Submitted By: Adam Bazer, MPD / Integrating the Healthcare Enterprise USA (IHE USA)

Submitted By: Adam Bazer, MPD / Integrating the Healthcare Enterprise USA (IHE USA)
Data Element Information
Use Case Description(s)
Use Case Description	A 24 year old female is being transported to a hospital for abdominal pains. During her transport she indicated that she is several weeks pregnant so the transport team makes sure to bring her to a hospital that has OBGYN capability. When she is in the hospital that pregnancy status indicator helps inform the providers to do some tests to make sure this pain is not related to her pregnancy and to avoid procedures that may have negative effects on the fetus.
Estimated number of stakeholders capturing, accessing using or exchanging	This indication of pregnancy can be important for a variety of health care providers to help make informed decisions for the care of a patient. This would be captured and used in by any provider that creates or utilizes a patient electronic health record. This also may be populated by the patient in a personal record or at an appointment.
Link to use case project page	https://www.ihe.net/uploadedFiles/Documents/PCC/IHE_PCC_Suppl_IPS.pdf
Healthcare Aims	Improving patient experience of care (quality and/or satisfaction) Improving provider experience of care
Maturity of Use and Technical Specifications for Data Element
Applicable Standard(s)	International Patient Summary (IPS) - https://www.ihe.net/uploadedFiles/Documents/PCC/IHE_PCC_Suppl_IPS.pdf http://hl7.org/fhir/uv/ips/ValueSet/pregnancy-status-uv-ips
Additional Specifications	Paramedicine Care Summary (PCS) - https://www.ihe.net/uploadedFiles/Documents/PCC/IHE_PCC_Suppl_PCS.pdf Routine Interfacility Patient Transport (RIPT) - https://www.ihe.net/uploadedFiles/Documents/PCC/IHE_PCC_Suppl_RIPT.pdf
Current Use	This data element has been used at scale between multiple different production environments to support the majority of anticipated stakeholders
Supporting Artifacts	HL7 FHIR Connecathon has trested the FHIR Pregnancy Status for eCR and the International Patient Summary in September 2020
Number of organizations/individuals with which this data element has been electronically exchanged	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	HL7 FHIR Connecathon has trested the FHIR Pregnancy Status for eCR and the International Patient Summary in September 2020
Potential Challenges
Restrictions on Standardization (e.g. proprietary code)	none
Restrictions on Use (e.g. licensing, user fees)	none
Privacy and Security Concerns	none
Estimate of Overall Burden	This is regularly tracked as part of electronic medical records
Other Implementation Challenges	none

Comment

Agree with the critical need for this element; our organization proposed this concept in USCDIv2 with ACOG. This concept profile should be promoted to USCore and would not ideally be referenced from IPS; however, more importantly the IPS and eCR versions of the profile do not link to the same LOINC code. We suggest that ONC create both a terminology standard for this concept in addition to linking to a resource that is well tested and deployed in the US. The data element LOINC code that should be referenced is missing from the USCDI draft proposal and as discussed, not the same in the two profiles mentioned above. We appreciate the use case for reported pregnancy status in a patient-facing survey; however, for use in EHRs we believe the intended concept would preferentially be the presence of a confirmed pregnancy status referenced by LOINC 82810-3. This is the code referenced in the federally sponsored FPAR program from HHS and should likely also be included as a reference in the USCDIv3 proposal.
1. NACHC suggests that the UCSDIv3 reference as a required binding for the pregnancy status data element:
  1. 82810-3 Pregnancy Status https://loinc.org/82810-3/
    1. with the acceptable answer codes:
      1. Answer List LL4129-4

Source: Association of Public Health Laboratories

Answer	Code	Score	Answer ID

Answer	Code	Score	Answer ID
Pregnant			LA15173-0
Not pregnant			LA26683-5
Unknown			LA4489-6

Pregnancy Status

Comment