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  1. V2 Specification Feedback
  2. V2-25659

Need a way to explicitly state that no fixed address exists

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    • Icon: Change Request Change Request
    • Resolution: Persuasive
    • Icon: Medium Medium
    • V2.x Message Specification (V2)
    • V2.9
    • Patient Administration
    • EXTENDED ADDRESS (XAD)
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      Question:  what is the driver of needing a "no fixed address" indicator?  If the motivator was to track homelessness, then we should focus on either a Condition or Observation (v2 equivalents) and may not need to handle no-fixed-address" at all.

       

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      PA Note:  We started drafting a proposal, but realized we didn't have a firm grasp of how the NFA could would be used.

      —

      As a practical solution, we will add a new code in the addressType code system to represent the concept of "patient-asked-but-said-they-don't-have-a-fixed-address"  (NFA - No Fixed Address). 

       

      It is understood that the NFA concept is orthogonal to the existing type codes, and this will make it difficult to represent several scenarios, such as:

      • Military service members that have an address at which they can receive mail, but which is not considered a fixed address (issue: should the address code be NFA-No Fixed Address or M-Mailing)
      • For persons that have a PO Box (issue: should the address code be NFA-No Fixed Address or M-Mailing)

       

      We would provide guidance that:

      • No Fixed Address DOES NOT indicate homelessness
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      Question :  what is the driver of needing a "no fixed address" indicator?  If the motivator was to track homelessness, then we should focus on either a Condition or Observation (v2 equivalents) and may not need to handle no-fixed-address" at all.   ------ PA Note :  We started drafting a proposal, but realized we didn't have a firm grasp of how the NFA could would be used. — As a practical solution, we will add a new code in the addressType code system  to represent the concept of "patient-asked-but-said-they-don't-have-a-fixed-address"  (NFA - No Fixed Address).    It is understood that the NFA concept is orthogonal to the existing type codes, and this will make it difficult to represent several scenarios, such as: Military service members that have an address at which they can receive mail, but which is not considered a fixed address (issue: should the address code be NFA-No Fixed Address or M-Mailing) For persons that have a PO Box (issue: should the address code be NFA-No Fixed Address or M-Mailing)   We would provide guidance that: No Fixed Address DOES NOT indicate homelessness

    Description

      This came up in the context of patient, but can be extrapolated to other person roles (like next of kin for example):

      In order to be able to explicitly state that a person has no fixed address, meaning they cannot provide either a physical address or a mailing address, we need to add a NEW code to the address type code system: https://terminology.hl7.org/5.4.0/CodeSystem-v2-0190.html 

      This was discussed on the PA call on 12/13/2023.

      Background email thread is here: https://confluence.hl7.org/rest/hotovo/amazon-s3/1.0/buckets/24/content/download?path=V2%20Documents%2FNoPermanentAddress.txt&targetId=86974068 

      Note that while the email uses the term permanent address, we established that this is NOT related to the address type "Permanent".

      This will need to be a UTG proposal to make the changes, since this is vocabulary on THO - here is the proposed solution:

      Code = NF

      Display = No Fixed Address

      Definition = The person (usually the patient, but coudl be next of kin also) was asked to provide and address, either mailing or physical, but said they don't have a fixed address.

      V2 Concept Comment = V2 Concept Comment As Published = Do not use this as an indicator for homelessness - there are other reasons why a person may not have a fixed address they can provide (like traveling the country in an RV). This code should be used to affirmatively indicate that there is no address that can be provided.

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            Unassigned Unassigned
            RikiM Ulrike Merrick
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