Assessments of a health-related matter of interest, importance, or worry to a patient, patient’s family, or patient’s healthcare provider that could identify a need, problem, or condition.

Data Element
Alcohol Use
Description

Evaluation of a patient's consumption of alcohol.

Examples include but are not limited to history of alcohol use, alcohol use disorder identification test and alcohol intake assessment.

Applicable Vocabulary Standard(s)

Applicable Standards
  • Logical Observation Identifiers Names and Codes (LOINC®) version 2.74
Submitted By: Clem McDonald / National Library of Medicine
Data Element Information
Rationale for Separate Consideration Please consider these data elements for alcohol use for Level 2
Use Case Description(s)
Use Case Description Each year, an estimated 88,000 people (approximately 62,000 men and 26,000 women) die from alcohol-related causes annually, making alcohol the third leading preventable cause of death in the United States, behind tobacco and diet/physical inactivity.
Estimate the breadth of applicability of the use case(s) for this data element The U.S. Preventive Services Task Force (USPSTF) recommends screening for unhealthy alcohol use in adults aged 18 years and older, including pregnant women, with a Grade B recommendation:
https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/unhealthy-alcohol-use-in-adolescents-and-adults-screening-and-behavioral-counseling-interventions

Alcohol use is widely screened and assessed by care providers.
Healthcare Aims
  • Improving the health of populations
Maturity of Use and Technical Specifications for Data Element
Applicable Standard(s) See below for relevant LOINC codes:

5640-8 Ethanol [Mass/volume] in Blood
69721-9 Do you ever drink alcohol - including beer or wine [Reported.PHQ]
74013-4 Alcoholic drinks per day
11286-2 Alcohol binge episodes per month - Reported
74043-1 Alcohol use disorder
64718-0 During this pregnancy, did you receive help with an alcohol or drug problem [PhenX]
72109-2 Alcohol Use Disorder Identification Test - Consumption [AUDIT-C]
Additional Specifications HL7® FHIR® US Core Implementation Guide v3.1.0 based on FHIR R4
Current Use This data element has been used at scale between multiple different production environments to support the majority of anticipated stakeholders
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.
Potential Challenges
Restrictions on Standardization (e.g. proprietary code) Data elements around the quantity of alcohol consumed may be measured in different units, or entered in different locations within electronic health records. However, these are minimal, as they do not involve access to proprietary code.
Restrictions on Use (e.g. licensing, user fees) N/A
Privacy and Security Concerns If data are aggregated and not linked to personal identifiers, concerns are minimal. Alcohol use disorder is widely stigmatized, thus, care must be taken to ensure privacy and security.
Estimate of Overall Burden Low estimate of burden to implement.
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 2 - Use cases apply to most care settings or specialties.

Comment

Submitted by pwilson@ncpdp.org on 2023-04-17

NCPDP Comment

NCPDP supports the use of LOINC codes for assessments and observations for alcohol use. NCPDP utilizes LOINC codes in the HL7/NCPDP Pharmacist eCare Plan.

NCPDP recommends the use of SNOMED CT codes as the NCPDP SCRIPT Standard utilizes these codes.

Submitted by aphillips@imoh… on 2022-04-28

Level 2 Data Element: Substance Use

IMO supports the proposed inclusions of the Level 2 data class and data element for Substance use.  However, the technical specification cited for the Level 2 submission is missing a number of LOINC codes used in evaluating alcohol use.  IMO notes that the value set for Substance Use Disorder OID: 2.16.840.1.113883.3.464.1003.106.12.1001 specified in eCQM 137 for Alcohol and Drug Dependence, includes codes for evaluating alcohol use as well as other substances. 

 

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