HRSA 2023 Uniform Data System (UDS) Patient Level Submission (PLS) (UDS+) FHIR IG
1.0.1 - STU1 Release 1 - Standard for Trial-Use International flag

This page is part of the HRSA Uniform Data System (UDS) Patient Level Submission (PLS) (UDS+ or uds-plus) FHIR IG (v1.0.1: STU1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions

Resource Profile: De-Identified UDS Plus Encounter

Official URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-encounter Version: 1.0.1
Standards status: Trial-use Maturity Level: 2 Computable Name: UDSPlusEncounter

The UDS+ profile is based on the Encounter resource and establishes the core elements, extensions, vocabularies and value sets for representing encounters,visit information for UDS+ program.

Introduction

This profile is used to represent de-identified Encounter information. The de-identification process has to remove all data elements not explicitly identified as “SUPPORTED” in the profile.

The HHS De-identification Guidance is to be followed to ensure appropriate level of de-identification is performed.

According to the HHS guidance, dates should not have a precision of more than the year. This means month and day cannot be included. This includes diagnosis dates, visit dates, onset dates etc.

In FHIR Resources, text elements and reference.display elements which provide human readable information to the providers may be generated using programs and tools from the data present within the resource. For e.g a Encounter resource text element may contain information such as the visit date. This type of information will enable identification of the individuals. In order to avoid inadvertent revealing of PII/PHI, text elements cannot be included in the De-identified FHIR resource and the submission will be rejected when text elements are present by the validation process.

Age Computation

The Data Submitter has to compute the age using the visit date of the encounter to be included in the UDS+ report.

Capturing Location Information

The Encounter.location.location points to a Location Resource. The Location.type element can be used to indicate the type of location where the service was provided. The existing Location.type value set can be used to indicate that the service was provided in a SCHOOL based setting. This will be used to compute Table 4, LINE 24 of the UDS Report. For Table 4, Line 26 use the public-housing code defined in UDS+ value set that is referenced in the UDS+ Location profile.

Ids and References

The original Encounter resource id should not be included in the De-identified Encounter instance. Instead a new id should be created and provided as part of the FHIR resource. This Data Submitter should be capable of using the generated id to relink the data to the original Encounter. All resource references to the Encounter submitted as part of the UDS+ report should refer to newly generated id.

Resource references cannot contain text element as it may contain PHI/PII. The text element for following references are not allowed

  • subject
  • reasonReference

Date Truncation

The Data Submitter has to truncate the following dates to only have a precision of year

  • period and its sub elements.
  • participant.period

Examples

Examples of identifiable data and its corresponding de-identifiable data is present in Reporting Guidance.

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from Encounter

NameFlagsCard.TypeDescription & Constraintsdoco
.. Encounter 0..*EncounterDe-Identified UDS Plus Encounter
... uds-plus-age-extension S1..1QuantityAge of the Patient computed using birthDate and the visit dates of the encounter
URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension
... status S1..1codeplanned | arrived | triaged | in-progress | onleave | finished | cancelled +
... class S1..1CodingClassification of patient encounter
.... text 0..0
... subject S1..1Reference(De-Identified UDS Plus Patient)The patient or group present at the encounter
.... display 0..0
... participant S0..1BackboneElementList of participants involved in the encounter
.... type S0..*CodeableConceptRole of participant in encounter
..... text 0..0
.... period S0..1PeriodPeriod of time during the encounter that the participant participated
.... individual S0..1Reference(US Core Practitioner Profile)Persons involved in the encounter other than the patient
... period S0..1PeriodThe start and end time of the encounter
... reasonCode S0..*CodeableConceptCoded reason the encounter takes place
.... text 0..0
... reasonReference S0..*Reference(De-Identified UDS Plus Diagnosis)Reason the encounter takes place (reference)
.... display 0..0
... diagnosis S0..*BackboneElementThe list of diagnosis relevant to this encounter
.... condition S1..1Reference(De-Identified UDS Plus Diagnosis)The diagnosis or procedure relevant to the encounter
.... use S0..1CodeableConceptRole that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
.... rank S0..1positiveIntRanking of the diagnosis (for each role type)
... hospitalization S0..1BackboneElementDetails about the admission to a healthcare service
.... dischargeDisposition S0..1CodeableConceptCategory or kind of location after discharge
Binding: US Core Discharge Disposition (preferred): The set of codes indicating the discharge disposition

..... text 0..0
... location S0..*BackboneElementList of locations where the patient has been
.... location S1..1Reference(UDS Plus Location)Location the encounter takes place
... serviceProvider S0..1Reference(US Core Organization Profile)The organization (facility) responsible for this encounter

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
Encounter.typeextensibleUSCoreEncounterType
Encounter.hospitalization.dischargeDispositionpreferredUSCoreDischargeDisposition (a valid code from http://www.nubc.org/patient-discharge)

 

Other representations of profile: CSV, Excel, Schematron