Da Vinci Payer Data Exchange
2.1.1 - STU 2.1

Da Vinci Payer Data Exchange, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-epdx/ and changes regularly. See the Directory of published versions

## US Core Smoking Status Observation

Page standards status: Informative

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This IG supports the full complement of US Core profiles. They are supported to enable a payer to produce FHIR resources from data provided in other formats.

For some resources, payers are unlikely to have the clinical information necessary to create a valid US Core resource. The US Core 3.1.1 Smoking Status or Smoking status is one potential example of an Observation profile that payers may be unable to create from the source clinical data they have available.

A Smoking Status observation requires codes and values for smoking observation. Payers may not have access to the detail data needed to create a valid observation resource.

The essential fields (Must Support or Cardinality greater than 0..*) to be provided in the US Core 3.1.1 Smoking Status or Smoking status Observation resource are:

R4 Element | Name | Cardinality | Type
--- | --- | --- | ---
Observation.status | status | 1..1 | code
Observation.code | code | 1..1 | CodeableConcept
Observation.subject | subject | 1..1 | Reference(US Core Patient Profile)
Observation.issued | issued | 1..1 | instant
Observation.value[x] | value[x] | 1..1 | (Slice Definition)
Observation.value[x]:valueCodeableConcept | value[x]:valueCodeableConcept | 1..1 | CodeableConcept
Observation.component.code | code | 1..1 | CodeableConcept

Table Definition

### Example Smoking Status Observation

​US Core Smoking Status Observation example:

    {
      "resourceType" : "Observation",
      "id" : "some-day-smoker",
      "meta" : {
        "profile" : [
          "http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus"
        ]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">Generated Narrativeid: some-day-smokermeta: category: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/observation-category social-history}\">Social History</span>code: <span title=\"Codes: {http://loinc.org 72166-2}\">Tobacco smoking status</span>subject: <a href=\"Patient-example.html\">Amy Shaw. Generated Summary: id: example; Medical Record Number: 1032702 (USUAL); active; Amy V. Shaw , Amy V. Baxter ; ph: 555-555-5555(HOME), amy.shaw@example.com; gender: female; birthDate: 1987-02-20</a>issued: 18/03/2016 4:27:04 PMvalue: <span title=\"Codes: {http://snomed.info/sct 428041000124106}\">Current some day smoker</span></div>"
      },
      "status" : "final",
      "category" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
              "code" : "social-history",
              "display" : "Social History"
            }
          ],
          "text" : "Social History"
        }
      ],
      "code" : {
        "coding" : [
          {
            "system" : "http://loinc.org",
            "code" : "72166-2",
            "display" : "Tobacco smoking status"
          }
        ],
        "text" : "Tobacco smoking status"
      },
      "subject" : {
        "reference" : "Patient/example",
        "display" : "Amy Shaw"
      },
      "issued" : "2016-03-18T05:27:04Z",
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "428041000124106"
          }
        ],
        "text" : "Current some day smoker"
      }
    }

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