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    • Change Request
    • Status: Published (View Workflow)
    • Medium
    • Resolution: Persuasive with Modification
    • US Core (FHIR)
    • 4.1.0
    • Cross-Group Projects
    • US Core Race Extension
    • Social Determinants of Health (SDOH)
    • 10.137.1
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      First element of this tracker:
      Avoid change to DataAbsentReason categories as it is a more significant change from existing practice that uses the HL7 v3 Null Flavors - note that "other" is already removed.
      Keep the UNK and ASKU in the value set.

      Motion to approve this portion of the ticket: Brett/Eric Haas: 12-0-3
      Recommend that new tracker be created to address the data absent reason value set change in future editions of US Core.

      Second element of this tracker:
      2131-1 Other Race (note that it exists in the PHIN VADS larger value set and in a VSAC value set 2.16.840.1.114222.4.11.836 “Race”). Noting that government (HHS) statistical analysis must use only the 5 existing OMB rules except in census data. The OMB rule from 1997 does not exclude the use of Other Race (page 58789 and 58790 of the OMB FR where other race is not disallowed). The OMB rule is related to federal data collection, not EHRs.
      Motion:

      • Add "Other Race" 2131-1
      • In the Race extension definition add text that the use of "other race" is discouraged for statistical analysis.
        Brett Marquard/Rob McClure: 8-1-3
      Show
      First element of this tracker: Avoid change to DataAbsentReason categories as it is a more significant change from existing practice that uses the HL7 v3 Null Flavors - note that "other" is already removed. Keep the UNK and ASKU in the value set. Motion to approve this portion of the ticket: Brett/Eric Haas: 12-0-3 Recommend that new tracker be created to address the data absent reason value set change in future editions of US Core. Second element of this tracker: 2131-1 Other Race (note that it exists in the PHIN VADS larger value set and in a VSAC value set 2.16.840.1.114222.4.11.836 “Race”). Noting that government (HHS) statistical analysis must use only the 5 existing OMB rules except in census data. The OMB rule from 1997 does not exclude the use of Other Race (page 58789 and 58790 of the OMB FR where other race is not disallowed). The OMB rule is related to federal data collection, not EHRs. Motion: Add "Other Race" 2131-1 In the Race extension definition add text that the use of "other race" is discouraged for statistical analysis. Brett Marquard/Rob McClure: 8-1-3
    • Brett Marquard/Rob McClure: 8-1-3
    • Enhancement
    • Compatible, substantive

    Description

      FHIR-35694 removed "Other" from the US Core (OMB race categories value set|http://build.fhir.org/ig/HL7/US-Core/ValueSet-omb-race-category.html). The rationale is that HL7 v3 Null Flavor "Other" does not indicate the right information. However, there exists a VSAC value set that contains all of the OMB codes (using the same codes from the larger CDC Race and Ethnicity value set) PLUS another code from the CDC Race and Ethnicity value set - 2131-1 "Other Race". This additional code does express the meaning and it allows an individual to also choose a more specific race which, based on the hierarchy, rolls up to one of the 5 OMB categories. This option also appears in the US Census form - see figure 2 at: https://www.census.gov/newsroom/blogs/random-samplings/2021/08/improvements-to-2020-census-race-hispanic-origin-question-designs.html. Thus, the addition of "Other Race" should be specific and allowable. Further, remove the HL7 v3 null flavor codes, ASKU and UNK as they are specifically null flavor, and instead substitute with 3 codes from the DataAbsentReason value set (http://terminology.hl7.org/CodeSystem/data-absent-reason): Asked-declined, Not-asked, and Asked-unknown. These codes are more specific and fit better with clinical and financial data than the current "null flavor" content.

      So 2 Options:
      *Option 1 *- (preferred solution): Modify ValueSet: OMB Race Categories (http://build.fhir.org/ig/HL7/US-Core/ValueSet-omb-race-category.html) to:

      OR

      *Option 2 *(allows persistence of direct reference to PHIN-VADS). Modify ValueSet: OMB Race Categories (http://build.fhir.org/ig/HL7/US-Core/ValueSet-omb-race-category.html) to:

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            Unassigned Unassigned
            feisenberg Floyd Eisenberg
            Carmela A. Couderc, Floyd Eisenberg, Rob McClure
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            Dates

              Created:
              Updated:
              Resolved: