Colorado BHA FHIR Implementation Guide
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Colorado BHA FHIR Implementation Guide, published by Colorado Behavioral Health Administration. This guide is not an authorized publication; it is the continuous build for version 0.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/CoBHA/CoBHRM-FHIR-IG/ and changes regularly. See the Directory of published versions

Implementation Guidance

Page standards status: Normative

BHA aims to leverage data interoperability capabilities already available in certified EHRs, in order to reduce the overall effort required for implementations of this IG. In cases where federal regulatory requirements for data exchange via FHIR are not sufficient for BHA reporting, this IG has identified FHIR resources and data elements that will effectively capture the required information and that we believe will have long-term value to Colorado providers and to technology implementers for this and other core healthcare use cases.

Specifically, the profiles in this IG are based on US Core STU6 where possible. A notable exception is the BHA Service profile, which is based on the FHIR R4 EpisodeOfCare resource.

Relationship to the Colorado Behavioral Health Reporting Model (Co-BHRM)

The Colorado Behavioral Health Reporting Model (Co-BHRM) specifies the full data requirements for BHA reporting. This IG does not cover the entirety of the Co-BHRM. Instead, the specification provided here defines, in FHIR, the data elements that must be captured at clinical sites to support BHA and SAMHSA reporting requirements.

This IG does not prescribe how data is exchanged between clinical sites and Behavioral Health Administrative Service Organizations (BHASOs) or other intermediaries. BHASOs and other organizations involved in the reporting pipeline are encouraged to adopt, extend, or build upon these FHIR definitions to suit their specific integration workflows.

Co-BHRM to FHIR Mapping

Co-BHRM File FHIR Profile or Questionnaire
Client CO BHA Client Profile
Client BHA Client Questionnaire
Client US Core Observation Sexual Orientation
Admission CO BHA Encounter
Admission CO BHA Episode Profile
Admission BHA Admission Questionnaire
Admission US Core Observation Pregnancy Status
Discharge CO BHA Encounter
Discharge CO BHA Episode Profile
Discharge BHA Discharge Questionnaire
Diagnosis CO BHA Episode Diagnosis Profile
Diagnosis CO BHA Encounter
Diagnosis CO BHA Episode Profile
Diagnosis BHA Diagnosis Questionnaire
Substance Use Disorder BHA Substance Use Disorder Questionnaire
SC Pregnancy/PostPartum BHA Special Connections Pregnancy/Postpartum Risk Screening Questionnaire
SC Baby BHA SC Baby Questionnaire
Full Mapping
Co-BHRM File Co-BHRM Field Name FHIR Element shorthand FHIR Profile or Resource
Client Effective Date Patient.meta.lastUpdated CO BHA Client Profile
Client Colorado PEAK State ID
/ Universal ID		 QuestionnaireResponse:PEAK_ID BHA Client Questionnaire
Client Trails Identifier QuestionnaireResponse:TRAILS_ID BHA Client Questionnaire
Client CCAR Client Identifier QuestionnaireResponse:CCAR_ID BHA Client Questionnaire
Client DACODS Client Identifier QuestionnaireResponse:DACODS_ID BHA Client Questionnaire
Client DOB Patient.birthDate US Core Patient
Client Last Name Patient.name.family US Core Patient
Client First Name Patient.name.given US Core Patient
Client Middle Name/Initial Patient.name.given US Core Patient
Client Name Suffix Patient.name.suffix US Core Patient
Client Social Security Number Patient.identifier:SSN CO BHA Client Profile
Client County of Residence Patient.address.district CO BHA Client Profile
Client Zip Code of Residence Patient.address.postalCode US Core Patient
Client Race Codes Patient.extension:BHArace CO BHA Client Profile
Client Ethnicity Patient.extension:ethnicity US Core Patient
Client Household Language Patient.communication.language US Core Patient
Client Sex at Birth Patient.extension:birthsex US Core Patient
Client Gender Identity Patient.extension:genderIdentity US Core Patient
Client Sexual Orientation Observation US Core Observation Sexual Orientation
Client Child Welfare Involvement QuestionnaireResponse:CHILD_WELFARE_INVOLVEMENT BHA Client Questionnaire
Client Disability Code(s) QuestionnaireResponse:DISABILITY_CODES BHA Client Questionnaire
Client Veteran Status Patient.extension:USVeteranStatus CO BHA Client Profile
Client Last known address line 1 Patient.address.line US Core Patient
Client Last known address line 2 Patient.address.line US Core Patient
Client Last known city Patient.address.city US Core Patient
Admission Effective Date Encounter.meta.lastUpdated CO BHA Encounter
Admission Clinic Location NPI Organization.identifier:NPI US Core Organization
Admission Admission Date Encounter.period.start CO BHA Encounter
Admission Service Identifier EpisodeOfCare.type CO BHA Episode Profile
Admission Date of First Contact QuestionnaireResponse US Core QuestionnaireResponse
Admission Date of First Appointment Offered QuestionnaireResponse US Core QuestionnaireResponse
Admission Medication Assisted Opioid Therapy QuestionnaireResponse US Core QuestionnaireResponse
Admission Referral Source QuestionnaireResponse US Core QuestionnaireResponse
Admission Arrests in Past 30 Days QuestionnaireResponse US Core QuestionnaireResponse
Admission Employment Status QuestionnaireResponse US Core QuestionnaireResponse
Admission Marital Status Patient.maritalStatus US Core Patient
Admission Living Situation QuestionnaireResponse US Core QuestionnaireResponse
Admission Monthly Income QuestionnaireResponse US Core QuestionnaireResponse
Admission Primary Source of income/support for client
(or for client's parent if client >18 years of age)		 QuestionnaireResponse US Core QuestionnaireResponse
Admission Pregnancy Status Observation US Core Observation Pregnancy Status
Admission Within 1 Year Postpartum Status QuestionnaireResponse US Core QuestionnaireResponse
Admission Enrollment in Special Connections QuestionnaireResponse US Core QuestionnaireResponse
Admission Enrollment in ACT? QuestionnaireResponse US Core QuestionnaireResponse
Admission Enrollment in Ascent (FEP)? QuestionnaireResponse US Core QuestionnaireResponse
Admission Number of Dependent Children
 QuestionnaireResponse US Core QuestionnaireResponse
Admission Self Help Attendance (Last 30 days at admission)/
Peer Support Attendance		 QuestionnaireResponse US Core QuestionnaireResponse
Admission Substance Use Prior Treatment (Total Lifetime admissions) QuestionnaireResponse US Core QuestionnaireResponse
Admission Psychiatric Hospital Admission (Last 30 days) QuestionnaireResponse US Core QuestionnaireResponse
Admission Legal Status QuestionnaireResponse US Core QuestionnaireResponse
Admission Involuntary Reason QuestionnaireResponse US Core QuestionnaireResponse
Admission Criminal Justice Involvement QuestionnaireResponse US Core QuestionnaireResponse
Admission Education Level QuestionnaireResponse US Core QuestionnaireResponse
Admission School Attendance Status (in the previous 3 months) QuestionnaireResponse US Core QuestionnaireResponse
Admission Visit to Psychiatric ER in last 6 months QuestionnaireResponse US Core QuestionnaireResponse
Admission Communication Accomodations QuestionnaireResponse US Core QuestionnaireResponse
Discharge Effective Date Provenance.recorded US Core Provenance
Discharge Date of Last Contact Encounter.period CO BHA Encounter
Discharge Discharge Date EpisodeOfCare.period.end CO BHA Episode Profile
Discharge Discharge Type / Status EpisodeOfCare.status CO BHA Episode Profile
Discharge End of Treatment Reason QuestionnaireResponse US Core QuestionnaireResponse
Discharge Arrests in Past 30 Days QuestionnaireResponse US Core QuestionnaireResponse
Discharge Employment Status QuestionnaireResponse US Core QuestionnaireResponse
Discharge Living Situation QuestionnaireResponse US Core QuestionnaireResponse
Discharge Self Help Attendance/ Peer Support Attendance (Last 30 days at discharge) QuestionnaireResponse US Core QuestionnaireResponse
Discharge Education Level QuestionnaireResponse US Core QuestionnaireResponse
Discharge School Attendance Status (in the previous 3 months) QuestionnaireResponse US Core QuestionnaireResponse
Discharge Legal Status QuestionnaireResponse US Core QuestionnaireResponse
Diagnosis Effective Date Provenance.recorded US Core Provenance
Diagnosis MH Diagnosis Identifier 1 EpisodeOfCare.diagnosis + EpisodeOfCare.diagnosis.role
OR EpisodeOfCare.diagnosis +
Condition.code + Condition.extension[diagnosisType]		 CO BHA Episode Profile
Diagnosis MH Diagnosis Identifier 2 EpisodeOfCare.diagnosis + EpisodeOfCare.diagnosis.role
OR EpisodeOfCare.diagnosis +
Condition.code + Condition.extension[diagnosisType]		 CO BHA Episode Profile
Diagnosis MH Diagnosis Identifier 3 EpisodeOfCare.diagnosis + EpisodeOfCare.diagnosis.role
OR EpisodeOfCare.diagnosis +
Condition.code + Condition.extension[diagnosisType]		 CO BHA Episode Profile
Diagnosis SUD Diagnosis Identifier EpisodeOfCare.diagnosis + EpisodeOfCare.diagnosis.role
OR EpisodeOfCare.diagnosis +
Condition.code + Condition.extension[diagnosisType]		 CO BHA Episode Profile
Diagnosis SMI/SED Status QuestionnaireResponse US Core QuestionnaireResponse
Substance Use Disorder Effective Date Provenance.recorded US Core Provenance
Substance Use Disorder ASAM Level of Care QuestionnaireResponse US Core QuestionnaireResponse
Substance Use Disorder Primary Substance Use QuestionnaireResponse US Core QuestionnaireResponse
Substance Use Disorder Times Used Primary Substance in Last 30 Days QuestionnaireResponse US Core QuestionnaireResponse
Substance Use Disorder Route of Use of Primary Substances QuestionnaireResponse US Core QuestionnaireResponse
Substance Use Disorder Age of First Use of Primary Substances QuestionnaireResponse US Core QuestionnaireResponse
Substance Use Disorder Secondary Substance Use QuestionnaireResponse US Core QuestionnaireResponse
Substance Use Disorder Times Used Secondary Substance in Last 30 Days QuestionnaireResponse US Core QuestionnaireResponse
Substance Use Disorder Route of Use of Secondary Substances QuestionnaireResponse US Core QuestionnaireResponse
Substance Use Disorder Age of First Use of Secondary Substances QuestionnaireResponse US Core QuestionnaireResponse
Substance Use Disorder Tertiary Substance Use QuestionnaireResponse US Core QuestionnaireResponse
Substance Use Disorder Times Used Tertiary Substance in Last 30 Days QuestionnaireResponse US Core QuestionnaireResponse
Substance Use Disorder Route of Use of Tertiary Substances QuestionnaireResponse US Core QuestionnaireResponse
Substance Use Disorder Age of First Use of Tertiary Substances QuestionnaireResponse US Core QuestionnaireResponse
SC Pregnancy/PostPartum Effective Date Provenance.recorded US Core Provenance
SC Pregnancy/PostPartum Evaluation Date QuestionnaireResponse US Core QuestionnaireResponse
SC Pregnancy/PostPartum Pregnancy/Postpartum Status QuestionnaireResponse US Core QuestionnaireResponse
SC Pregnancy/PostPartum Pregnancy/Postpartum Care Status QuestionnaireResponse US Core QuestionnaireResponse
SC Pregnancy/PostPartum Access to other drug/alcohol treatment QuestionnaireResponse US Core QuestionnaireResponse
SC Pregnancy/PostPartum Family/Social Support QuestionnaireResponse US Core QuestionnaireResponse
SC Pregnancy/PostPartum Family substance use disorder history QuestionnaireResponse US Core QuestionnaireResponse
SC Pregnancy/PostPartum Family substance use disorder current QuestionnaireResponse US Core QuestionnaireResponse
SC Pregnancy/PostPartum Drug using partner QuestionnaireResponse US Core QuestionnaireResponse
SC Pregnancy/PostPartum HIV Risk QuestionnaireResponse US Core QuestionnaireResponse
SC Pregnancy/PostPartum Home Stability and Safety QuestionnaireResponse US Core QuestionnaireResponse
SC Pregnancy/PostPartum Personal Safety QuestionnaireResponse US Core QuestionnaireResponse
SC Pregnancy/PostPartum Prior Criminal Record QuestionnaireResponse US Core QuestionnaireResponse
SC Pregnancy/PostPartum Mental Health History QuestionnaireResponse US Core QuestionnaireResponse
SC Pregnancy/PostPartum Prior alcohol/drug treatment QuestionnaireResponse US Core QuestionnaireResponse
SC Pregnancy/PostPartum Children Living in home with you QuestionnaireResponse US Core QuestionnaireResponse
SC Pregnancy/PostPartum Children Ages living in home with you QuestionnaireResponse US Core QuestionnaireResponse
SC Baby Effective Date QuestionnaireResponse:lastUpdated BHA SC Baby Questionnaire
SC Baby Live Birth QuestionnaireResponse:LIVE_BIRTH BHA SC Baby Questionnaire
SC Baby Baby Date of Birth QuestionnaireResponse:DOB BHA SC Baby Questionnaire
SC Baby Baby Weight Pounds QuestionnaireResponse:WEIGHT_LBS BHA SC Baby Questionnaire
SC Baby Baby Weight Ounces QuestionnaireResponse:WEIGHT_OZ BHA SC Baby Questionnaire
SC Baby Baby Last Name QuestionnaireResponse:LAST_NAME BHA SC Baby Questionnaire
SC Baby Baby First Name QuestionnaireResponse:FIRST_NAME BHA SC Baby Questionnaire
SC Baby Baby Middle Name or Initial QuestionnaireResponse:MIDDLE_NAME_INITIAL BHA SC Baby Questionnaire
SC Baby Baby Sex at Birth QuestionnaireResponse:SEX_AT_BIRTH BHA SC Baby Questionnaire

CCAR and DACODS

The Co-BHRM incorporates elements of the CCAR and DACODS user manuals, and they may provide additional context for the information being gathered and transmitted to BHA. Those user manuals are publicly available at the following sites: