general data elements.
Evaluation Comment This data element represents data included in an existing USCDI data element Encounter Location.

Comment

Submitted by molenda on

Data element name change suggestion for "Location of Procedure"

"Location of Procedure" is currently Level 0. Anatomy Mapper OpCo recommends clarifying and renaming the "Location of Procedure" element to "Place of Service" or "Procedure Setting"  or "Performance Location" to make explicit that it captures the physical facility / department / setting where the procedure occurred.  

The current "Location of Procedure" data element is explicitly different from the "Anatomic Location of Procedure" (i.e. where on the body did the procedure occur?).  On a related note, Anatomy Mapper OpCo recommends an "Anatomic Localization" data element for Procedures, which can be recycled to other relevant data classes.

Submitted by aphillips@imoh… on

Level 2 Data Element: Location of Procedure

IMO supports the inclusion of proposed Level 2 Data Elements for Procedure Timing and Location of Procedure in USCDI V3.  These data elements are incorporated in mature technical specifications including CDA R2 Implementation Guide: Healthcare Associated Infection (HAI) Reports, Release 3. ONC certified HIT should be capable of exchanging these data elements.

 

Submitted by CDC_DSMH_WG on

Unified Comment from CDC

CDC considers this element to be high priority and strongly recommends its inclusion in the USCDI V3

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