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  1. CDA Specification Feedback
  2. CDA-21054

Align Smoking Status with what is coming out of US Core 7.0 Smoking Status Ballot Changes

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Medium Medium
    • C-CDA Templates Clinical Notes (CDA)
    • 3.0.0-ballot
    • Structured Documents
    • Smoking Status - Meaningful Use
      Tobacco Use
    • Hide

      Motion :

      to deprecate Smoking Status MU and Tobacco Use templates
      To build a new Smoking status template that aligns with US Core: Draft: https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-SmokingStatusMeaningfulUse.html
      USCDI Table at Smoking Status will point to the new template

      Design of new template to align with US Core Resolutions in new smoking status template:

      401201003 | Cigarette pack-years (observable entity) |
      782516008 | Number of calculated pack years for cumulative lifetime tobacco exposure (observable entity) |
      72166-2 Tobacco smoking status
      11367-0 History of Tobacco use

      Add Guidance at Observation.value to use REAL number or Integer:
      for
      Snomed codes:
      401201003 | Cigarette pack-years (observable entity) |
      and
      782516008 | Number of calculated pack years for cumulative lifetime tobacco exposure (observable entity) |
      and
      For Observation.code 72166-2 Tobacco smoking status or 11367-0 History of Tobacco use SHALL use valueCode
      d. remove constraints on effective time
      e. update and add examples

      Value set for use at Observation.code: (Smoking Status Type) https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1267.6/expansion
      Value set for use at observation.value: Smoking Status Comprehensive: https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1267.3/expansion/

      Show
      Motion : to deprecate Smoking Status MU and Tobacco Use templates To build a new Smoking status template that aligns with US Core: Draft: https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-SmokingStatusMeaningfulUse.html USCDI Table at Smoking Status will point to the new template Design of new template to align with US Core Resolutions in new smoking status template: 401201003 | Cigarette pack-years (observable entity) | 782516008 | Number of calculated pack years for cumulative lifetime tobacco exposure (observable entity) | 72166-2 Tobacco smoking status 11367-0 History of Tobacco use Add Guidance at Observation.value to use REAL number or Integer: for Snomed codes: 401201003 | Cigarette pack-years (observable entity) | and 782516008 | Number of calculated pack years for cumulative lifetime tobacco exposure (observable entity) | and For Observation.code 72166-2 Tobacco smoking status or 11367-0 History of Tobacco use SHALL use valueCode d. remove constraints on effective time e. update and add examples Value set for use at Observation.code: (Smoking Status Type) https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1267.6/expansion Value set for use at observation.value: Smoking Status Comprehensive: https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1267.3/expansion/
    • Jean Duteau / Benjamin Flessner : 19-0-0
    • Correction
    • Compatible, substantive

    Description

      See https://jira.hl7.org/browse/FHIR-43355 and https://jira.hl7.org/browse/FHIR-43589
      and
      https://docs.google.com/presentation/d/13SyfECa99f3tK8TBgBjUKdPPEA5dfNhsEaFp5ksdOjw/edit?usp=sharing

      • Delete or Deprecate Tobacco Use Template
      • Retain C-CDA Smoking Status MU template,
      • Change name (to remove “MU”)
      • Bind to a value set at Observation.code replacing the current single value binding
      • Bind to an improved Tobacco Use value set @observation.value
      • Loosen effective time binding

      carmela_couderc and albert.taylor@hhs.gov both confirmed that:

      • the Smoking Status value set (https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.11.20.9.38/expansion), (that USCDI no longer specifies that only those codes qualify for certification and that broader snomed concepts are desired
      • The name "Smoking Status" which is the name of the USCDI data element, is intended to be broader than just cigarette smoking and is intended to include the concepts of eCigarettes, chew, pipe smoking, etc

      Vendors agreed that in EHRs Smoking status is also broader than just cigarettes

      Value set notes (seperate JIRA to be made)
      Add the 3 missing codes from the Smoking Status value set that are not currently in the Tobacco Use value set
      Add 722499006 | Electronic cigarette user (finding) | hierarchy
      The improved set will contain a mix of temporal codes and not temporal codes*
      Develop a value set for use at Observation.code to replace single value binding
      E.g. Tobacco Use, Smoking Status, pack/day, pack years

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            benjamin Benjamin Flessner
            GDolin Gay Dolin
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            Dates

              Created:
              Updated:
              Resolved: