Da Vinci - Member Attribution (ATR) List
2.1.0-preview - STU 2.0.0 United States of America flag

Da Vinci - Member Attribution (ATR) List, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.0-preview built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-atr/ and changes regularly. See the Directory of published versions

ValueSet: DaVinci Group Characteristic (Experimental)

Official URL: http://hl7.org/fhir/us/davinci-atr/ValueSet/davinci-group-characteristic Version: 2.1.0-preview
Active as of 2020-09-06 Computable Name: DaVinciGroupCharacteristic

The DaVinci Group CharacteristicCodeSystem is a ‘starter set’ of codes supported for identifying the characteristics shared by members of a group.

References

Logical Definition (CLD)

Generated Narrative: ValueSet davinci-group-characteristic

version: versionId: id (PrimitiveType/ValueSet.meta.versionId): native = id -> 1; Last updated: 2022-08-04 15:52:33+0000;

Information Source: #3Te0anOrvocKgcow

Profile: Shareable ValueSet

This value set includes codes based on the following rules:

 

Expansion

Generated Narrative: ValueSet

version: versionId: id (PrimitiveType/ValueSet.meta.versionId): native = id -> 1; Last updated: 2022-08-04 15:52:33+0000;

Information Source: #3Te0anOrvocKgcow

Profile: Shareable ValueSet

This value set contains 17 concepts

CodeSystemDisplayDefinition
  locationhttp://hl7.org/fhir/us/davinci-atr/CodeSystem/davinci-group-characteristic-codesLocation

Members (Patients) whose care is at the location specified by the value which references the Location resource representing the physical structures managed/operated by an organization (e.g., a ward, building, clinic, etc)

  careteamhttp://hl7.org/fhir/us/davinci-atr/CodeSystem/davinci-group-characteristic-codesCareTeam

Members (Patients) who are under the care of the care-team specified by the value which references the CareTeam resource representing the care-team. (e.g., Respiratory Therapy CareTeam, CareTeam blue , etc)

  organizationhttp://hl7.org/fhir/us/davinci-atr/CodeSystem/davinci-group-characteristic-codesOrganization

Members (Patients) whose care is at the organization specified by the value which references the Organization resource representing the organization. (e.g., Burgess Medical Group)

  practitionerhttp://hl7.org/fhir/us/davinci-atr/CodeSystem/davinci-group-characteristic-codesPractitioner

Members (Patients) who are under the care of the practitioner specified by the value which references the Practitioner resource representing the practitioner. (e.g., Dr Leung)

  attributed-tohttp://hl7.org/fhir/us/davinci-atr/CodeSystem/davinci-group-characteristic-codesAttributed to a specific Provider, Organization etc.

Members (Patients) who are attributed to a specific Organization or Provider by the value which references the Practitioner or Organization resource (e.g., Neighborhood Hospitals or Dr Leung). This is different from the practitioner code which may be shared by patients for any reason beyond attribution such as PCP etc.

  COVERAGEhttp://terminology.hl7.org/CodeSystem/v3-ActReasoncoverage under policy or program

To perform one or more operations on information for conducting activities related to coverage under a program or policy.

  CLMATTCHhttp://terminology.hl7.org/CodeSystem/v3-ActReasonclaim attachment

To perform one or more operations on information for provision of additional clinical evidence in support of a request for coverage or payment for health services.

  COVAUTHhttp://terminology.hl7.org/CodeSystem/v3-ActReasoncoverage authorization

To perform one or more operations on information for conducting prior authorization or predetermination of coverage for services.

  HQUALIMPhttp://terminology.hl7.org/CodeSystem/v3-ActReasonhealth quality improvement

To perform one or more operations on information used for conducting administrative activities to improve health care quality.

  HDMhttp://terminology.hl7.org/CodeSystem/v3-ActReasonhealthcare delivery management

To perform one or more actions on information used for conducting administrative and contractual activities by or on behalf of organizational entities responsible for delivery of an individual's benefits in a healthcare program, health plan or insurance. Explicitly excludes the use of information to organize the delivery of health care for care coordination and case management, or to provide healthcare treatment.

Usage Note: Examples of activities conducted under this purpose of use: provider profiling, risk adjustment, underwriting, fraud and abuse, quality improvement population health and care management. Aligns with HIPAA Operation POU minus coordination of care or other treatment related activities. Similar to the description in SAMHSA Confidentiality of Substance Use Disorder Patient Records Supplemental notice of proposed rulemaking.

Map: Maps to ISO 14265 Classification Term "Administration of care for an individual subject of care" described as "To inform persons or processes responsible for enabling the availability of resources or funding or permissions for providing health care services to the subject of care."

However, this classification term is described as activities, i.e., "to inform persons" or "to inform processes" rather than the rationale for performing actions/operations on information related to the activity.

  COChttp://terminology.hl7.org/CodeSystem/v3-ActReasoncoordination of care

To perform one or more actions on information in order to organize the provision and case management of an individual's healthcare, including: Monitoring a person's goals, needs, and preferences; acting as the communication link between two or more participants concerned with a person's health and wellness; organizing and facilitating care activities and promoting self-management by advocating for, empowering, and educating a person; and ensuring safe, appropriate, non-duplicative, and effective integrated care.

Usage Note: Use when describing these functions: 1. Monitoring a person's goals, needs, and preferences. 2. Acting as the communication link between two or more participants concerned with a person's health and wellness. 3. Organizing and facilitating care activities and promoting self-management by advocating for, empowering, and educating a person. 4. Ensuring safe, appropriate, non-duplicative, and effective integrated care.

The goal is to clearly differentiate this type of coordination of care from HIPAA Operations by specifying that these actions on information are undertaken in the provision of healthcare treatment.

For similar uses of this concept, see SAMHSA Confidentiality of Substance Use Disorder Patient Records Supplemental notice of proposed rulemaking, which differentiates concepts of care coordination and case management for the provision of treatment as specifically distinct from activities related to health care delivery management and the operations of organizational entities involved in the delivery of healthcare.

Map: Maps to ISO 14265 Classification Terms: "Support of care activities within the provider organisation for an individual subject of care" described as "To inform persons or processes enabling others to provide health care services to the subject of care." "Subject of Care Uses" described as "To inform the subject of care in support of his or her own interests."

  TREAThttp://terminology.hl7.org/CodeSystem/v3-ActReasontreatment

To perform one or more operations on information for provision of health care.

  care-planninghttp://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-tempCare Planning

Request for data from payers or providers to determine how to deliver care for a particular patient, group or community.

  social-riskhttp://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-tempSocial Risk

Request for data from payers or other providers to assess of social risk, establishing coded health concerns/problems, creating patient driven goals, managing interventions, and measuring outcomes.

  payment-noehttp://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-tempPayment Not Otherwise Enumerated

[Existing concepts do not define a more detailed Payment as defined by HIPAA. Therefore, implicit in using this code is that an implementer must supply an additional, alternate code.

  operations-noehttp://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-tempOperations Not Otherwise Enumerated

Existing concepts do not define a more detailed Healthcare Operations as defined by HIPAA. Therefore, implicit in using this code is that an implementer must supply an additional, alternate code.

  treatment-noehttp://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-tempTreatment Not Otherwise Enumerated

Existing concepts do not define a more detailed Treatment as defined by HIPAA. Therefore, implicit in using this code is that an implementer must supply an additional, alternate code.


Explanation of the columns that may appear on this page:

Level A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
System The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code The code (used as the code in the resource instance)
Display The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition An explanation of the meaning of the concept
Comments Additional notes about how to use the code