Section 1a: Clinical Document Architecture (CDA®)
Section 3: Implementation Guides

HL7 CDA® R2 Implementation Guide: National Health Care Surveys (NHCS), R1 STU Release 3.1 - US Realm

DESCRIPTION

This standard is an HL7 Clinical Document Architecture (CDA) Implementation Guide for representing data extracted from provider systems as required by the Centers for Disease Control and Prevention's National Center for Health Statistics (CDC/NCHS) for the National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Care Survey (NHCS).

The NAMCS focuses on ambulatory care and is based on a sample of visits to non-federally employed office-based physicians primarily engaged in direct patient care. The National Hospital Care Survey (NHCS) is based on a sample of visits to hospital inpatient, emergency, and outpatient departments. The surveys currently require manual data extraction. Field representatives visit physician practice locations for NAMCS, and hospitals for NHCS, to abstract survey data elements. Data captured include information on patient demographics, vital signs, medical history, reasons for visit, diagnoses, procedures and medications. Data is entered into a computer-based tool that sends data back to NCHS. This process is labor and resource intensive, costly, and does not take advantage of emerging health information technology. NCHS would like to automate this process and collect more data without needing to send field representatives to physician offices/hospitals and allow all selected physicians/ hospitals to participate in the surveys by providing electronic files from their EHR to do so. The surveys contain patient encounter and facility components; this project will focus on the patient encounter components. Data from these surveys are widely used by health policy makers, health service researchers, epidemiologists and health care industry and other interested parties.

ALTERNATIVE NAMES

HL7 CDA® R2 Implementation Guide: National Health Care Surveys (NHCS), R1 STU Release 3.1 - US Realm may also go by the following names or acronyms:

"HL7 IG for CDA® R2: National Ambulatory Medical Care Survey (NAMCS), R1", NHCS, NAMCS, NHAMCS

TARGETS

  • Centers for Disease Control and Prevention/National Center for Health Statistics
  • Health care community, researchers, and policymakers
  • EHR, PHR Vendors
  • Health Care IT Vendors
  • Emergency Services Providers
  • Healthcare Institutions (hospitals, long term care, home care, mental health)
  • Ambulatory Health Care Facilities (office-based physicians)

BENEFITS

  • Creates a standardized format to represent ambulatory, inpatient, and outpatient healthcare data collected by the NCHS within the Division of Health Care Statistics (DHCS), NCHS, part of the CDC
  • Enables automation of the survey data collection process by using CDA to streamline the collection of data and increase the sample pool by allowing all providers who participate in the surveys to do so electronically
  • Supports physician offices'/hospitals' ability to participate in the NCHS surveys by providing electronic files from their EHRs

IMPLEMENTATIONS/CASE STUDIES

  • The Centers for Disease Control and Prevention (CDC)/National Center for Health Statistics (NCHS) sponsored the development of this specification
  • CDC/NCHS is collaborating and in discussion with Epic, Allscripts and Cerner to support DSTU implementation activities
  • CDC/NCHS/National Health Care Survey respondents’ names are held in confidence due to legislation that requires their confidentiality. Therefore CDC/NCHS is unable to list likely DSTU implementers. NCHS has been in discussion with physicians and hospitals to encourage participation in implementation activities using the HL7 NHCS IGs.

DEVELOPMENT BACKGROUND

The audience for this implementation guide includes the architects and developers of healthcare information technology (HIT) systems in the US Realm that exchange patient clinical data in hospital, emergency and ambulatory care settings.

Current Release

Upgrade Release

Notes

Issue Reporting

STU 1.2

STU 2.1

STU 1.2 Aligns with Promoting Interoperability program requirements.
Current STU 1.2 implementations who want to fix issues with 1.2 submissions should consider upgrading to STU 2.1

https://jira.hl7.org/projects/CDA/issues/
Select Project = CDA Specification Feedback
Specification = National Health Care Surveys (NHCS)(CDA)
Raised in Version = 1.2.1

STU 2.0

STU 2.1

Current STU 2.0 implementations who want to fix issues with 2.0 submissions should consider upgrading to STU 2.1.

https://jira.hl7.org/projects/CDA/issues/
Select Project = CDA Specification Feedback
Specification = National Health Care Surveys (NHCS)(CDA)
Raised in Version = 1.2.1

STU 3.0

STU 3.1

Path to FHIR implementation.
Aligns with USCDI V1.

https://jira.hl7.org/projects/CDA/issues/
Select Project = CDA Specification Feedback
Specification = National Health Care Surveys (NHCS)(CDA)
Raised in Version = 1.3.1

New implementation

STU 3.0

Aligns with Promoting Interoperability program requirements through SVAP.
Net new implementers, path to FHIR implementation.
Aligns with USCDI V1.

https://jira.hl7.org/projects/CDA/issues/
Select Project = CDA Specification Feedback
Specification = National Health Care Surveys (NHCS)(CDA)
Raised in Version = 1.3.0

New implementation

STU 3.1

Net new implementers, path to FHIR implementation.
Aligns with USCDI V1

https://jira.hl7.org/projects/CDA/issues/
Select Project = CDA Specification Feedback
Specification = National Health Care Surveys (NHCS)(CDA)
Raised in Version = 1.3.1

 

 

RELATED DOCUMENTS

HL7 CDA® R2 Implementation Guide: National Health Care Surveys (NHCS), R1 STU Release 3.1 - US Realm

STU DOCUMENTS

HL7 CDA® R2 Implementation Guide: National Health Care Surveys (NHCS), Release 1, STU Release 2.1 – US Realm (Submit Feedback on STU)

(Download) (4.82 MB)

HL7 CDA® R2 Implementation Guide: National Health Care Surveys (NHCS), Release 1, STU Release 2 – US Realm (Submit Feedback on STU)

(Download) (3.92 MB)

HL7 CDA® R2 Implementation Guide: National Health Care Surveys (NHCS), Release 1, STU Release 3 – US Realm Expiration Feb 2024

(Download) (8.93 MB)

HL7 CDA® R2 Implementation Guide: National Health Care Surveys (NHCS), Release 1, STU Release 3.1 – US Realm Expiration Feb 2024

(Download) (10.39 MB)

HL7 CDA® R2 Implementation Guide: National Health Care Surveys (NHCS), Release 1, DSTU Release 1.2 – US Realm Expiration Dec 2021

(Download) (5.60 MB)

HL7 CDA® R2 Implementation Guide: National Health Care Surveys (NHCS), Release 1, DSTU Release 1.1 – US Realm Expiration Jul 2017

(Download) (5.94 MB)

HL7 Implementation Guide for CDA® Release 2: National Health Care Surveys (NHCS), Release 1 - US Realm Expiration Jul 2016

(Download) (5.83 MB)

ADDITIONAL DETAILS

SUPPORT FILES

 

GitHub link for STU 2.1: https://github.com/HL7/CDA-nhcs-1.2.1

GitHub link for STU 3.1: https://github.com/HL7/CDA-nhcs-1.3.1

-- Schematron Validation files Located in GitHub:
 
validation/CDAR2_IG_NHCS_R1_STU2.1.sch Schematron for validation
validation/CDAR2_IG_NHCS_R1_STU2.1.xml Schematron vocabulary file

 See the “_readme.txt” file included in the STU document download for more details.

TOPIC

  • Public Health

BALLOT TYPE

  • DSTU
  • STU

STATUS DATE

2022-01-06

RESPONSIBLE WORK GROUPS

Public Health

Structured Documents

PRODUCT TYPE

  • Implementation Guide

STAKEHOLDERS

  • EHR, PHR Vendors
  • Emergency Services Providers
  • Health Care IT Vendors
  • Healthcare Institutions
  • Regulatory Agency
  • Standards Development Organizations (SDOs)

FAMILY

  • CDA

CURRENT STATE

  • Active

REALM

  • US Realm