| Type | Standard / Implementation Specification | Standards Process Maturity | Implementation Maturity | Adoption Level | Federally required | Cost | Test Tool Availability |
|---|---|---|---|---|---|---|---|
|
Standard for observations
|
Final
|
Production
|
 |
No
|
Free
|
N/A
|
|
|
Standard for observation values
|
Final
|
Production
|
|
No
|
Free
|
N/A
|
| Limitations, Dependencies, and Preconditions for Consideration |
Applicable Value Set(s) and Starter Set(s)
|
|---|---|
|
The 2015 Edition smoking status criterion (§ 170.315(a)(15)) applies only to smoked tobacco. It does not require the ability to capture other forms of tobacco or nicotine use (e.g., smokeless tobacco, e-cigarettes, secondhand smoke). In HTI-1, the criterion language did not change however SNOMED CT is required as a result of including USCDI v3. HL7® FHIR® US Core 7.0.0 and C-CDA 3.0 terminology bindings are updated to reference a value set that encompasses smoked tobacco, exposure to secondhand smoke, vaping and other methods of ingesting tobacco products. Smoking Status Type is used to categorize whether the smoking status is for smoking or tobacco use. It also includes concepts to reflect number of pack years or calculated pack years for cumulative lifetime tobacco exposure. Units of measure for quantitative result values should be represented using UCUM, see Representing Units of Measure. For more information about observations and observation values, see Appendix III for an informational resource developed by the Health IT Standards Committee. |
|
Comment
Submitted by chris.baumgart… on
WA State Department of Health Tobacco/Smoking/Vaping Comments
In 2018, e-cigarette products with nicotine concentrations of five percent or greater comprised approximately two-thirds of the e-cigarette market, while zero-nicotine products accounted for less than one percent.[1] To more accurately assess nicotine intake and potential nicotine dependence among patients, Washington State Department of Health recommends distinguishing e-cigarette use by nicotine concentration, rather than e-cigarette liquid with nicotine versus e-cigarette liquid without nicotine. Additionally, Washington State Department of Health concurs with the recommendation submitted on September 19, 2018 by Dr. Michael Fiore and Robert Adsit to implement non-overlapping values for smoking status.
[1] Romberg AR, Miller Lo EJ, Cuccia AF, Willet JG, Xiao H, Hair EC . . . King BA (2019). Patterns of nicotine concentrations in electronic cigarettes sold in the United States, 2013-2018, Drug and Alcohol Dependence, 203, 1-7. doi:10.1016/j.drugalcdep.2019.05.029.
Submitted by pwilson@ncpdp.org on
NCPDP Comments
Modify NCPDP SCRIPT Standard, Implementation Guide, Version 2017071 Adoption Level to 5.
Submitted by Spruitt 
on
Removed Reference
Removed “See LOINC projects in the Interoperability Proving Ground” since LOINC has been removed from the Standards in this section.
Submitted by pwilson@ncpdp.org on
NCPDP Comment
- Substance use fields are available in NCPDP SCRIPT Standard Version 2017071 to allow tobacco use information to be transmitted via SNOMED codes
- Add the following:
Type-Implementation Specification
Standard Implementation/Specification- NCPDP SCRIPT Standard, Implementation Guide, Version 2017071
Standards Process Maturity – Final
Implementation Maturity- Production
Adoption Level – 1
Federally Required – Yes
Cost – $
Test Tool Availability – Yes
- Include Test Tool Link: https://tools.ncpdp.org/erx/#/home
Submitted by chris.baumgart… on
WA State Department of Health Tobacco/Smoking/Vaping Comments
In 2018, e-cigarette products with nicotine concentrations of five percent or greater comprised approximately two-thirds of the e-cigarette market, while zero-nicotine products accounted for less than one percent.[1] To more accurately assess nicotine intake and potential nicotine dependence among patients, Washington State Department of Health recommends distinguishing e-cigarette use by nicotine concentration, rather than e-cigarette liquid with nicotine versus e-cigarette liquid without nicotine. Additionally, Washington State Department of Health concurs with the recommendation submitted on September 19, 2018 by Dr. Michael Fiore and Robert Adsit to implement non-overlapping values for smoking status. [1] Romberg AR, Miller Lo EJ, Cuccia AF, Willet JG, Xiao H, Hair EC . . . King BA (2019). Patterns of nicotine concentrations in electronic cigarettes sold in the United States, 2013-2018, Drug and Alcohol Dependence, 203, 1-7. doi:10.1016/j.drugalcdep.2019.05.029.