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Section 1b: EHR - Electronic Health Records
Section 1e: Version 3 (V3)
Section 2: Clinical and Administrative Domains
Section 3: Implementation Guides

HL7 Version 3 Specification: Data Elements for Emergency Department Systems (DEEDS), Release 1 - US Realm

DESCRIPTION

This document expands the scope and updates the original Center for Disease Control Data Elements for Emergency Department Systems. This comprehensive set of data elements will serve as the content for the interchange formats described above and as a basis for smooth integration between emergency response systems.

ALTERNATIVE NAMES

HL7 Version 3 Specification: Data Elements for Emergency Department Systems (DEEDS), Release 1 - US Realm may also go by the following names or acronyms:

"HL7 V3 Specification: Data Elements for Emergency Department Systems (DEEDS), R1", DEEDS, Data Elements for Emergency Department Systems

TARGETS

  • Quality Reporting Agencies
  • Standards Development Organizations (SDOs)
  •  Payors
  • EHR, PHR Vendors
  • Clinical Decision Support Systems
  • Emergency Services Providers
  • Local and State Departments of Health
  • Healthcare Institutions (hospitals, long term care, home care, mental health)

BENEFITS

  • Provide a shared specification for ?voluntary adoption by individuals and organizations responsible for maintaining or improving record systems in 24-hour, hospital-based EDs.1
  • Updates and extends the original DEEDS specification published by the Center for Disease Control in 1996. 
  • Provides a migration pathway from the original specification provided by the CDC and the new specification. 
  • Adopting current HL7 terminology standards and information modeling approach for data elements used by emergency departments and secondary users of ED data. 
  • Harmonization with other groups working in the same space (e.g. IHE5 and other HL7 workgroups).
  • LOINC codes have been updated to reflect use in other specifications to facilitate future harmonization

1 DEEDS Writing Committee Data Elements for Emergency Department Systems, Release 1.0 (DEEDS): A Summary Report. Academic Emergency Medicine, 1998; 5(2):185-193.

IMPLEMENTATIONS/CASE STUDIES

  • N/A

DEVELOPMENT BACKGROUND

            Data Elements for Emergency Department Systems (DEEDS)2 was initially published by the US Center for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control (NCIPC) in 1997. This represented one of the first detailed clinical content standards created for general use by the public. The methodology was exemplary. Existing standards (HL7 v2.3, ASTEM E1238-94, LOINC) were used as the framework and starting point for the data element definitions.

                Participation in DEEDS r1.0 involved 35 professional organizations, 12 federal agencies and over 160 individual participants. While not balloted by any currently recognized SDOs, the broad outreach and subsequent adoption and reuse in various public health reporting systems is a model for standards development.

                During early development of the X12N/HL7 claims attachment specifications (1997) in response to HIPAA, DEEDS was recognized as an example of work potentially leading the way to automated claims adjudication. As the schedule for adoption of these specifications changed with the notice of intended rule-making as part of the HIPAA Administrative Simplification [45 CFR 162], and other CDA r1.0 specifications and collections of LOINC codes evolved, the need for a separate claims attachment for emergency departments was reviewed.

                Working with the Claims Attachment SIG, the Emergency Care SIG reviewed the existing DEEDS specification based CDA r1 specification, and suggested its withdrawal, as it was felt that the needs for ED records was likely met by subsequently developed specifications with more general scope. This reflected needs addressed in a consensus conference on emergency medicine informatics3.

                The review surfaced the need to update the DEEDS specification to accommodate changes in the practice of clinical informatics, availability of HL7 v3 based standards, the recognized changes in the scope of emergency care in the United States, and the need for specifications with the details needed for Emergency Department Information Systems (EDIS) vendor implementation.

                The purpose of DEEDS has been to provide a shared specification for ?voluntary adoption by individual and organizations responsible for maintaining or improving record systems in 24-hour, hospital-based EDs.4

                The objective of the HL7 DEEDS specification is to update and extend the original DEEDS specification published by the Center for Disease Control in 1996. This new specification replaces the HL7 v2.3 based data types and modeling approach with a more modern treatment, suggesting data elements for deprecation, and identifying new data elements required for further development. This informative ballot is intended to publish the updated DEEDS 1.1 specification.

                In addition, considerable effort has been invested in harmonization with other groups working in the same space (e.g. IHE5 and other HL7 workgroups). In particular, LOINC codes have been changed to reflect use in other specifications to facilitate future harmonization.

 

2 National Center for Injury Prevention and Control. Data elements for emergency department systems, release 1.0. Atlanta, GA: Centers for Disease Control and Prevention, 1997. www.cdc.gov/ncipc/pub-res/deedspage.htm  

3 Barthell ED, Coonan, KM, Finnell, JT, Pollock DA, Cochrane D. Disparate Systems, Disparate Data: Integration, Interfaces, and Standards in Emergency Medicine Information Technology. Academic Emergency Medicine 2004;11:1142-48.

4 DEEDS Writing Committee Data Elements for Emergency Department Systems, Release 1.0 (DEEDS): A Summary Report. Academic Emergency Medicine, 1998; 5(2):185-193.

5 Integrating the Healthcare Enterprise www.ihe.net

RELATED DOCUMENTS

HL7 Version 3 Specification: Data Elements for Emergency Department Systems (DEEDS), Release 1 - US Realm

(Download) (814 KB)

TOPIC

  • Terminology

BALLOT TYPES

  • Informative

STATUS DATE

2013-10-29

RESPONSIBLE WORK GROUP

Emergency Care

PRODUCT TYPES

  • ANSI-registered Technical Report
  • Data Types

STAKEHOLDERS

  • EHR, PHR Vendors
  • Emergency Services Providers
  • Healthcare Institutions
  • Local and State Departments of Health
  • Payors
  • Quality Reporting Agencies
  • Standards Development Organizations (SDOs)

FAMILY

  • V3

CURRENT STATE

  • Stable

REALM

  • US Realm