Laboratory Test Performed Date

Analysis of clinical specimens to obtain information about the health of a patient.

Data Element

Description

The clinically relevant date/time of the observation. In the case of observations taken directly from a subject, it is the actual date and time the observation was obtained. In the case of a specimen-associated study, this field shall represent the date and time the specimen was collected or obtained.

Submitted By: Maria Michaels / CDC
Data Element Information
Use Case Description(s)
Use Case Description	Actively monitoring diseases, making decisions about public health threats, identifying trends in healthcare services utilization and other public health matters depend on accessible and accurate data. EHRs are a data source that can provide timely and relevant data beyond its use by health care providers. EHR data, if made more available for public health professionals and researchers, can lead to more rapid disease detection, tracking, and treatment and innovation in healthcare delivery. Laboratory information, including the test code, test performed date, result status, result value and the result date, are important to multiple public health reporting and research use cases to track and analyze information about treatment for various health conditions. The Making EHR Data More Available for Research and Public Health (MedMorph) project's goal is to create a reliable, scalable, and interoperable method to get electronic health record data for multiple public health and research scenarios (use cases). MedMorph has identified Cancer Reporting, Healthcare Surveys, Hepatitis C Reporting, electronic Initial Case Reporting (eICR), PCORnet, and Birth Defect Reporting use cases that support the adoption of these data elements. These specific use cases are described in more depth on their respective web pages.
Estimate the breadth of applicability of the use case(s) for this data element	All 50 states participate in one or more of the public health use cases that exchange these data elements. Up to 14 territorial or city jurisdictions also participate in one of these public health use cases and use these data elements. All hospitals and physicians who diagnose or treat cancer are required to provide cancer related laboratory information to state cancer registries. Approximately 620,000 physicians in the US are active and have at least some component of ambulatory practice and thus are annually eligible to sampling and recruitment into the National Ambulatory Medical Care Survey (NAMCS), which samples from between 3,500 to 20,000 of these physicians annually. Presently each sampled physician submits one weeks' worth of patient encounters to NAMCS. Approximately 600 hospitals are in the National Hospital Care Survey (NHCS). 1/3 of that number are either in, or actively being recruited into, the EHR data submission mode for NHCS. NHCS is already receiving electronic CDA documents. When they reach their target of 200 hospitals submitting by this mode annually they will be receiving >1.2 million documents and sets including multiple sets of medication data annually. There were approximately 1,000,000 practicing physicians (as of 2020), approximately 120,000 certified physician assistants (as of 2019), and 290,000 licensed nurse practitioners (as of 2019). Most of these licensed clinicians interact with one of these public health use cases intermittently, annually. As of 2018, AHA reported 6,146 hospitals in the US experiencing 36,353,946 admissions. Almost all of those hospitals and at least half of the admissions interact with one or more of the public health use cases. The vast majority of these exchanges include full sets of medication data, including the data elements requested for USCDI consideration here. Supporting Links: MedMorph Project Page: https://www.cdc.gov/csels/phio/making-ehr-data-more-available.html Cancer Reporting: https://www.cdc.gov/cancer/npcr/ Healthcare Surveys: https://www.cdc.gov/nchs/dhcs/nhcs_registry_landing.htm Hepatitis C Reporting: https://www.cdc.gov/hepatitis/pdfs/HepatitisCaseRprtForm.pdf eICR: https://www.cdc.gov/ecr/index.html PCORnet: https://pcornet.org/ Birth Defect Reporting: https://www.cdc.gov/nchs/nvss/births.htm
Link to use case project page	https://www.cdc.gov/csels/phio/making-ehr-data-more-available.html; https://www.cdc.gov/cancer/npcr/; https://www.cdc.gov/nchs/dhcs/nhcs_registry_landing.htm; https://www.cdc.gov/hepatitis/pdfs/HepatitisCaseRprtForm.pdf
Supporting Attachments	MedMorph-ChronicHepatitisCSurveillanceUseCase-DRAFT.pdf MedMorph-CancerReportingUseCase-DRAFT.pdf MedMorph-HealthCareSurveyReportingUseCase-DRAFT.pdf
Use Case Description	A foundational goal of MedMorph is generalizability beyond the 10 use cases that are actively informing the MedMorph project, in order to support many more public health and research use cases. Therefore, other public health and research use cases that use the MedMorph architecture will also benefit from the adoption of these data elements.
Estimate the breadth of applicability of the use case(s) for this data element	All 50 states participate in one or more of the public health use cases that exchange these data elements. Up to 14 territorial or city jurisdictions also participate in one of these public health use cases and use these data elements. All hospitals and physicians who diagnose or treat cancer are required to provide cancer related laboratory information to state cancer registries. Approximately 620,000 physicians in the US are active and have at least some component of ambulatory practice and thus are annually eligible to sampling and recruitment into the National Ambulatory Medical Care Survey (NAMCS), which samples from between 3,500 to 20,000 of these physicians annually. Presently each sampled physician submits one weeks' worth of patient encounters to NAMCS. Approximately 600 hospitals are in the National Hospital Care Survey (NHCS). 1/3 of that number are either in, or actively being recruited into, the EHR data submission mode for NHCS. NHCS is already receiving electronic CDA documents. When they reach their target of 200 hospitals submitting by this mode annually they will be receiving >1.2 million documents and sets including multiple sets of medication data annually. There were approximately 1,000,000 practicing physicians (as of 2020), approximately 120,000 certified physician assistants (as of 2019), and 290,000 licensed nurse practitioners (as of 2019). Most of these licensed clinicians interact with one of these public health use cases intermittently, annually. As of 2018, AHA reported 6,146 hospitals in the US experiencing 36,353,946 admissions. Almost all of those hospitals and at least half of the admissions interact with one or more of the public health use cases. The vast majority of these exchanges include full sets of medication data, including the data elements requested for USCDI consideration here.
Healthcare Aims	Improving the health of populations
Maturity of Use and Technical Specifications for Data Element
Applicable Standard(s)	Laboratory Test/Panel Code: LOINC Codes: http://loinc.org Laboratory Test Performed Date: FHIR dateTime, Period, Timing, Instant: http://hl7.org/fhir/observation-definitions.html#Observation.effective_x_ Laboratory Result Status: FHIR Observation Status: http://hl7.org/fhir/valueset-observation-status.html Laboratory Result Value: FHIR Quantity\|CodeableConcept\|string\|boolean\|integer\|Range\|Ratio\|SampledData\|time\|dateTime\|Period: http://hl7.org/fhir/observation-definitions.html#Observation.value_x_ http://loinc.org
Additional Specifications	HL7 FHIR US Core Implementation Guide v3.1.1 (https://www.hl7.org/fhir/us/core/index.html) HL7 FHIR US Core Laboratory Result Observation (http://hl7.org/fhir/us/core/StructureDefinition-us-core-observation-lab.html). MustSupport for the following elements: Laboratory Test/Panel Code, Laboratory Test Performed Date, Laboratory Result Status, Laboratory Result Value HL7 CDA® R2 Implementation Guide: Consolidated CDA Templates for Clinical Notes - US Realm (http://www.hl7.org/implement/standards/product_brief.cfm?product_id=492). SHALL for the following elements: Laboratory Test/Panel Code, Laboratory Test Performed Date, Laboratory Result Value HL7 CDA ® Release 2 Implementation Guide: Reporting to Public Health Cancer Registries from Ambulatory Healthcare Providers, Release 1, DSTU Release 1.1 – US Realm (https://www.hl7.org/implement/standards/product_brief.cfm?product_id=398). SHALL for the following elements: Laboratory Test/Panel Code, Laboratory Test Performed Date, Laboratory Result Value HL7 CDA® R2 Implementation Guide: National Health Care Surveys (NHCS), R1 STU Release 3 - US Realm (https://www.hl7.org/implement/standards/product_brief.cfm?product_id=385) HL7 FHIR® Implementation Guide: Electronic Case Reporting (eCR) - US Realm (http://hl7.org/fhir/us/ecr/STU1/) HL7 CDA® R2 Implementation Guide: Public Health Case Report, Release 2 - US Realm - the Electronic Initial Case Report (eICR) (https://www.hl7.org/implement/standards/product_brief.cfm?product_id=436) HL7 FHIR® Implementation Guide: Common Data Models Harmonization FHIR Implementation Guide (Release 0.1.0) (http://hl7.org/fhir/us/cdmh/2019May/) HL7 CDA® R2 Implementation Guide: Ambulatory and Hospital Healthcare Provider Reporting to Birth Defect Registries Release 1, STU 2 -US Realm (https://www.hl7.org/implement/standards/product_brief.cfm?product_id=428) HL7 FHIR® Implementation Guide: Birth Defect Reporting Implementation Guide 0.1.0 (https://build.fhir.org/ig/HL7/fhir-birthdefectsreporting-ig/index.html)
Current Use	Extensively used in production environments
Supporting Artifacts	Level 2 – at scale, or in more widespread production use (routinely collected already) on several different EHR/HIT systems. Widely available in EHR systems. These data elements exist in FHIR with a FHIR Maturity level of Normative for the Observation Resource. FHIR Observation Resource: http://hl7.org/fhir/observation.html LOINC is included in the ISA with an adoption level of 3 in production implementations for representing laboratory tests. SNOMED CT is included in the ISA with an adoption level of 1 in production implementations for representing laboratory tests. Laboratory in ISA: https://www.healthit.gov/isa/section/laboratory Part of Core EHR Certification since at least 2014 Specified in Meaningful Use/Promoting Interoperability since Stage 1 Part of EHR Certification for Transmission to Cancer Registries (2015 and 2014 Editions) Promoting Interoperability Programs Eligible Hospitals and Critical Access Hospitals are required to, and Merit-based Incentive Payment System (MIPS) participants may optionally, report on any two measures under the Public Health and Clinical Data Exchange objective of these programs. The § 170.315(f)(5) – Transmission to public health agencies – electronic case reporting certification criteria in the 2015 Edition Final Rule and the ONC Cures Act Final Rule, the § 170.315(f)(7) – Transmission to public health agencies – health care surveys, and the § 170.315 (f)(4) – Transmission to Cancer Registries are three such options to meet these measures. The current standard for § 170.315(f)(5), as listed in ONC’s 2020 Interoperability Standards Advisory Reference Edition, is HL7® CDA® R2 Implementation Guide: Public Health Case Report, Release 2: the Electronic Initial Case Report (eICR), Release 1, STU Release 1.1. ONC’s Certified Health IT Product List (CHPL) lists 73 EHR or HIT Module products certified to (f)(5) using this standard. eCR IG: https://www.hl7.org/implement/standards/product_brief.cfm?product_id=436 The current standard for § 170.315(f)(7), as listed in ONC’s 2020 Interoperability Standards Advisory Reference Edition, is HL7® CDA® R2 Implementation Guide: National Health Care Surveys (NHCS), R1 DSTU Release 1.2 - US Realm. ONC’s Certified Health IT Product List (CHPL) lists 116 EHR or HIT Module products certified to (f)(5) using this standard. NHCS IG: https://www.hl7.org/implement/standards/product_brief.cfm?product_id=385 The current standard for § 170.315 (f)(4), as listed in ONC’s 2020 Interoperability Standards Advisory Reference Edition, is HL7 CDA® R2 IG: Reporting to Public Health Cancer Registries from Ambulatory Healthcare Providers, R1, DSTU Release 1.1 - US Realm. ONC’s Certified Health IT Product List (CHPL) lists 288 EHR or HIT Module products certified to (f)(4) using this standard. Cancer Reporting IG: https://www.hl7.org/implement/standards/product_brief.cfm?product_id=398 These three widely adopted CDA standards have many of the Laboratory data elements contained on this form as Shall (required) or Should (best practice to include if available) conformance criteria, which demonstrates the maturity of these commonly exchanged data elements. Supporting Links: §170.315(f)(4) Transmission to cancer registries: https://www.healthit.gov/test-method/transmission-cancer-registries#test_procedure 2014 Edition Test Methods: https://www.healthit.gov/sites/default/files/2014_test_methods/2014_edition_test_methods_archived.zip Observation API: https://fhir.epic.com/Specifications?api=998 Certified Health IT Product List: https://chpl.healthit.gov/#/search Certified Health IT Product List for Cancer: https://chpl.healthit.gov/#/search: 170.315 (f)(4): Transmission to Cancer Registries Retired \| 170.314 (f)(5): Optional - ambulatory setting only - cancer case information Retired \| 170.314 (f)(6): Optional - ambulatory setting only - transmission to cancer registries) http://hl7.org/fhir/observation.html; https://www.healthit.gov/isa/section/laboratory; §170.315(f)(4) Transmission to cancer registries: https://www.healthit.gov/test-method/transmission-cancer-registries#test_procedure
Extent of exchange	5 or more. This data element has been tested at scale between multiple different production environments to support the majority of anticipated stakeholders.
Supporting Artifacts	Level 2 – exchanged between 4 or more different EHR/HIT systems. More routinely exchanged between multiple different systems can justify adding to the next draft version. HL7 CDA® R2 Implementation Guide: Public Health Case Report, Release 2 - US Realm (https://www.hl7.org/implement/standards/product_brief.cfm?product_id=436) - the Electronic Initial Case Report (eICR) is currently implemented in 5,400+ reporting sites nationally and exchanges Laboratory information including: Laboratory Test Code, Performed Date, Test Result Status, Result Value. As part of Cancer Reporting CDA IGs: IHE Connectathons 2010-2020 HIMSS Interoperability Showcase 2010-19 Public Health Informatics Conference Interoperability Showcase 2014, 2016, 2018 NACCHO 360X Interoperability Demonstrations, 2020 As part of National Health Care Surveys CDA IGs: IHE Connectathons 2019-2020 ONC Interoperability Standards Advisory - Sending Health Care Survey Information to Public Health Agencies. https://www.healthit.gov/isa/sending-health-care-survey-information-public-health-agencies Supporting Links: Certified Health IT Product List for Cancer: https://chpl.healthit.gov/#/search: 170.315 (f)(4): Transmission to Cancer Registries Retired \| 170.314 (f)(5): Optional - ambulatory setting only - cancer case information Retired \| 170.314 (f)(6): Optional - ambulatory setting only - transmission to cancer registries) IHE Connectathon: https://connectathon-results.ihe.net/ https://www.hl7.org/implement/standards/product_brief.cfm?product_id=436
Potential Challenges
Restrictions on Standardization (e.g. proprietary code)	None
Restrictions on Use (e.g. licensing, user fees)	None
Privacy and Security Concerns	None
Estimate of Overall Burden	Low. All providers need to capture laboratory information as a basic component of patient care. Several existing IGs, as listed, require the exchange of this data element. The Promoting Interoperability Programs Objective 8 - Public Health and Clinical Data Registry Reporting, Measures 1: Immunization Registry Reporting, 2: Syndromic Surveillance Reporting, 3 -: Electronic Case Reporting and 4: Public Health Registry Reporting all require these data elements. This information is routinely communicated in HL7 CDA Documents and some FHIR API transactions.
Other Implementation Challenges	None

ONC Evaluation Details Each submitted Data Element has been evaluated based on the following criteria. The overall Level classification is a composite of the maturity based on these individual criteria. This information can be used to identify areas that require additional work to raise the overall classification level and consideration for inclusion in future versions of USCDI
Criterion #1 Maturity - Current Standards	Level 2 - Data element is represented by a terminology standard or SDO-balloted technical specification or implementation guide.
Criterion #2 Maturity - Current Use	Level 2 - Data element is captured, stored, or accessed in multiple production EHRs or other HIT modules from more than one developer.
Criterion #3 Maturity - Current Exchange	Level 2 - Data element is electronically exchanged between more than two production EHRs or other HIT modules of different developers using available interoperability standards.
Criterion #4 Use Case(s) - Breadth of Applicability	Level 0 - Use cases apply to a limited number of care settings or specialties, or data element represents a specialization of other, more general data elements.
Evaluation Comment	This data element represents a specific type of existing USCDI data element Performance Time in the Procedures data class.

Comment

Submitted by BLampkins_CSTE on 2024-09-30

CSTE Comment - v6

CSTE supports inclusion of this data element in USCDI V6. Please see previously submitted CSTE comments for additional recommendations.

Submitted by Riki Merrick on 2024-09-30

APHL requests an updated definition

APHL requests an update to the definition to actually define what the name implies which is the “Date (and optionally time) when testing was conducted by the testing laboratory.”
This element maps to in V2 = OBX-19 (Date and time of Analysis) (https://www.hl7.eu/refactored/segOBX.html#1480), in CDA = <still needs to be mapped> and in FHIR unfortunately it only exists as an extension (https://build.fhir.org/ig/HL7/fhir-extensions/StructureDefinition-observation-analysis-date-time.html)
Rationale for elevating to V6 level:
For public health, this is used to calculate turnaround time/timeliness metrics or as a proxy date for classifying a specimen result for temporal aggregation if other dates are not available.
It is a "Must Support" (represented by usage code "RE") data element in many lab-result data exchange IGs, including the base LRI profile (https://www.hl7.org/implement/standards/product_brief.cfm?product_id=279), NAACR (https://www.naaccr.org/pathology-laboratory-electronic-reporting/) and ELR R1 IGs (https://www.hl7.org/implement/standards/product_brief.cfm?product_id=98). ELR R1 has been part of certification requirements for lab result reporting to public health since MU1 as called out "Implementation specifications. HL7 Version 2.5.1 Implementation Guide: Electronic Laboratory Reporting to Public Health, Release 1 (US Realm) (incorporated by reference in § 170.299) with Errata and Clarifications, (incorporated by reference in § 170.299) and ELR 2.5.1 Clarification Document for EHR Technology Certification, (incorporated by reference in § 170.299)." in https://www.ecfr.gov/current/title-45/part-170/section-170.205#p-170.205(g) - covers these 3 criteria for at least being level 2: Represented by a terminology standard or SDO-balloted technical specification or implementation guide.
Data element is captured, stored, or accessed in multiple production EHRs or other HIT modules from more than one developer.
Data element is electronically exchanged between more than two production EHRs or other HIT modules of different developers using available interoperability standards.

Submitted by BLampkins_CSTE on 2024-04-15

CSTE Comment - v5

CSTE supports collection of more granular laboratory data to support case adjudication and reporting as well as patient deduplication and linking of data from cases to ELR, which can be critical. The variables we recommend be added to USCDI v5 include:

Name of testing/performing laboratory and associated identifiers (CLIA) (HIGH PRIORITY)
Name of ordering provider and submitter
Address of testing/performing laboratory
Accession number at testing laboratory (HIGH PRIORITY for matching purposes)
Date the test was ordered
Date the test was performed (needs to be reconciled with results date/timestamp)
Specimen collection date and time (HIGH PRIORITY) (Needs to be reconciled with Test Date=Clinically relevant time)
Test result value (needs to be reconciled with values/results), units, reference range and interpretation (HIGH PRIORITY)
Abnormal flag (HIGH PRIORITY)
Test kit identifier

Dates and times are critical to evaluating the timeliness of reporting - it is a major indicator for the performance of public health surveillance systems and without this information it is unknown how data exchange is impacting the ability for public health to respond in a timely fashion. Although the date and time data are generated by the system, in practice it has been observed that availability of this data to Public Health Departments is sparse for use in timeliness analysis

Submitted by nedragarrett_CDC on 2024-04-15

CDC's Comment for draft USCDI v5

CDC supports the inclusion of this data element in USCDI v5 as it is an element that may be necessary for calculation of our digital quality metrics from FHIR data.

For public health, this is used to calculate turnaround time/timeliness metrics or as a proxy date for classifying a specimen result for temporal aggregation if other dates are not available.

Overarching Comment:
There are extensive comments that have been submitted in support of the specific, granular date/timestamps for laboratory data, including a very granular one submitted by CMS. We agree with these, and CSTE explained it best in their existing comment: “Dates and times are critical to evaluating the timeliness of reporting - it is a major indicator for the performance of public health surveillance systems and without this information it is unknown how data exchange is impacting the ability for public health to respond in a timely fashion. Although the date and time data are generated by the system, in practice it has been observed that availability of this data to Public Health Departments is sparse for use in timeliness analysis.”

These are required data elements in the many laboratory data-public health exchange standards (including the dominant one used for laboratory data exchange currently, ELR 251 r1).

Laboratory test performed date/time is also occasionally used for laboratory situational awareness and surveillance needs. It is used for very time sensitive tests to determine the validity of the result as compared to the specimen date/time.

Submitted by nedragarrett_CDC on 2023-09-19

CDC's comment on behalf of CSTE for USCDI v5

CSTE supports collection of more granular laboratory data to support case adjudication and reporting as well as patient deduplication and linking of data from cases to ELR, which can be critical. The variables we recommend be added to USCDI v5 include:

Name of testing/performing laboratory and associated identifiers (CLIA)(HIGH PRIORITY)
Name of ordering provider and submitter
Address of testing/performing laboratory
Accession number at testing laboratory (HIGH PRIORITY for matching purposes)
Date the test was ordered
Date the test was performed (needs to be reconciled with results date/timestamp)
Specimen collection date and time (HIGH PRIORITY) (Needs to be reconciled with Test Date=Clinically relevant time)
Test result value (needs to be reconciled with values/results in USCDI V1 and V2), units, reference range and interpretation (HIGH PRIORITY)
Abnormal flag (HIGH PRIORITY)
Test kit identifier

Dates and times are critical to evaluating the timeliness of reporting - it is a major indicator for the performance of public health surveillance systems and without this information it is unknown how data exchange is impacting the ability for public health to respond in a timely fashion. Although the date and time data are generated by the system, in practice it has been observed that availability of this data to Public Health Departments is sparse for use in timeliness analysis.

Submitted by nedragarrett_CDC on 2023-09-15

CDC's Consolidated Comment for USCDI v5

Propose to change the definition of this data element to: "This is the date and time a laboratory test was executed, and an observation made."This data element is created when the test is run at the performing lab. The LIMS will capture and store this data element in its database. It will be used by the laboratory professional when interpreting lab results. It will be exchanged as part of the results message. It may be stored by the EHR receiving the results message. Care providers may look up this date and time for decision-making. For bedside tests, it will be the time the test was performed, and an observation was made.
An additional use case is laboratory auditing.This element may be seen as similar to performance time. This should be considered separately as this is crucial for test interpretation irrespective of the type of test. Since this is fundamental to testing, it may not be considered a specialization or related to performance measurement. Similar to a test needing to be represented in USCDI even though it may be “performed for a patient as part of the provision of care,” observation timing also needs to be represented as it is fundamental to the test element.
NAACCR Comment: Agree this element is necessary for cancer reporting to public health.
NACCHO supports CDC's recommendations.

Submitted by hantran on 2023-04-17

CAP Comments on Laboratory Test Performed Date

Data Class: Laboratory
Data Element: Laboratory Test Performed Date
CAP Comment:
- One single Time of Procedure data element cannot clearly represent all the many times and dates associated with laboratory and pathology data, including this Laboratory Test Performed Date data element, which is required in regulation and represents the most clinically relevant time point in which to interpret the result and is distinct from result reporting date (Laboratory Results Issued Date/Time). In the case of observations taken directly from a subject, this data element is the actual date and time the observation was obtained. In the case of a specimen-associated study, this data element represents the date and time the specimen was obtained from a patient and collected into a container or obtained.
- This data element should be combined with the Specimen Collection Date/Time Level 2 data element, titled Specimen Collection Date/Time, and included as a data element in USCDI v4. This data element should accommodate time zone differences.
- This data element aligns with the FHIR observation.effective data element (if greater alignment with FHIR is desired, this data element could also be renamed Laboratory Results Effective). CLIA specifies the use of this data element if appropriate.
Vocabulary Standard: The College of American Pathologists (CAP) recommends the value format from the SPM-17 field in HL7 2.5.1, which is a version of the Health Level Seven (HL7) standard that defines methods for transferring and sharing data between various healthcare systems and providers. The CAP supports the use of the HL7 2.5.1 standard because the standard was designed to help laboratories comply with CLIA requirements. HL7 2.5.1 SPM-17 is aligned with the ISO 8601 international standard for communicating date and time information.

Submitted by nedragarrett_CDC on 2023-04-06

CDC's Consolidated Comment for USCDI v4

This element is needed to know when the laboratory performed the test on the specimen. Cancer registries have been receiving this information from laboratories for over a decade with no issue. It is a standard element that laboratories track and it is important to monitor timeliness of reporting that can impact the quality of care provided to the patient.
Comments from NACCHO: NACCHO supports including this data element laboratory test performed date

Submitted by hantran on 2022-09-30

CAP Comment on Laboratory Test Performed Date

Data Element: Laboratory Test Performed Date

Corresponding CLIA Reporting Requirement: The test report date
Description: The CAP supports the inclusion of this Level 2 data element into USCDI v4. This inclusion will align the USCDI with CLIA’s Test Report Date reporting requirement. The CLIA reporting requirements are required for clinical laboratory reporting and should be used as the basis for laboratory and public health reporting standards. For future iterations of USCDI, we would suggest collapsing this data element with the Laboratory results: date and timestamps data element called “Date/time of the analysis,” which is the name of the OBX-19 field of the HL7 2.5.1 standard. The CAP may submit this new data element for USCDI v5 in 2023.
Vocabulary Standard: The CAP recommends replacing the listed standards in this data element with the value format from the OBX-19 field in HL7 2.5.1, which is a version of the Health Level Seven (HL7) standard that defines methods for transferring and sharing data between various healthcare systems and providers. The CAP supports the use of the HL7 2.5.1 standard because the standard was designed to help laboratories comply with CLIA requirements. HL7 2.5.1 OBX-19 is aligned with the ISO 8601 international standard for communicating date and time information.

Submitted by Riki Merrick on 2022-09-30

APHL Comments on ISA 2022

APHL suggests to include this data element in USCDIV4. APHL supports renaming to Performed Date/Time as suggested by WA DOH and requests a different definition for this element to match its name of: Date and time (if available) the result was created and approved the supervisor for reporting.

If the intent of this element is the clinically relevant date time of the observation (which for a lab test is the specimen collection) then it should be merged with this element Specimen collection date/time . For non- lab observations the clinically relevant time is the same as this element Observation Timing (https://www.healthit.gov/isa/taxonomy/term/1411/level-2)